ABSTRACT
A doença de Huntington (DH) é uma desordem neurodegenerativa, que cursa com distúrbios motores, cognitivos e comportamentais que contribuem para o comprometimento da funcionalidade. Este estudo investigou o grau de funcionalidade e acometimento de indivíduos portadores da DH, com o Índice de Barthel Modificado (IBM) e por meio do Disease Burden Score (DBS). As variáveis analisadas de cada indivíduo foram: a idade atual, o gênero, a idade de início da doença e o número das repetições CAG (gene HTT). Seis indivíduos foram avaliados, três do sexo masculino 63,6 anos (±10,9) e três do sexo feminino 58,3 anos (±14,2) com o diagnóstico genético positivo para DH provenientes do município de Ervália/MG. O sexo feminino apresentou a idade de início menor comparado ao sexo masculino, com média de 38,3 anos (±8,9) e 46,6 anos (±7,6), respectivamente. O valor médio do número de repetições CAG no sexo feminino foi de 46,3 (±4,1) e no sexo masculino, 42,33 (±1,5). O grau de desempenho funcional determinado pelo IBM foi de 9,3 (±1,1) para o sexo feminino, com dependência total, e para o sexo masculino, 36 (±4,3), com dependência severa. O valor médio obtido pelo DBS no sexo feminino foi de 596,8 (±101,9), com maior grau de acometimento da doença comparado ao sexo masculino com 425,1 (±39,2). O grupo de mulheres com DH apresentou início dos sintomas mais cedo com maior número de expansões CAG quando comparado ao grupo masculino. Todos os pacientes apresentaram dependência total em relação à execução das atividades de vida diária. Sugere-se que pesquisas futuras sejam realizadas com maior número de indivíduos afetados pela DH para que os resultados observados sejam confirmados.
Huntington's disease (HD) is a neurodegenerative disorder, presenting with motor, cognitive and behavioral impairments that contribute to the decrease of the functional performance. This study investigated the degree of functionality and impairment of individuals with HD using the Modified Barthel Index (MBI) and the Disease Burden Score (DBS). The following variables were investigated : the age of onset, the gender, the current age and the number of CAG (HTT gene) repeats. Six HD patients from the municipality of Ervália-MG, three males 63.6 years old (±10.9) and three females 58.3 years old (±14.2), who had a positive genetic diagnosis for HD, were investigated. The female group had the lowest age of onset with an average of 38.3 years (±8.9), compared to the male group, with 46.6 years (±7.6). The mean of the number of CAG repeats in the female gender was 46.3 (±4.1) and in the male, 42.33 (±1.5). The degree of functional performance assessed by IBM was 9.3 (±1.1) for the female group, with total dependence, and for the male group, 36 (±4.3), with severe dependence. The mean of DBS value in the female group was 596.8 (±101.9) with a higher degree of disease involvement compared to the male group 425.1 (±39.2). The group of women with HD showed earlier onset of symptoms with a greater number of CAG repeats when compared to the male group. All patients presented total dependence on daily living activities. We strongly suggest further research involving a larger group of individuals affected by HD for statistical validation.
Subject(s)
Humans , Male , Female , Middle Aged , Huntington Disease/complications , Huntington Disease/diagnosis , Huntington Disease/genetics , Severity of Illness Index , Activities of Daily Living , Cross-Sectional Studies , Age of Onset , Disease ProgressionABSTRACT
Tissue damage triggers innate immune response mediated by Toll-like receptor 4 (TLR) that recognizes endogenous host danger molecules associated with cell death and tissue inflammation, although the precise role of TLR-4 signaling in muscle tissue repair is still uncertain. Previously, we observed that TLR-4 exerted a protective effect preventing excessive muscular damage induced by Bothrops jararacussu crude venom. This study aimed to evaluate the involvement of TLR-4 at early stages of muscular tissue remodeling in distinct mouse strains after injection of purified snake venom. Muscular injury was induced by injection of 25 µl (0.05 mg/ml) of cardiotoxin (CTX) from Naja mossambica in the gastrocnemius muscle of C3H/HeN (wild-type); C3H/HeJ mice that express a non-functional TLR-4 receptor, C57BL/6 and Tlr4 -/- (B6 background) mice. Comparing to control, Tlr4 -/- mice presented at early stages (3 DPI) of muscle injury mild inflammation with low MMP-9 activity, scarce macrophage infiltration and premature change to anti-inflammatory phenotype, low TNF-α mRNA levels and reduced myogenin expression, with low regeneration and tissue remodeling. The presence of more Ly6Cneg macrophages in Tlr4 -/- mice at 3 DPI indicates that TLR-4 may influence the differentiation into Ly6Cneg or likely affect proliferation of such cells in the muscle. The present study shows that TLR-4 deficiency and genetic background influence the outcome of muscular tissue repair in aseptic lesions and yet still maintaining some level of signaling in the TLR4-mutant mice.
Subject(s)
Cardiotoxins/pharmacology , Muscle Fibers, Skeletal/drug effects , Toll-Like Receptor 4/deficiency , Animals , Cardiotoxins/administration & dosage , Male , Mice , Mice, Inbred C3H , Mice, Inbred C57BL , Mice, Knockout , Muscle Fibers, Skeletal/metabolism , Muscle Fibers, Skeletal/pathology , Toll-Like Receptor 4/metabolismABSTRACT
Immune cells and skeletal muscle express Toll-like receptors (TLRs) that participate as sensors of tissue injury triggering signals for activation of innate and adaptive immune responses. This study aimed to investigate the involvement of TLR4 in the process of skeletal muscle repair. Muscular injury was induced by injection of 0.6 mg/kg of Bothrops jararacussu snake venom in the gastrocnemius muscle of C3H/HeJ mice that express a non-functional TLR-4 receptor and C3H/HeN mice with functional receptor. TLR4-deficient mice had persistent muscular inflammation with few F4/80 macrophages at onset but increased MMP9 activity and collagen deposition during resolution of injury. Since such effect was not observed in the mouse strain with functional receptor it is concluded that TLR4 signaling exerts a protective role preventing from excessive muscular damage induced by B. jararacussu venom.
