Long-Term Treatment with Alcaligenes faecalis A12C Improves Host Resistance to Pathogens in Septic Rats: Possible Contribution of Curdlan-Like Immune Trainer.

Curdlan, a ß-1,3/1,6-glucan found in Alcaligenes faecalis (A. faecalis) wall, activates innate and humoral immunity. The aim of this study is to evaluate whether pretreated rats with A. faecalis A12C could prevent sepsis disturbances and identify the immunomodulatory mechanisms involved. Experiments occurred in two stages: a survival study with 16 rats randomly divided into septic (SC) (n = 8) and septic pretreated (SA) (n = 8) groups and 45 rats divided into four groups: healthy (AGUSAN) (n = 9), septic (AGUIC) (n = 13), septic pretreated (AGUIA) (n = 14), and healthy pretreated (AGUSTO) (n = 9). Sepsis was induced by cecal ligation and puncture after 30 days of A. faecalis A12C pretreatment or without. SA group had a higher survival rate of 58% vs. 16% for SC group (P < 0.05). Overall, AGUIA showed better status than AGUIC (P < 0.01). Higher monocytosis was found in AGUIA and AGUSTO vs. AGUIC and AGUSAN, respectively (P < 0.05). A gradual increase in curdlan fecal concentration was observed in AGUIA during pretreatment. Fecal concentrations of Escherichia coli significantly decreased in AGUIA and AGUSTO. Bacterial load in urine, peritoneal lavage fluid (PLF), and bronchoalveolar lavage fluid (BALF) decreased (P < 0.05) in AGUIA vs. AGUIC. Finally, lower inflammation was observed in serum, BALF, and PLF, with reduced IL-6, IL-10, IL-1ß, and TNF-α, along with less damage in lungs and peritoneum in AGUIA vs. AGUIC. These findings suggest the connection between curdlan-produced by A. faecalis A12C-with the immune system and the reduction in severity of experimental sepsis.

Probiotic Properties of Alcaligenes faecalis Isolated from Argyrosomus regius in Experimental Peritonitis (Rat Model).

A strain of Alcaligenes faecalis A12C (A. faecalis A12C) isolated from Argyrosomus regius is a probiotic in fish. Previous experiments showed that A. faecalis A12C had inhibitory effects on the growth of multidrug-resistant bacteria. We aimed to confirm whether A. faecalis A12C is safe and has adequate intestinal colonization in experimental rats, and evaluate its efficacy in an animal model of peritonitis. We used 30 male rats, randomly divided into 6 groups (n = 5): three groups (HA7, HA15, HA30) received A. faecalis A12C in drinking water (6 × 108 CFU/mL) for 7 days, and three control groups received drinking water only. All groups were evaluated at 7, 15, and 30 days. Survival after A. faecalis A12C administration was 100% in all groups. Mild eosinophilia (1.5%, p < 0.01) and increased aspartate aminotransferase (86 IU/L, p < 0.05) were observed in HA7, followed by progressive normalization. No histological signs of organ injury were found. We observed significant E. coli decline in faeces, parallel to an increase in A. faecalis A12C at 7 days. E. coli had a tendency to recover initial values, while A. faecalis A12C disappeared from the intestinal microbiota at 30 days. To evaluate its efficacy against peritonitis, we studied two additional groups of animals: IA group pretreated with A. faecalis A12C before E. coli intra-abdominal inoculation, and IC group inoculated with no A. faecalis A12C. We found an increase in C-reactive protein, alanine aminotransferase, urea, and eosinophils in IC animals when compared with IA. Peritonitis was more evident in IC than in IA animals. Our findings suggest that A. faecalis A12C altered clinically relevant parameters in sepsis and was associated with a lesser spread of infection.

Primary duodenal follicular lymphoma successfully treated with rituximab.

Non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal lymphoma, accounting for approximately 40% of all extranodal NHLs. Initial treatment of duodenal lymphoma includes surgery, chemotherapy and radiotherapy, alone or in combination. Here, we present a case of stage I primary duodenal follicular lymphoma (FL) showing a complete response after rituximab therapy. Rituximab alone can be an effective alternative treatment for duodenal FL.

