ABSTRACT
Vasoactive intestinal peptide (VIP) is a neuropeptide with potent immunoregulatory properties. Reduced serum VIP levels and alterations in VIP receptors/signaling on immune cells have been associated with different inflammatory/autoimmune diseases. However, its role in autoimmune thyroid diseases (AITD) remains unknown. This study examined the interrelationship between VIP system, autoimmune background and thyroid hormones in peripheral immune cells in patients with AITD. Only Graves' disease (GD) patients showed significantly lower serum VIP levels when compared to healthy subjects and to Hashimoto's thyroiditis patients. Serum VIP levels were lower at the onset of GD, showing a significant negative correlation with thyroid hormone levels. The expression of VIP receptors, VPAC1 and VPAC2, was significantly upregulated in peripheral blood mononuclear cells (PBMC) from GD patients. There was an impairment of VIP signalling in these patients, probably attributable to a dysfunction of VPAC1 with preservation of VPAC2. The correlation between VPAC1 and thyroid hormone receptor expression in PBMC from healthy subjects was lost in GD patients. In summary, the VIP system is altered in peripheral immune cells of GD patients and this finding is associated with different thyroid hormone receptor patterns, showing a dynamic inter-regulation and a prominent role of VIP in this setting.
Subject(s)
Graves Disease/metabolism , Vasoactive Intestinal Peptide/metabolism , Adult , Female , Humans , Male , Middle Aged , Receptors, Vasoactive Intestinal Peptide, Type II/metabolism , Receptors, Vasoactive Intestinal Polypeptide, Type I/metabolism , Thyroid Hormones/metabolism , Vasoactive Intestinal Peptide/bloodABSTRACT
The heterogeneous nature of rheumatoid arthritis (RA) complicates early recognition and treatment. In recent years, a growing body of evidence has demonstrated that intervention during the window of opportunity can improve the response to treatment and slow- or even stop-irreversible structural changes. Advances in therapy, such as biologic agents, and changing approaches to the disease, such as the treat to target and tight control strategies, have led to better outcomes resulting from personalized treatment to patients with different prognostic markers. The various biomarkers identified either facilitate early diagnosis or make it possible to adjust management to disease activity or poor outcomes. However, no single biomarker can bridge the gap between disease onset and prescription of the first DMARD, and traditional biomarkers do not identify all patients requiring early aggressive treatment. Furthermore, the outcomes of early arthritis cohorts are largely biased by the treatment prescribed to patients; therefore, new challenges arise in the search for prognostic biomarkers. Herein, we discuss the value of traditional and new biomarkers and suggest the need for intensive treatment as a new surrogate marker of poor prognosis that can guide therapeutic decisions in the early stages of RA.
Subject(s)
Arthritis, Rheumatoid/metabolism , Biomarkers/metabolism , Arthritis, Rheumatoid/pathology , Humans , Severity of Illness IndexABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Palliative Care/ethics , Palliative Care/legislation & jurisprudence , Palliative Care/organization & administration , Organizations , National Health Programs/ethics , National Health Programs/trends , Palliative Care/trends , National Health Programs/organization & administration , National Health Programs/standards , National Health Programs , International Acts/ethics , International Acts/policiesABSTRACT
The angiographic characteristics of central serous chorioretinopathy (CSC) were studied by analyzing digitalized angiograms with an IMAGEnet system. We determined the type of leak, its location, and its distance from the fovea and from the center of the detachment. Round leaks were located farther from the detachment center and farther from the fovea than smokestack leaks. Detachments tended to center on the fovea regardless of the leak to fovea distance. These findings suggest that for serous detachment of the sensory retina to develop and be maintained, there must be a diffuse dysfunctional area of retinal pigment epithelium and a focal leak.
Subject(s)
Choroid Diseases/pathology , Image Processing, Computer-Assisted , Retinal Diseases/pathology , Adult , Exudates and Transudates , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Retinal Detachment/pathologyABSTRACT
One hundred oral fluorescein angiographic explorations were performed in 85 patients of both sexes, mean age 55.57 years, and range 8 to 77 years. Fluorescein was administered as one 250-mg (15 patients) or 500-mg (70 patients) capsule per 15 kg of body weight. In 15 fasting and 15 postprandial patients administered 500-mg capsules, no significant differences by group were found between fluorescein plasma levels. Fundus fluorescence under slitlamp illumination was poor for patients receiving the lower dosage of fluorescein, whereas at the higher dosage it was visible in all but one patient. The best filters were found to be a Kodak-Wratten 47A for the excitation filter and Kodak-Wratten 8 for the barrier filter. With a conventional fundus camera and fluorescein angiography filters, good photographs were achieved in all cases. The integrity of the blood-retina barriers was explored for various chorioretinal pathologies.
