Clinical and serological characteristics of Cuban patients with Systemic Lupus Erythematosus

Introduction: Systemic lupus erythematosus (SLE) is the prototype of systemic autoimmune disease with clinical characteristics that show geographic variations. However, these differences between regions have not been fully described; therefore, the objective of this study is to describe the clinical and sociodemographic characteristics of Cuban patients with SLE. Patients and methods: 149 patients with SLE and 151 with other systemic autoimmune diseases were studied. Sociodemographic and clinical characteristics according on the criteria of the American College of Rheumatology of 1997 were identified. To evaluate the associations between clinical manifestations and SLE, a logistic regression analysis was performed; the odds ratio (OR) was calculated with its corresponding 95% confidence interval and the method of multiple correspondence analysis was also used. By an analysis of the configurations of frequency the typical combinations of criteria related to the patients with SLE were identified. Results: The most frequent criteria in SLE were immunological disorders (85.2%). ANA positive (85.2%) arthritis (78.5%), photosensitivity (77.2%), and malar rash (61%). The renal involvement and immunological disorders criteria were the best (highest OR) at discriminating SLE patients. The combination of only three criteria (malar rash, positive ANA, and immunological disorder) could be enough to classify a homogeneous population. Conclusions: This study enabled us to determine the main clinical characteristics of patients with SLE in Cuba. This information could be useful to improve the efficiency of SLE diagnosis and facilitate more specific treatments.

Introducción: El lupus eritematoso sistémico (LES) es el prototipo de enfermedad autoinmune sistémica, con características clínicas que muestran variaciones geográficas. Sin embargo, estas diferencias entre regiones no están completamente descritas, por lo cual, el objetivo de este trabajo es describir las características clínicas y sociodemográficas de pacientes cubanos con LES. Pacientes y métodos: Se hizo un estudio con 149 pacientes con LES y 151 con otras enfermedades autoinmunes sistêmicas. Se identificaron sus características sociodemográficas y clínicas, basadas principalmente en los criterios del Colegio Americano de Reumatología de 1997. Para evaluar las asociaciones entre las manifestaciones clínicas y el LES se llevó a cabo un análisis de regresión logística, se calculó la odds ratio, con su correspondiente intervalo de confianza al 95%, y se empleó la técnica de análisis de correspondencia múltiple. Mediante un análisis frecuencial de las configuraciones, se identificaron las combinaciones típicas de criterios relacionadas con los pacientes con LES. Resultados: Los criterios más frecuentes en el LES fueron: alteraciones inmunológicas (85,2%), ANA positivo (85,2%), artritis (78,5%), fotosensibilidad (77,2%) y rash malar (61%). Los criterios afección renal y alteraciones inmunológicas son los que mejor (mayor valor de la odds ratio) discriminan a los pacientes con LES. La combinación de solamente tres criterios (rash malar, ANA positivo y alteraciones inmunológicas) podría ser suficiente para clasificar a una población homogénea. Conclusiones: El estudio permitió conocer las principales características clínicas de pacientes con LES en Cuba. Esta información puede ser útil para mejorar la eficacia del diagnóstico del LES y favorecer la aplicación de tratamientos más específicos.

Immune Dysregulation in Autism Spectrum Disorder: What Do We Know about It?

Autism spectrum disorder (ASD) is a group of complex multifactorial neurodevelopmental disorders characterized by a wide and variable set of neuropsychiatric symptoms, including deficits in social communication, narrow and restricted interests, and repetitive behavior. The immune hypothesis is considered to be a major factor contributing to autism pathogenesis, as well as a way to explain the differences of the clinical phenotypes and comorbidities influencing disease course and severity. Evidence highlights a link between immune dysfunction and behavioral traits in autism from several types of evidence found in both cerebrospinal fluid and peripheral blood and their utility to identify autistic subgroups with specific immunophenotypes; underlying behavioral symptoms are also shown. This review summarizes current insights into immune dysfunction in ASD, with particular reference to the impact of immunological factors related to the maternal influence of autism development; comorbidities influencing autism disease course and severity; and others factors with particular relevance, including obesity. Finally, we described main elements of similarities between immunopathology overlapping neurodevelopmental and neurodegenerative disorders, taking as examples autism and Parkinson Disease, respectively.

