Caracterização clínico-patológica da papilomatose laríngea / Clinical-pathological characterization of laryngeal papillomatosis

A papilomatose laríngea (PL) é uma doença rara e grave, dividida em dois grupos: juvenil (PLJ) e adulta (PLA), ambas causadas pelo papilomavírus humano (HPV). Seu curso pode ser agressivo, com inúmeras recidivas, risco de malignização, disseminação pulmonar e obstrução das vias aéreas. Para identificar os casos mais agressivos e nortear os tratamentos foram desenvolvidas escalas laringoscópicas, dentre elas; a escala desenvolvida por Derkay et al. (1998). O objetivo deste projeto foi caracterizar a PL e correlacionar suas características clínico-patológicas com com a escala laringoscópica de Derkay. Os dados e biópsias de 36 pacientes com PLJ e 56 com PLA foram coletados e analisados por meio da microscopia de luz. Os pacientes foram separados em grupos de acordo com os índíces de Derkay: ≥20 para os mais agressivos e <20 para os casos menos agressivos. Foram realizadas reações de imuno-histoquímicas anti- Fator XIIIa, CD3, CD4, CD8, CD15, CD20, CD68, FoxP3 e MUM-1. As células inflamatórias foram quantificadas. Todas as características clínico-patológicas e os resultados da reação imuno-histoquímica encontrados foram comparados entre os grupos propostos através do teste estatístico de Qui-Quadradro e correlacionados através do teste de correlação de Spearman. O nível de significância considerado foi de 5%. Ao comprar a severidade entre os grupos PLJ e PLA, o grupo PLJ foi considerado mais agressivo (P=0,02). Os pacientes entre as amostras com score ≥20 apresentaram maior incidência de traqueostomia e dificuldade respiratória grave. As displasias de alto grau foram associadas à presença de células FatorXIII+ e CD68+ (P<0,05) e tanto para PLJ quanto para PLA não houve associação destas displasias com a severidade (P=0,55 e P=0,87, respectivamente). A média do índice de Derkay para as amostras com mitoses acima da camada basal e atípicas foi 10,65 (± 5,93), maior do que a média das amostras que não apresentavam esta característica (8,02 ± 4,64), sendo estatisticamente significante (P=0,03). Amostras de PLA apresentaram maior quantidade de células CD3+. CD8+ e MUM1+ (P<0,05). A presença de CD15+ é diretamente proporcional ao índice de Derkay (P<0,05), enquanto MUM-1 é inversamente proporcional (P=0,01). Baseados nestes resultados, conclui-se que a PL é mais severa no pacientes jovens; mitoses atípicas e nas camadas mais superiores do epitélio foram mais frequentes na PLJ e estas foram correlacionadas com a maior severidade. As células inflamatórias também foram relacionadas a severidade e diferiram entre os grupos PLJ e PLA (AU)

Laryngeal papillomatosis (LP) is a rare and serious disease, divided into two groups: juvenile (JLP) and adult (ALP), both caused by the human papillomavirus (HPV). Its course can be aggressive, with numerous relapses, risk of malignancy, pulmonary dissemination and airway obstruction. To identify the most aggressive cases and guide the treatments, laryngoscopic scales were developed, among them; the scale developed by Derkay et al. (1998). The objective of this project was to characterize LP and to correlate its clinical-pathological characteristics with Derkay's laryngoscopic scale. The data and biopsies of 36 patients with JLP and 56 patients with ALP were collected and analyzed by light microscopy. The patients were separated into groups according to the Derkay indices: ≥20 for the most aggressive and <20 for the less aggressive cases. Anti-Factor XIIIa, CD3, CD4, CD8, CD15, CD20, CD68, FoxP3 and MUM-1 immunohistochemical reactions were performed and the inflammatory cells were quantified. All the clinical-pathological characteristics and the results of the immunohistochemical reaction were compared between the groups proposed using the Chi-Square test and correlated through the Spearman correlation test. The significance level considered was 5%. When comparing aggressivity between the JLP and ALP groups, the JLP group was considered more aggressive (P = 0.02). Patients among the samples with score ≥20 had a higher incidence of tracheostomy and severe respiratory distress. High-grade dysplasias were associated with the presence of Factor XIII+ and CD68+ cells (P <0.05), and for both JLP and ALP there was no association of these dysplasias with aggressivity (P = 0.55 and P = 0.87, respectively). The mean of the Derkay index for the samples with mitoses above the basal and atypical layer was 10.65 (± 5.93), higher than the mean of the samples that did not show this characteristic (8.02 ± 4.64), (P = 0.03) being statistically significant. The ALP samples showed higher quantities of CD3+ cells, CD8+ and MUM1+ (P <0.05). The presence of CD15+ is directly proportional to the Derkay index (P <0.05), while MUM-1 is inversely proportional (P = 0.01). Based on these results, it is concluded that LP is more aggressive in young patients; atypical mitoses and in the uppermost layers of the epithelium were more frequent in JLP and these were correlated with aggressivity. Inflammatory cells were also related to aggressiveness and differed between the groups PLJ e PLA (AU)