Primary duodenal follicular lymphoma successfully treated with rituximab

Non-Hodgkin's lymphoma (NHL) of the gastrointestinal (GI) tract is the most common extranodal lymphoma, accounting for approximately 40% of all extranodal NHLs. Initial treatment of duodenal lymphoma includes surgery, chemotherapy and radiotherapy, alone or in combination. Here, we present a case of stage I primary duodenal follicular lymphoma (FL) showing a complete response after rituximab therapy. Rituximab alone can be an effective alternative treatment for duodenal FL (AU)

[Putative chromophobe cell renal carcinoma: are they or are they not?]. / Carcinomas renales de células cromófobas putativos: son o no son?

OBJECTIVE: According to the literature, the typical histological findings and simple colloidal iron staining permit the identification of chromophobe cell renal carcinoma, a genetically well-established entity. Our doubts on whether this tumor type can be recognized by conventional methods are presented in this study. METHODS: 130 cases of renal carcinoma were treated from 1977 to 1997. Of these, 12 showed characteristic general histological features compatible with chromophobe cell renal carcinoma and reticulated and intense, diffuse cytoplasmic positivity on colloidal iron staining. These tumors were reviewed for the following: 1) gross appearance, 2) architecture, 3) cytoplasmic characteristics, 4) nuclear characteristics, 5) colloidal iron histochemical staining which is considered fundamental and exclusive, 6) immunohistochemical phenotype. Ultrastructural study of material fixed in paraffin was also performed. RESULTS: One case met all 6 criteria, 3 met 5 of them, 6 cases met 4, and 2 cases met 3 of the criteria. The ultrastructural study was not useful in making the diagnosis due to the poor quality of the material. CONCLUSIONS: If all cases were chromophobe cell renal carcinoma, then this tumor type can be recognized and diagnosed by simple techniques in any pathology laboratory, and its incidence, presence of necrosis, hemorrhage and high nuclear grade would be even greater than currently accepted. Furthermore, it would be expected that the prognosis, by each grade and stage, would not be so different from that of the conventional renal carcinoma, as some large series have already indicated. On the other hand, if our cases or some of them were in fact conventional renal cell carcinoma that closely resembled chromophobe cell renal carcinoma, an exact diagnosis cannot be made without a genetic or ultrastructural study (using adequately fixed material), and most of the published studies would therefore have to be questioned.

[Renal carcinoma of sarcomatoid chromophobe cells]. / Carcinoma renal de células cromófobas sarcomatoide.

OBJECTIVE: Based on the clinicopathological findings of two additional cases of sarcomatoid chromophobe renal cell carcinoma and a review of the literature, we analyzed the prognosis in this and other forms of sarcomatoid carcinoma to determine the differences, if any, and their histopathological basis. METHODS: Of 139 cases of renal cell carcinoma that were surgically resected during the period 1977-1999, two were sarcomatoid chromophobe renal cell carcinoma, accounting for 15% of 13 cases of chromophobe cell carcinoma and 18% of 11 cases of sarcomatoid cell carcinoma in the same series. RESULTS: The first case was a 73-year-old male with a locally advanced, non-metastatic tumor. Palliative resection was performed and the histological analysis showed a predominantly sarcomatoid mass with small epithelial foci with the morphological, histochemical and immunohistochemical characteristics of chromophobe renal cell carcinoma. The patient died 11 months later. The second case was a 70-year-old female who presented with flank and lumbar pain and episodes of gross hematuria. Anatomopathological analysis showed a chromophobe cell carcinoma with sarcomatous foci, stage pT2pN0M0. The patient is disease-free at 46 months' follow-up. Immunohistochemically, in both cases the sarcomatoid component was found to be strongly positive for vimentin and focally for EMA, and negative for actin, desmin and myoblogin; isolated cells were positive for AE1 and AE3 in the second case. The epithelial component was positive for AE3 and EMA, and negative for AE1, vimentine and CD68. CONCLUSIONS: Like our first case, most of the reported cases of sarcomatoid chromophobe renal cell carcinoma show a sarcomatoid mass with foci of carcinoma, and a poor prognosis. In our view, as in all renal cell carcinomas, prognosis depends on tumor grade and stage, which is the highest for sarcomatoid chromophobe renal cell carcinoma. Furthermore, although the epithelial component (chromophobe, chromophilic, clear cells, etc.) may probably have little significance, the influence that the proportion of epithelial and sarcomatoid component might have in these tumors cannot be completely discarded.