Impact of SARS-CoV-2 on neuropsychiatric disorders.

Evolving data show a variable expression of clinical neurological manifestations in patients suffering with coronavirus disease 2019 (COVID-19) from early disease onset. The most frequent symptoms and signs are fatigue, dizziness, impaired consciousness, ageusia, anosmia, radicular pain, and headache, as well as others. Based on the high number of series of cases reported, there is evidence for the implication of the immune system in the pathological mechanism of COVID-19. Although the exact role of the immunological mechanism is not elucidated, two main mechanisms are suggested which implicate the direct effect of severe acute respiratory syndrome coronavirus 2 infection in the central nervous system and neuroinflammation. In the context of neurological manifestations associated with COVID-19, neuropsychiatric disorders show an exacerbation and are described by symptoms and signs such as depression, anxiety, mood alterations, psychosis, post-traumatic stress disorder, delirium, and cognitive impairment, which appear to be common in COVID-19 survivors. A worsened score on psychopathological measures is seen in those with a history of psychiatric comorbidities. We review the neuropsychiatric manifestations associated with COVID-19 and some critical aspects of the innate and adaptive immune system involved in mental health disorders occurring in COVID-19.

Peripheral Inflammatory Markers Contributing to Comorbidities in Autism.

This study evaluates the contribution of peripheral biomarkers to comorbidities and clinical findings in autism. Seventeen autistic children and age-matched typically developing (AMTD), between three to nine years old were evaluated. The diagnostic followed the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DMS-IV) and the Childhood Autism Rating Scale (CARS) was applied to classify the severity. Cytokine profile was evaluated in plasma using a sandwich type ELISA. Paraclinical events included electroencephalography (EEG) record. Statistical analysis was done to explore significant differences in cytokine profile between autism and AMTD groups and respect clinical and paraclinical parameters. Significant differences were found to IL-1ß, IL-6, IL-17, IL-12p40, and IL-12p70 cytokines in individuals with autism compared with AMTD (p < 0.05). All autistic patients showed interictalepileptiform activity at EEG, however, only 37.5% suffered epilepsy. There was not a regional focalization of the abnormalities that were detectable with EEG in autistic patients with history of epilepsy. A higher IL-6 level was observed in patients without history of epilepsy with interictalepileptiform activity in the frontal brain region, p < 0.05. In conclusion, peripheral inflammatory markers might be useful as potential biomarkers to predict comorbidities in autism as well as reinforce and aid informed decision-making related to EEG findings in children with Autism spectrum disorders (ASD).

Principios y relevancia del ensayo cometa / Principles and relevance of the comet assay

Desde hace varias décadas el ensayo Cometa, o electroforesis alcalina de células individuales, se ha convertido en un método establecido para el estudio del daño de ácido desoxirribonucleico, con múltiples aplicaciones en ensayos de genotoxicidad, estudios de biomonitoreo en humanos, epidemiologia molecular y ecotoxicología; así como una herramienta fundamental para investigaciones sobre daño y reparación del ácido desoxirribonucleico. Este ensayo se distinguió por su simplicidad, sensibilidad, versatilidad, rapidez y economía. Es una poderosa técnica que se basa en la visualización microscópica de las imágenes del ácido desoxirribonucleico después que las células son embebidas en agarosa, lisadas y sometidas a una electroforesis alcalina. Esta metodología básica ha sido ampliada, y permite ahora, detectar con alta sensibilidad una gran variedad de daños del ácido desoxirribonucleico en cualquier tipo de células. La inclusión en este ensayo, de enzimas capaces de producir lesiones específicas en la hebra de ácido desoxirribonucleico, ha incrementado su rango de detección y sensibilidad. Pero es importante tener claro que su especificidad no es absoluta. El propósito es destacar algunos aspectos útiles de este método y sus ventajas; describir la experiencia en algunos aspectos técnicos del proceder, normalizado según las condiciones del laboratorio en el instituto para ampliar su utilización en el país (AU)

