Conceitos de vulnerabilidade humana e integridade individual para a bioética / Concepts of human vulnerability and individual integrity in bioethics / Los conceptos de vulnerabilidad humana y la Integridad individual para la bioética

Resumo Este artigo consiste em revisão bibliográfica dos significados e conceitos de vulnerabilidade e integridade nos documentos internacionais mais significativos para a bioética. Também é objetivo deste artigo apresentar as categorias de classificação de vulnerabilidades mais utilizadas. Avanços tecnológicos e a multiplicação de pesquisas clínicas no século XX suscitaram novas formas de vulnerabilidade e deixaram mais evidentes aquelas causadas por determinantes sociais, políticos e ambientais, isto é, a vulnerabilidade social. A bioética de intervenção é proposta que pode ser utilizada por países periféricos para enfrentar o problema dos excluídos sociais mediante prudência, prevenção, precaução e proteção. A bioética latino-americana foi importante para ampliar a compreensão sobre conflitos morais em saúde e gerar politização, possibilitando a construção de uma bioética global, na qual a vulnerabilidade pode ser trabalhada agregando diferentes perspectivas para enfrentar problemas comuns.

Abstract This article consists of a literature review of the meanings and concepts of vulnerability and integrity contained in the most significant international documents on bioethics, and aims to describe the categories most commonly used to classify vulnerabilities. Technological advances and the increase in clinical research studies in the 20th century have given rise to new forms of vulnerability, and have emphasized the vulnerabilities caused by social, political and environmental determinants, or in other words, social vulnerability. The intervention bioethics can be used by peripheral countries to address the problem of social exclusion through the use of prudence, prevention, precaution and protection. Latin American bioethics have been important for the expansion and politicization of moral conflicts in health care, allowing the construction of a global bioethics, in which vulnerability can be tackled by adding different perspectives to solve common problems.

Resumen Este artículo consiste en una revisión bibliográfica de los significados y conceptos de vulnerabilidad e integridad en los documentos internacionales más importantes para la bioética. También este artículo tiene como objetivo presentar las categorías de clasificación de vulnerabilidad más utilizadas. Los avances tecnológicos y la multiplicacion de la investigacion clínica en el siglo XX plantearon nuevas formas de vulnerabilidad e hicieron más evidentes las vulnerabilidades causadas por determinantes sociales, políticos y ambientales, o sea, la vulnerabilidad social. La bioética de intervención es una propuesta que puede ser utilizada por los países periféricos para enfrentar el problema de la exclusión social por medio de la prudencia, la prevención, la precaución y la protección. La bioética de América Latina fue importante para ampliar la comprensión de los conflictos morales en salud y generar politización, lo cual posibilita la construcción de una bioética global, en la cual la vulnerabilidad puede trabajarse agregando diferentes perspectivas para enfrentar problemas comunes.

Mangiferin ameliorates the intestinal inflammatory response and the impaired gastrointestinal motility in mouse model of postoperative ileus.

Our previous study has shown that mangiferin (MGF), a glucosylxanthone from Mangifera indica, exerts gastrointestinal prokinetic action involving a cholinergic mechanism. Postoperative ileus (POI) is a temporary disturbance in gastrointestinal motility following surgery, and intestinal inflammatory response plays a critical role in the pathogenesis of POI. The present study investigated to know whether MGF having anti-inflammatory and prokinetic actions can ameliorate the intestinal inflammation and impaired gastrointestinal transit seen in the mouse model of POI. Experimental POI was induced in adult male Swiss mice by standardized small intestinal manipulation (IM). Twenty-four hours later, gastrointestinal transit was assessed by charcoal transport. MGF was administered orally 1 h before the measurement of GIT. To evaluate the inflammatory response, plasma levels of proinflammatory cytokines TNF-α, IL-1ß, IL-6, and chemokine MCP-1, and the myeloperoxidase activity, nitrate/nitrite level, and histological changes of ileum were determined in mice treated or not with MGF. Experimental POI in mice was characterized by decreased gastrointestinal transit and marked intestinal and systemic inflammatory response. MGF treatment led to recovery of the delayed intestinal transit induced by IM. MGF in ileum significantly inhibited the myeloperoxidase activity, a marker of neutrophil infiltration, and nitrate/nitrite level and reduced the plasma levels of TNF-α, IL-1ß, IL-6, and MCP-1 as well. MGF treatment ameliorates the intestinal inflammatory response and the impaired gastrointestinal motility in the mouse model of POI.

