RESUMEN
The mucosa of the female reproductive tract must reconcile the presence of commensal microbiota and the transit of exogenous spermatozoa with the elimination of sexually transmitted pathogens. In the vagina, neutrophils are the principal cellular arm of innate immunity and constitute the first line of protection in response to infections or injury. Neutrophils are absent from the vaginal lumen during the ovulatory phase, probably to allow sperm to fertilize; however, the mechanisms that regulate neutrophil influx to the vagina in response to aggressions remain controversial. We have used mouse inseminations and infections of Neisseria gonorrhoeae, Candida albicans, Trichomonas vaginalis, and HSV-2 models. We demonstrate that neutrophil infiltration of the vaginal mucosa is distinctively contingent on the ovarian cycle phase and independent of the sperm and pathogen challenge, probably to prevent sperm from being attacked by neutrophils. Neutrophils extravasation is a multi-step cascade of events, which includes their adhesion through selectins (E, P and L) and integrins of the endothelial cells. We have discovered that cervical endothelial cells expressed selectin-E (SELE, CD62E) to favor neutrophils recruitment and estradiol down-regulated SELE expression during ovulation, which impaired neutrophil transendothelial migration and orchestrated sperm tolerance. Progesterone up-regulated SELE to restore surveillance after ovulation.
Asunto(s)
Células Endoteliales , Semen , Masculino , Femenino , Ratones , Animales , Infiltración Neutrófila , Vagina , Ciclo MenstrualRESUMEN
STUDY QUESTION: What is the vaginal polymorphonuclear (PMN) spermicidal mechanism to reduce the excess of sperm? SUMMARY ANSWER: We show that PMNs are very efficient at killing sperm by a trogocytosis-dependent spermicidal activity independent of neutrophil extracellular traps (NETs). WHAT IS KNOWN ALREADY: Trogocytosis has been described as an active membrane exchange between immune cells with a regulatory purpose. Recently, trogocytosis has been reported as a mechanism which PMNs use to kill tumour cells or Trichomonas vaginalis. STUDY DESIGN, SIZE, DURATION: We used in vivo murine models and human ex vivo sperm and PMNs to investigate the early PMN-sperm response. PARTICIPANTS/MATERIALS, SETTING, METHODS: We set up a live/dead sperm detection system in the presence of PMNs to investigate in vivo and ex vivo PMN-spermicidal activity by confocal microscopy, flow cytometry and computer-assisted sperm analysis (SCA). MAIN RESULTS AND THE ROLE OF CHANCE: We revealed that PMNs are highly efficient at killing sperm by way of a NETs-independent, contact-dependent and serine proteases-dependent engulfment mechanism. PMNs 'bite' sperm and quickly reduce sperm motility (within 5 min) and viability (within 20 min) after contact. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: This study was conducted using murine models and healthy human blood PMNs; whether it is relevant to human vaginal PMNs or to cases of infertility is unknown. WIDER IMPLICATIONS OF THE FINDINGS: Vaginal PMNs attack and immobilize excess sperm in the vagina by trogocytosis because sperm are exogenous and may carry pathogens. Furthermore, this mechanism of sperm regulation has low mucosal impact and avoids an exacerbated inflammatory response that could lead to mucosal damage or infertility. STUDY FUNDING/COMPETING INTEREST(S): This work was partially supported by Ministry of Economy and Competitiveness ISCIII-FIS grants, PI16/00050, and PI19/00078, co-financed by ERDF (FEDER) Funds from the European Commission, 'A way of making Europe' and IiSGM intramural grant II-PI-MRC-2017. M.R. holds a Miguel Servet II contract (CPII14/00009). M.C.L. holds IiSGM intramural contract. There are no competing interests.