For several decades now the comet assay (single cell gel electrophoresis assay) has been the method used for the study of deoxyribonucleic acid damage, with multiple applications in genotoxicity assays, biomonitoring studies in humans, molecular epidemiology and ecotoxicology, and a fundamental tool for research into deoxyribonucleic acid damage and repair. The comet assay has stood out for its simplicity, sensitivity, versatility, rapidity and economy. It is a powerful technique based on microscopic visualization of deoxyribonucleic acid images after the cells have been embedded in agarose, lysed and subjected to alkaline electrophoresis. This basic methodology has been broadened, and may now detect with great sensitivity a large variety of deoxyribonucleic acid damage in any type of cell. Inclusion in the assay of enzymes capable of producing specific lesions on the deoxyribonucleic strand has broadened its detection range and sensitivity. However, it is important to bear in mind that its specificity is not absolute. The purpose of the present study is to point out some useful aspects and advantages of the method, and describe the experience with some technical aspects of the procedure, standardized in keeping with the conditions in the laboratory at the institute to extend its use in the country (AU)

Principios y relevancia del ensayo cometa / Principles and relevance of the comet assay

Desde hace varias décadas el ensayo Cometa, o electroforesis alcalina de células individuales, se ha convertido en un método establecido para el estudio del daño de ácido desoxirribonucleico, con múltiples aplicaciones en ensayos de genotoxicidad, estudios de biomonitoreo en humanos, epidemiologia molecular y ecotoxicología; así como una herramienta fundamental para investigaciones sobre daño y reparación del ácido desoxirribonucleico. Este ensayo se distinguió por su simplicidad, sensibilidad, versatilidad, rapidez y economía. Es una poderosa técnica que se basa en la visualización microscópica de las imágenes del ácido desoxirribonucleico después que las células son embebidas en agarosa, lisadas y sometidas a una electroforesis alcalina. Esta metodología básica ha sido ampliada, y permite ahora, detectar con alta sensibilidad una gran variedad de daños del ácido desoxirribonucleico en cualquier tipo de células. La inclusión en este ensayo, de enzimas capaces de producir lesiones específicas en la hebra de ácido desoxirribonucleico, ha incrementado su rango de detección y sensibilidad. Pero es importante tener claro que su especificidad no es absoluta. El propósito es destacar algunos aspectos útiles de este método y sus ventajas; describir la experiencia en algunos aspectos técnicos del proceder, normalizado según las condiciones del laboratorio en el instituto para ampliar su utilización en el país.

For several decades now the comet assay (single cell gel electrophoresis assay) has been the method used for the study of deoxyribonucleic acid damage, with multiple applications in genotoxicity assays, biomonitoring studies in humans, molecular epidemiology and ecotoxicology, and a fundamental tool for research into deoxyribonucleic acid damage and repair. The comet assay has stood out for its simplicity, sensitivity, versatility, rapidity and economy. It is a powerful technique based on microscopic visualization of deoxyribonucleic acid images after the cells have been embedded in agarose, lysed and subjected to alkaline electrophoresis. This basic methodology has been broadened, and may now detect with great sensitivity a large variety of deoxyribonucleic acid damage in any type of cell. Inclusion in the assay of enzymes capable of producing specific lesions on the deoxyribonucleic strand has broadened its detection range and sensitivity. However, it is important to bear in mind that its specificity is not absolute. The purpose of the present study is to point out some useful aspects and advantages of the method, and describe the experience with some technical aspects of the procedure, standardized in keeping with the conditions in the laboratory at the institute to extend its use in the country.

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007.

BACKGROUND: Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. OBJECTIVE: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. METHOD: Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. RESULTS: Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. CONCLUSION: It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment.