The natural flavonoid quercetin ameliorates cerulein-induced acute pancreatitis in mice.

Many plant-derived flavonoids including quercetin exhibit antioxidant and antiinflammatory properties. Proinflammatory cytokines and oxidative stress play an important role in acute pancreatitis. This study aimed to evaluate the effect of quercetin on cerulein-induced acute pancreatitis in mice. Animal groups were pretreated with quercetin (25, 50, 100 mg/kg, per os (p.o.)), thalidomide (200 mg/kg, p.o.) or vehicle (2% dimethyl sulfoxide (DMSO)) 1 h before hourly (x5) intraperitoneal injections of cerulein. A saline (0.9%, NaCl)-treated control group was included for comparison. Cerulein significantly enhanced the serum levels of amylase and lipase, and pancreatic myeloperoxidase activities, malondialdehyde and the proinflammatory cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and IL-6, as well as the pancreatic wet weight/body weight ratio. Cerulein significantly reduced the serum levels of IL-10. Histological assessment of the pancreas showed tissue edema, neutrophil infiltration, acinar vacuolization, and cell necrosis and a marked increase in the immunoreactivity staining for TNF-alpha. Pretreatment with quercetin or thalidomide significantly attenuated the severity of cerulein-induced acute pancreatitis as evidenced by effective reductions in the pancreatic wet weight/body weight ratio, biochemical indices, proinflammatory cytokines, myeloperoxidase activity, malondialdehyde formation, and an increase in antiinflammatory cytokine IL-10. Quercetin treatment also markedly suppressed the histological changes such as pancreatic edema, inflammatory cell infiltration, acinar cell necrosis, and the expression of TNF-alpha. Taken together, these results indicate that quercetin ameliorates the severity of cerulein-induced acute pancreatitis by acting as an antiinflammatory and antioxidant agent.

alpha,beta-amyrin, a natural triterpenoid ameliorates L-arginine-induced acute pancreatitis in rats.

AIM: To study the beneficial effects of triterpene alpha,beta-amyrin and the underlying mechanisms in an experimental pancreatitis model. METHODS: Acute pancreatitis was induced in five groups of rats (n = 8) by L-arginine (2 x 2.5 g/kg, intraperitoneal, 1 h apart) and 1 h later, they received a single oral dose of alpha,beta-amyrin (10, 30 and 100 mg/kg), methylprednisolone (30 mg/kg) and vehicle (3% Tween 80). A saline (0.9% NaCl) treated group served as a normal control. Efficacy was assessed at 24 h by determination of serum levels of amylase, lipase and pro-inflammatory cytokines [tumor necrosis factor (TNF)-alpha and interleukin (IL)-6], pancreatic myeloperoxidase (MPO) activity, lipid peroxidation [thiobarbituric acid reactive substances (TBARS)], nitrate/nitrite levels, and the wet weight/body weight ratio. Tissue histology and the immunoreactivity for TNF-alpha and inducible nitric oxide synthetase (iNOS) were performed. RESULTS: alpha,beta-amyrin and methylprednisolone treatments significantly (P < 0.05) attenuated the L-arginine-induced increases in pancreatic wet weight/body weight ratio, and decreased the serum levels of amylase and lipase, and TNF-alpha and IL-6, as compared to the vehicle control. Also, pancreatic levels of MPO activity, TBARS, and nitrate/nitrite were significantly lower. Histological findings and TNF-alpha and iNOS immunostaining further confirmed the amelioration of pancreatic injury by alpha,beta-amyrin. CONCLUSION: alpha,beta-amyrin has the potential to combat acute pancreatitis by acting as an anti-inflammatory and antioxidant agent.