Asunto(s)
Neutrófilos , Motilidad Espermática , Animales , Europa (Continente) , Femenino , Humanos , Masculino , Ratones , Espermatozoides , VaginaRESUMEN
In commercial layer poultry farming, molt induction is an important tool used by egg producers to prolong the production cycle of laying hens. Conventional molt induction programs involve total feed withdrawal, which raises questions about animal welfare and increased infection susceptibility. The high incidence of paratyphoid salmonellosis infections in commercial poultry farming is still an important health challenge because in addition to affecting the birds, such infections also cause public health problems. In this context, experiments were performed with laying hens at 79 wk of age to compare the conventional forced molting method (fasting) with an alternative method (free wheat bran supply) and determine their effect on the persistence of vaccine antibodies against Newcastle disease, the control and reduction of experimentally inoculated Salmonella Enteritidis, and the performance and egg quality of hens. A reduction (P < 0.05) of Salmonella Enteritidis in the crop and lower production of corticosterone were observed in the birds that received wheat bran compared with those subjected to total fasting. Moreover, a better performance (P < 0.05) with regard to egg production, egg mass, and feed conversion/kg and dozen eggs was observed in the hens that received the alternative treatment compared to the conventional forced molting method. Thus, the use of wheat bran for forced molting was found to be feasible and met the welfare needs of the hens.
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Crianza de Animales Domésticos/métodos , Pollos , Corticosterona/sangre , Muda , Enfermedades de las Aves de Corral/prevención & control , Reproducción/efectos de los fármacos , Salmonelosis Animal/prevención & control , Alimentación Animal/análisis , Animales , Anticuerpos Antivirales/sangre , Dieta/veterinaria , Fibras de la Dieta/administración & dosificación , Femenino , Privación de Alimentos/fisiología , Virus de la Enfermedad de Newcastle/inmunología , Óvulo/efectos de los fármacos , Óvulo/fisiología , Enfermedades de las Aves de Corral/microbiología , Distribución Aleatoria , Salmonelosis Animal/microbiología , Salmonella enteritidis/fisiologíaRESUMEN
An epidemiological study was carried out to determine the spatial-temporal trends and risk factors potentially involved in the seropositivity to bluetongue virus (BTV) in hunting areas with presence of red deer (Cervus elaphus). A total of 60 of 98 (61.2%; CI95% : 51.6-70.9) hunting areas sampled presented at least one seropositive red deer. Antibodies against BTV were detected in juvenile animals during the hunting seasons 2007/2008 to 2013/2014 in 15 of 98 (15.3%) hunting areas, which indicates an uninterrupted circulation of BTV in this period. A multivariate logistic regression model showed that the red deer density at hunting area level (>22 individuals/km(2) ), the annual abundance of Culicoides imicola (>1.4 mosquitoes/sampling) and the goat density at municipality level (>24.1 individuals/km(2) ) were factors significantly associated with BTV seropositivity in hunting areas. Control measures against BTV in the studied area include vaccination programmes in wild and domestic ruminants, movement control in areas with high densities and abundance of red deer and C. imicola, respectively. Considering the potential risk of BTV re-emergence, red deer should be included in the BT surveillance programmes in regions where these species share habitats with livestock.
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Animales Domésticos/virología , Virus de la Lengua Azul/aislamiento & purificación , Lengua Azul/epidemiología , Ciervos/virología , Animales , Anticuerpos Antivirales/aislamiento & purificación , Lengua Azul/prevención & control , Ceratopogonidae/virología , Estudios Transversales , Cabras/virología , Modelos Logísticos , Recreación , Factores de Riesgo , Rumiantes/virología , Estudios Seroepidemiológicos , Ovinos/virología , España/epidemiología , VacunaciónRESUMEN
Con el fin de disminuir el tiempo de isquemia durante la nefrectomía parcial, se han diseñado distintas opciones como clampeo arterial selectivo, técnica sin clampeo con hipotermia corporal y técnica de des clampeo precoz (DP). El objetivo del presente trabajo es analizar el resultado y complicaciones de un grupo de pacientes sometidos a nefrectomía parcial laparoscópica (NPL), aplicando la técnica de DP. Materiales y métodos: A través de una base de datos que se mantiene prospectivamente, se analizó los datos clínicos de los pacientes sometidos a nefrectomía parcial laparoscópica con técnica de desclampeo precoz entre los años 2010 y 2011.Resultados: Once pacientes fueron sometidos a NPL con técnica de DP entre agosto de 2010 y diciembre de 2011. Seis hombres y 5 mujeres, mediana de edad 59 (43-76) años. El tiempo operatorio fue de 180 min (180-220), con tiempo de clampeo 19,5 min (11-23). El sangrado total fue 300 ml (180-2.500). No hubo necesidad de conversión a cirugía abierta, pero un paciente requirió nefrectomía radical por sangrado importante. Márgenes positivos se encontró en un solo caso. Conclusión: El desclampeo precoz permite disminuir el tiempo de isquemia en la nefrectomía parcial laparoscópica, sin aumentar el riesgo de sangrado. Además, podría disminuir las complicaciones vasculares. Sin embargo, técnicamente es una cirugía compleja que requiere entrenamiento adecuado...