Seasonal distribution and evolving forms of multiple sclerosis patients diagnosed from April 2004 to November 2007 / Distribución estacional y formas evolutivas de esclerosis múltiple en pacientes diagnosticados entre Abril del 2004 y Noviembre del 2007

BACKGROUND: Multiple sclerosis (MS) was first reported in Cuba in 1965. The most frequent appearance is observed in the first six months of the year. OBJECTIVE: To determine the seasonal distribution and evolving forms of MS patients diagnosed with the disease between April 2004 and November 2007. METHOD: Twenty-one patients with suspected MS and 42 outbreaks were studied. Patients were classified according to Lublin and Revingold's criteria for clinical forms and according to McDonald. RESULTS: Most patients were classified in outbreak and remission and only two patients classified as primary-progressive multiple sclerosis. The higher number of outbreaks occurred in the first two quarters of the year. CONCLUSION: It is recommended to study further weather variables that may be related to the emergence of these outbreaks in our environment.

INTRODUCCIÓN: La esclerosis múltiple (EM) fue reportada en Cuba por primera vez en 1965. Se ha venido observando la aparición más frecuente en los primeros seis meses del año. OBJETIVO: Determinar la distribución estacional y formas evolutivas de EM en pacientes con diagnóstico de esta enfermedad entre abril 2004 y noviembre 2007. MÉTODO: Se estudiaron 21 pacientes con sospecha de EM y un total de 42 brotes. Los pacientes fueron clasificados según los criterios de Lublin y Revingold para las formas evolutivas y según los criterios de McDonald. RESULTADOS: Solo dos pacientes clasificaron en la forma evolutiva progresiva primaria; los primeros dos trimestres del año fueron los de mayor número de brotes. CONCLUSIÓN: Se recomienda profundizar en las variables climatológicas que pudieran tener vínculo con la aparición de estos brotes en nuestro medio.

Síntesis intratecal de C3c e inmunoglobulinas en niños con meningoencefalitis bacteriana / Intrathecal synthesis of C3c and immunoglobulins in children with bacterial meningoencephalitis

Las meningoencefalitis bacterianas constituyen una fuente importante de morbilidad, mortalidad y discapacidad endiferentes regiones del mundo. El objetivo del presente trabajo es conocer si el sistema de complemento puede estar involucrado en la lisis de las bacterias productoras de meningoencefalitis a través de la liberación de C3c al líquidocefalorraquídeo. Se estudiaron siete pacientes con edad promedio de 3 años, que ingresaron en el Hospital Pediátricode San Miguel del Padrón, a los que se les realizó una punción lumbar diagnóstica y se les aislaron los gérmenes siguientes: Neisseria meningitidis, Streptococcus pneumoniae y Haemophilus influenzae. La cuantificación de los niveles de C3c, albúmina e inmunoglobulinas mayores en suero y líquido cefalorraquídeo se realizó en placas de inmunodifusión radial. Los resultados obtenidos fueron recogidos en un reibergrama. El total de los pacientes estudiados mostraron síntesis intratecal del componente C3c del sistema de complemento. Este hecho evidenció la activación de este sistema en alguna de sus vías y que una vez cumplidas sus funciones biológicas, ha sufrido un proceso de degradación y liberación al LCR en forma de C3c(AU)

Bacterial meningoencephalitis is an important source of morbidity, mortality and disabilities in different regions of the world. The objective of this paper is to know if the complement system can be involved in producing-meningoencephalitis bacteriallysis through C3c release into cerebrospinal fluid. Seven patients with an average age of 3 years-old, who attended the Pediatric Hospital of San Miguel del Padrón, were studied by lumbar puncture diagnosis. Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae were isolated from the samples taken. The quantification of C3c, albumin and mainimmunoglobulins in serum and in cerebrospinal fluid were carried out by radial immunodifusion. Results were analyzed using a Reibergram. All patients showed C3c intrathecal synthesis. This fact demonstrates that the activation of this system hasoccurred in some of their three pathways and once its biological functions are fulfilled, it suffered a degradation and release process into cerebrospinal fluid as C3c(AU)

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis.

