ABSTRACT
A tireoide é uma glândula endócrina que pode ser afetada por diversas lesões, que incluem doenças reativas, autoimunes e neoplásicas. Evidências mostram que a resposta imunológica, a partir da liberação de citocinas inflamatórias por células imunes e não imunes, desempenha um importante papel no desenvolvimento de diversas doenças. Dentre essas citocinas, destacam-se a IL-17 e a IL-23, as quais têm sido associadas à resposta Th17 e patogênese de diversas doenças tireoidianas. Dessa forma, esta pesquisa teve como objetivo avaliar a imunoexpressão das proteínas IL-17 e IL-23 em carcinomas papilíferos de tireoide (CPTs), adenomas foliculares (AFs), bócios coloides (BCs) e tireoidites de Hashimoto (THs) (isoladas e associadas a CPTs ou BCs), com o intuito de compreender melhor a atuação destas citocinas nestas entidades. A amostra foi composta por 30 casos de CPTs, 10 AFs, 15 BCs e 15 THs. A análise da imunoexpressão das proteínas nas células foliculares/tumorais foi realizada semiquantitativamente em toda extensão das lesões, as quais foram classificadas em três escores: 1 (≤ 33%), 2 (> 33% 66%) e 3 (> 66%). Para a avaliação dos linfócitos imunopositivos, foram selecionados cinco campos com maior quantidade de linfócitos positivos, onde foi realizada a contagem. Os dados foram submetidos à análise estatística por meio dos testes de Kruskal-Wallis (KW), Mann-Whitney (U) e Spearman (r), com o nível de significância estabelecido em 5% (p < 0,05). Na análise da IL-17 entre as lesões, foi verificada maior imunoexpressão pelos linfócitos nas THs comparado aos AFs e BCs (p=0,041 e p=0,013). Na avaliação da IL-23 foi constatada uma maior imunomarcação das células foliculares/tumorais nas THs em relação aos CPTs (p=0,002), assim como, observou-se uma maior expressão desta citocina nos linfócitos das THs em comparação aos CPTs, AFs e BCs (p=0,001; p=0,023 e p=0,003). Além disso, foram observadas nas THs correlações estatisticamente significativas entre a imunoexpressão da IL-17 e IL-23 tanto nas células foliculares/tumorais, como nos linfócitos (r=0,539; p=0,038 e r=0,522; p=0,046). Sugere-se que a IL-17 e IL-23 influenciam a patogênese destas lesões tireoidianas e que em algumas delas, represente atuação da resposta Th17 (AU).
The thyroid is an endocrine gland that can be affected by several lesions, including reactive, autoimmune and neoplastic diseases. Evidence shows that the immune response, from the release of inflammatory cytokines by immune and non-immune cells, plays an important role in the development of several diseases. Among these cytokines, IL-17 and IL-23 stand out, which have been associated with the Th17 response and pathogenesis of several thyroid diseases. Hence, this research aimed to evaluate the immunoexpression of IL-17 and IL-23 proteins in papillary thyroid carcinomas (PTCs), follicular adenomas (FAs), colloid goiters (CGs) and Hashimoto's thyroiditis (HTs) (isolated and associated with PTCs or GCs), in order to better understand the role of these cytokines in these entities. The sample consisted of 30 cases of PTCs, 10 FAs, 15 CGs and 15 HTs. The analysis of protein immunoexpression in follicular/tumor cells was semiquantitatively performed in all lesions, which were classified into three scores: 1 (≤ 33%), 2 (> 33% - 66%) and 3 (> 66%). For the evaluation of immunopositive lymphocytes, five fields with the greater number of positive lymphocytes were selected, where the count was performed. The data were submitted to statistical analysis using the Kruskal-Wallis (KW), Mann-Whitney (U) and Spearman (r) tests, with the significance level set at 5% (p < 0,05). In the analysis of IL-17 between lesions, a higher immunoexpression was verified in the HT lymphocytes compared to FAs and CGs (p=0.041 and p=0.013). In the evaluation of IL-23, a higher immunostaining of follicular/tumor cells in HTs was detected in relation to PTCs (p=0.002), as well as, a greater expression of this cytokine was observed in the lymphocytes of HTs compared to PTCs, FAs and CGs (p=0.001; p=0.023 and p=0.003). In addition, statistically significant correlations between the immunoexpression of IL17 and IL-23 were observed in both follicular/tumor cells and lymphocytes (r=0.539; p=0.038 and r=0.522; p=0.046). It is therefore suggested that IL-17 and IL-23 influence the pathogenesis of these thyroid lesions and that in some of them, they represent the Th17 response (AU).
Subject(s)
Humans , Male , Female , Thyroid Diseases/pathology , Thyroid Gland , Interleukin-17 , Endocrine Glands , Interleukin-23 , Statistics, Nonparametric , Hashimoto Disease/immunologyABSTRACT
BACKGROUND: To identify the implications of bariatric surgery on the oral health of patients with morbid obesity. METHODS: Two reviewers independently performed a search of the electronic databases: MedLine, PubMed, SciELO, LILACS, and Scopus, for clinical trials in humans and cohort studies. The search strategy used was Bariatric Surgery and Oral Health or Mouth Disease and Humans and Periodontitis. A total of 26 articles were obtained, and after title screening and full reading, 8 articles were included in this review. RESULTS: Increased food intake at shorter intervals and increased frequency of regurgitation in these patients were associated with the increased development of dental caries, dental erosion, and increased salivary flow rate. CONCLUSION: Intense oral control is recommended for the prevention and early treatment of these conditions and to avoid nonsystemic effects in these patients.
