Perfil lipídico de transplantados renais em uso de terapia imunossupressora / Lipid profile in post renal transplant patients treated with immunosuppressive therapy

Objetivo: A prevalência de alterações no perfil lipídico dos transplantados renais é muito alta, sendo a doença cardiovascular uma das principais causas de mortalidade nesses pacientes. Mesmo após o transplante renal, as complicações cardíacas não diminuem. O objetivo foi avaliar o perfil lipídico de pacientes transplantados renais em uso de terapia imunossupressora e relacionar qual dos imunossupressores estaria associado a alterações no perfil lipídico. Métodos: Estudo retrospectivo realizado com 186 pacientes em terapia imunossupressora pós-transplante renal com ciclosporina, tacrolimus ou sirolimus. Foram coletadas amostras dos pacientes que realizaram transplante renal entre 2002 e 2007 , na Irmandade Santa Casa de Misericórdia de Porto Alegre, e que foram incluídos na pesquisa. Resultados: Foi observado que os níveis de colesterol aumentaram nos pacientes em uso de ciclosporina e sirolimus. O HDL-C mostrou-se mais elevado em todos os grupos, independente do tempo, após o transplante renal. Quanto ao LDL-C, verificou-se diminuição com o passar do tempo de tratamento no grupo que fazia uso de ciclosporina. A razão colesterol total/HDL-C diminuiu com o tratamento de ciclosporina e de tacrolimus após 24 meses. Conclusão: Os resultados sugerem que o tacrolimus e a ciclosporina são os imunossupressores menos prejudiciais ao perfil lipídico dos pacientes transplantados renais, no entanto, o sirolimus está associado à maior alteração no perfil lipídico, podendo levar os pacientes a um pior prognóstico cardíaco.

Na+,K(+)-ATPase activity is reduced in hippocampus of rats submitted to an experimental model of depression: effect of chronic lithium treatment and possible involvement in learning deficits.

This study was undertaken to verify the effects of chronic stress and lithium treatments on the hippocampal Na+,K(+)-ATPase activity of rats, as well as to investigate the effects of stress interruption and post-stress lithium treatment on this enzyme activity and on spatial memory. Two experiments were carried out; in the first experiment, adult male Wistar rats were divided into two groups: control and submitted to a chronic variate stress paradigm, and subdivided into treated or not with LiCl. After 40 days of treatment, rats were killed, and Na+,K(+)-ATPase activity was determined. In the second experiment, rats were stressed during 40 days, and their performance was evaluated in the Water Maze task. The stressed group was then subdivided into four groups, with continued or interrupted stress treatment and treated or not with lithium for 30 additional days. After a second evaluation of performance in the Water Maze, rats were killed and Na+,K(+)-ATPase activity was also measured. Results showed an impairment in Na+,K(+)-ATPase activity and in Water Maze performance of chronically stressed rats, which were prevented by lithium treatment and reversed by lithium treatment and by stress interruption. These results suggest that the modulation of Na+,K(+)-ATPase activity may be one of the mechanisms of action of lithium in the treatment of mood disorders.