The intercellular adhesion molecule is a transmembrane glycoprotein belonging to the immunoglobulin superfamily. Serum and cerebrospinal fluid (CSF) soluble intercellular adhesion molecule 1 (sICAM-1) from normal control children as well as from children with Guillain-Barré syndrome (GBS), with Coxsackie A9 virus meningoencephalitis and with Streptococcus pneumoniae meningoencephalitis were studied. sICAM-1 was quantified using an immunoenzimatic assay and albumin using the immunodiffusion technique in both biological fluids. Increased sICAM-1 values in CSF in patients with GBS correspond to an increase of the albumin CSF/serum quotient. In contrast, in inflammatory diseases like S. pneumoniae and Coxsackie A9 virus meningoencephalitis an increased brain-derived fraction was observed. In particular cases these values are 60-65% and 70-75% respectively. The results indicate an additional synthesis of sICAM-1 in subarachnoidal space during central nervous system (CNS) inflammatory process. An important role of sICAM-1 in the transmigration of different cell types into CSF during CNS inflammation in children with S. pneumoniae and Coxsackie A9 meningoencephalitis may be suggested.

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S. pneumoniae meningoencephalitis / Sintesis intratecal de sICAM-1 y liberación durante la fase aguda en niños con meningoencefalitis por Coxsackie A9 y S pneumoniae

The intercellular adhesion molecule is a transmembrane glycoprotein belonging to the immunoglobulin superfamily. Serum and cerebrospinal fluid (CSF) soluble intercellular adhesion molecule 1 (sICAM-1) from normal control children as well as from children with Guillain-Barré syndrome (GBS), with Coxsackie A9 virus meningoencephalitis and with Streptococcus pneumoniae meningoencephalitis were studied. sICAM-1 was quantified using an immunoenzimatic assay and albumin using the immunodiffusion technique in both biological fluids. Increased sICAM-1 values in CSF in patients with GBS correspond to an increase of the albumin CSF/serum quotient. In contrast, in inflammatory diseases like S. pneumoniae and Coxsackie A9 virus meningoencephalitis an increased brain-derived fraction was observed. In particular cases these values are 60-65 percent and 70-75 percent respectively. The results indicate an additional synthesis of sICAM-1 in subarachnoidal space during central nervous system (CNS) inflammatory process. An important role of sICAM-1 in the transmigration of different cell types into CSF during CNS inflammation in children with S. pneumoniae and Coxsackie A9 meningoencephalitis may be suggested.

La molécula de adhesión intercelular es una glicoproteína que pertenece a la superfamilia de las inmunoglobulinas. Se estudiaron los niveles de molécula de adhesión intercelular tipo 1 soluble (sICAM-1) en suero y líquido cefalorraquídeo (LCR) de niños con meningoencefalitis por Streptococcus pneumoniae y por Coxsackie A9 al igual que en niños con sindrome de Guillain-Barré (SGB). sICAM-1 fue cuantificado por ensayo inmunoenzimático y la albúmina por inmunodifusión en ambos líquidos biológicos. Los valores incrementados de sICAM-1 en LCR en los pacientes con GBS corresponden a valores aumentados de razón LCR/suero de albúmina. En contraste, en las enfermedades inflamatorias como las meningoencefalitis por S. pneumoniae y por Coxsackie A9 se observa un incremento en la fracción derivada del cerebro. En casos particulares los valores se incrementan hasta un 60-65 por ciento y 70-75 por ciento respectivamente. Los resultados indican una síntesis adicional de sICAM-1 en el espacio subaracnoideo durante el proceso inflamatorio del sistema nervioso central (SNC). Esto puede sugerir un importante papel del sICAM-1 en la transmigración de diferentes tipos celulares en el LCR durante la inflamación del SNC en niños con meningoencefalitis por S pneumoniae y coxsackie A9.