Are new pets really responsible for development of new allergies?

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Inmunonutrición: primera parte / Immunonutrition: first part

El campo de la inmunonutrición es relativamente nuevo y está siendo estudiado a nivel mundial por su gran aplicabilidad en la medicina. Se denomina resistencia específica o inmunidad a la capacidad del cuerpo humano para defenderse contra agentes invasores específicos, como bacterias, toxinas, virus y tejidos extraños; y se define estrés oxidativo como una situación en la que existe tanto un aumento en la velocidad de generación de especies reactivas del oxígeno como una disminución de los sistemas de defensa del organismo. La desnutrición calórica y proteica, que incluye también, invariablemente, la privación de vitaminas y minerales, puede causar una desnutrición primaria relacionada con la atrofia de órganos linfoides, lo cual conduce al desarrollo de infecciones oportunistas. Para poder entender el efecto de los farmaconutrimentos en el tubo digestivo y en el sistema inmunitario, hay que entender las bases fisiológicas de la inmunonutrición, lo cual requiere la integración de procesos de regulación a nivel del intestino.

The field of immunonutrition is relatively new and is being studied worldwide for its wide applicability in medicine. It is called the specific resistance or immunity to the human body's ability to defend against specific inaders such as bacteria, toxins, viruses and foreign tissue, and oxidative stress is defined as a situation in which there is both an increase in the rate of generation of reactive oxygen species as a decrease in the body's defense systems. Caloric and protein malnutrition, which also includes invariably deprived of vitamins and minerals can cause malnutritionrelated primary lymphoid organ atrophy, leading to the development of opportunistic infections. To understand the effect of pharmacology and nutrients in the digestive tract and immune system, one must understand the physiological basis of immunonutrition, which requires the integration of regularoty processes in the intestine.

Respiratory tract infections and lung function in early life - 'Cling together, swing together'

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A new era for innate immunity

In recent years our concept of the non-specific nature of innate immunity has changed following the identification of a network of germline-encoded receptors that recognise with substantial specificity molecular motifs of microorganisms and many other cues produced during tissue injury. Stimulation of these innate sensors by their specific ligands triggers signalling pathways that result in the activation of innate effector mechanisms as well as the priming of naive lymphocytes for the type of response that must be induced. These events culminate in the generation of an immune response appropriately adapted to the damage that has occurred. These new insights into innate immunity herald an entirely new era in the understanding of the molecular events that initiate and drive a host-protective response, changing many concepts about susceptibility to infections and providing greater insight into the underlying inflammatory pathology of other diseases. Targeted manipulation of innate immunity has enormous potential for the development of new vaccines and innovative therapies for the treatment of diseases such as infections, cancer, allergy, autoimmunity and autoinflammatory diseases. This article provides an overview of current trends in the field of innate immunity and its role in the control of infection and disease

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Efficient bibliographic searches on allergy using ISI databases

The aim of this article is to provide an introduction to using databases from the Thomson ISI Web of Knowledge, with special reference to Citation Indexes as an analysis tool for publications, and also to explain the meaning of the well-known Impact Factor. We present the partially modified new Consultation Interface to enhance information search routines of these databases. It introduces distinctive methods in search bibliography, including the correct application of analysis tools, paying particular attention to Journal Citation Reports and Impact Factor. We finish this article with comment on the consequences of using the Impact Factor as a quality indicator for the assessment of journals and publications, and how to ensure measures for indexing in the Thomson ISI Databases

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