Respuesta inmune intratecal y características clínicas de la meningoencefalitis por Neisseria meningitidis en pacientes inmunizados con la vacuna cubana VA-MENGOC-BC® / Intrathecal immune response and clinical characteristics of meningoencephalitis due to Neisseria meningitidis in immunized patients with the Cuban vaccine VA-MENGO-BC®

La morbimortalidad por la enfermedad meningocócica en Cuba disminuyó notablemente después de la introducción de la vacuna VA-MENGOC-BC®. Sin embargo, años después de ser vacunados se han reportado algunos niños que enfermaron. En este trabajo nos propusimos describir el comportamiento neuroinmunológico y clínico de esta enfermedad en 12 pacientes vacunados que fueron ingresados en el Hospital Pediátrico de San Miguel del Padrón con el diagnóstico de meningoencefalitis producida por Neisseria meningitidis. Se tomaron muestras de forma simultánea de sangre y líquido cefalorraquídeo para la cuantificación de albúmina e inmunoglobulinas mayores porinmunodifusión radial; para el análisis de los resultados se tomó como referencia el registro histórico de los resultados de ocho pacientes no inmunizados que enfermaron antes de incluir esta vacuna en el Esquema Nacional de Vacunación. La respuesta neuroinmunológica y las características clínicas de los pacientes vacunados resultaron diferentes a lo observado previamente en pacientes no vacunados. El grupo vacunado mostró un cuadro menos grave de la enfermedad. El patrón de síntesis intratecal de inmunoglobulinas fue diferente entre los dos grupos. La media de la síntesis intratecal de IgG, IgM e IgA fue significativamente superior en el grupo de los pacientes no vacunados. Este estudio nos permitió concluir que en la muestra estudiada la vacuna modificó la respuesta neuroinmunológica y el cuadro clínico de la enfermedad(AU)

Morbimortality due to meningococcal disease in Cuba have been diminished by a massive meningococcal (VA-MENGOCBC ®) vaccination campaign. However, some years later, meningococcal disease in vaccinated children is reported. This studyaims at describing the neuroinmmunological and clinical behavior of the illness in 12 vaccinated children, who were admitted at the Pediatric Hospital from San Miguel del Padrón municipality suffering from meningoencephalitis due to Neisseriameningitidis. Simultaneous blood and cerebrospinal fluid samples were obtained. Major immunoglobulin and albumin were quantified in both fluids by radial immunodiffusion, these results were compared to those of eight non–immunized patients who were sick before this vaccine was included in the National Vaccination Schedule. Neuroimmunological response and theclinical characteristics of vaccinated patients were different from what was previously observed in non-vaccinated patients. The disease was less serious in the vaccinated group. The pattern of intrathecal synthesis of immunoglobulins was also different in both groups. The mean value of intrathecal synthesis of IgG, IgM, IgA was statistically significant higher in non-vaccinatedpatients. This study leads to the conclusion that in the studied sample the vaccine modifies the immunological response and the clinical frame of the disease(AU)

Vinculación de la docencia y la investigación en la asignatura Inmunología para estudiantes de Tecnología de la Salud / Link of teaching and research in the Immunology subject for students of Health Technology

OBJETIVO: lograr la vinculación de la docencia y la investigación en la asignatura Inmunología para los estudiantes de Tecnología de la Salud. MÉTODOS: se establecieron actividades prácticas de Inmunología en el Laboratorio Central de Líquido Cefalorraquídeo para todos los alumnos de cuarto año de la carrera de esta especialidad y modalidad. La actividad práctica incluyó la realización de diversas técnicas. Además, se orientó a los interesados en hacer un trabajo de investigación con temas de neuroinmunología a partir de pacientes con determinadas enfermedades en los hospitales de procedencia de los estudiantes como examen final de la asignatura. RESULTADOS: el respaldo a esta forma fue unánime con resultados altamente satisfactorios. La evaluación fue la presentación oral y por escrito de los trabajos finales. De los 10 trabajos presentados, 6 obtuvieron la máxima calificación y 4 fueron recomendados para ser presentados en la Jornada Científica Estudiantil de la facultad. CONCLUSIONES: los resultados confirman lo beneficioso que resulta vincular la teoría con la práctica y las actividades de investigación en la docencia de esta especialidad y modalidad.

OBJECTIVE: to attain the link between teaching and research in the Immunology subject for students of Health Technology. METHODS: practical activities of Immunology were established in the Cerebrospinal Fluid Central Lab for all the 4th-year students of the career of this specialty and modality. The practical activity included the use of various techniques. The interested were advised to make a research paper on neuroimmunology topics based on the patients suffering specific diseases at the same hospitals of the students as a final test of the subject. RESULTS: the support to this strategy was unanimous with highly satisfactory results. The evaluation consisted in the oral and writing presentation of the final papers. Of the 10 papers presented, 6 have the highest qualification, and 4 were recommended to be presented in the Student's Scientific Meeting of faculty. CONCLUSIONS: the results confirmed the convenience of linking theory with practice and with the research activities in the teaching of this specialty and modality.

Vinculación de la docencia y la investigación en la asignatura Inmunología para estudiantes de Tecnología de la Salud / Link of teaching and research in the Immunology subject for students of Health Technology

Se establecieron actividades prácticas de Inmunología en el Laboratorio Central de Líquido Cefalorraquídeo para todos los alumnos de cuarto año de la carrera de esta especialidad y modalidad. La actividad práctica incluyó la realización de diversas técnicas. Además, se orientó a los interesados en hacer un trabajo de investigación con temas de neuroinmunología a partir de pacientes con determinadas enfermedades en los hospitales de procedencia de los estudiantes como examen final de la asignatura. El respaldo a esta forma fue unánime con resultados altamente satisfactorios. La evaluación fue la presentación oral y por escrito de los trabajos finales. De los 10 trabajos presentados, 6 obtuvieron la máxima calificación y 4 fueron recomendados para ser presentados en la Jornada Científica Estudiantil de la facultad...(AU)

Practical activities of Immunology were established in the Cerebrospinal Fluid Central Lab for all the 4th-year students of the career of this specialty and modality. The practical activity included the use of various techniques. The interested were advised to make a research paper on neuroimmunology topics based on the patients suffering specific diseases at the same hospitals of the students as a final test of the subject. The support to this strategy was unanimous with highly satisfactory results. The evaluation consisted in the oral and writing presentation of the final papers. Of the 10 papers presented, 6 have the highest qualification, and 4 were recommended to be presented in the Student's Scientific Meeting of faculty...(AU)

sICAM-1 intrathecal synthesis and release during the acute phase in children suffering from Coxsackie A9 and S pneumoniae meningoencephalitis

The intercellular adhesion molecule is a transmembrane glycoprotein belonging to the immunoglobulin superfamily. Serum and cerebrospinal fluid (CSF) soluble intercellular adhesion molecule 1 (sICAM-1) from normal control children as well as from children with Guillain-Barré syndrome (GBS), with Coxsackie A9 virus meningoencephalitis and with Streptococcus pneumoniae meningoencephalitis were studied. sICAM-1 was quantified using an immunoenzimatic assay and albumin using the immunodiffusion technique in both biological fluids. Increased sICAM-1 values in CSF in patients with GBS correspond to an increase of the albumin CSF/serum quotient. In contrast, in inflammatory diseases like S pneumoniae and Coxsackie A9 virus meningoencephalitis an increased brain-derived fraction was observed... (AU)

C3c intrathecal synthesis evaluation in patients with multiple sclerosis.

INTRODUCTION: Multiple sclerosis (MS) is a chronic, inflammatory and progressive disease of the central nervous system in which local inflammatory injuries of the brain white matter appears, being the most outstanding feature the myeline loss (demyelination). OBJECTIVE: To determine if the complement system might be involved in the MS immunopathogeny favouring the mechanism intervening in the myelin destruction. METHOD: Samples of sera and CSF from twelve patients with a diagnosis of MS obtained at the moment of the admission to the hospital at the beginning of the break out, were collected. Levels of C3c and albumin in sera and in CSF were quantified using radial immunodiffusion plates. RESULTS: High values over 80% of intrathecal synthesis were obtained except in one of the patients. CONCLUSION: Intrathecal synthesis of C3c and its liberation to the CSF means that the activation of the complement system in any of the two ways has taken place, and that once performed its biological functions, has suffered a degradation process.