To decrease the time of ischemia during partial nephrectomy, various options were designed as selective arterial clamping, unclamping technique with body hypothermia and early unclumping technique (EU). The aim of this paper is to analyze the results and complications of a group of patients undergoing laparoscopic partial nephrectomy (LPN), using the EU technique. Materials and Methods: Using a prospective database, the clinical data of patients undergoing laparoscopic partial nephrectomy with early uncclamping technique between 2010 and 2011 is analyzed. Results: 11 patients underwent LPN with EU technique between August 2010 and December 2011. 6men and 5 women, median age 59 (43-76) years. The operative time was 180 min (180-220), with clamping time 19.5 min (11-23). The total estimated bleeding was 300 ml (180-2500). There was no need for conversion to open surgery, but one patient required radical nephrectomy due major bleeding. Positive margins were found in one case Conclusion: Early unclamping technique decreases the ischemia time in laparoscopic partial nephrectomy without increasing the risk of bleeding. Furthermore, it may reduce vascular complications. However, this is a technically demanding surgery that requires proper training...
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Isquemia/prevención & control , Laparoscopía/efectos adversos , Nefrectomía/efectos adversos , Neoplasias Renales/cirugía , Complicaciones Posoperatorias , Factores de Tiempo , Laparoscopía/métodos , Nefrectomía/métodos , Pérdida de Sangre Quirúrgica/prevención & control , Tempo Operativo , Tiempo de InternaciónRESUMEN
Objetivo: Análisis de la sobrevida y de los factores que influyen en el pronóstico del cáncer vesical infiltrante. Material y métodos: Se realiza un estudio retrospectivo de pacientes con el diagnóstico de cáncer vesical infiltrante sometidos a cirugía entre los años 1996-2006. Se realiza un análisis de sobrevida mediante Método de Kaplan-Meier y se analizan las variables que influyen en el pronóstico. Resultados: La serie consta de 78 pacientes que ingresaron al Servicio de Urología y que presentaron cáncer vesical infiltrante. La edad promedio es de 69,11 años, siendo el 65,38 por ciento de los pacientes (51) de sexo masculino. El tipo histológico predominante fue Carcinoma de Células Transicionales (69,2 por ciento).De los 78 pacientes de la serie, el 52,5 por ciento (41) fue sometido a cistectomía radical. El resto sólo tuvo procedimientos de carácter paliativo para control local de la enfermedad. Respecto de la presentación según etapas (clasificación TNM-AJCC), el 40 por ciento de los pacientes se presentó en etapa II, 20 por ciento en etapa III y un 40 por ciento en etapa IV. El seguimiento promedio fue de 22,1 meses. La sobrevida cáncer específica estimada según Kaplan- Meier fue de 54,3 por ciento, 34,6 por ciento, 25,9 por ciento a 1, 3 y 5 años respectivamente. El factor más importante que se correlaciona con la sobrevida fue la etapa de presentación. Conclusión: En nuestra serie el cáncer vesical infiltrante se presenta en etapas avanzadas (etapa IIIy IV) lo que limita las posibilidades de ofrecer procedimientos efectivos con intención curativa asociándose a una baja sobrevida. Se hace necesario aumentar los esfuerzos para una pesquisa precoz y ofrecer un manejo terapéutico activo a estos pacientes.
Objective: Survival and prognostic factors analysis in Muscle-Invasive Bladder Cancer. Material and Methods: A retrospective analysis of patients with Muscle-Invasive Bladder Cancer between years 1996-2006. Survival analysis was made with Kaplan-Maier method and prognostic variables that affect the survival were analyzed. Results: Our study cohort included 78 patients who were hospitalized at the Urology Service with the diagnosis of Muscle-Invasive Bladder Cancer. The mean patient age was 69.11 years, being a 65.38 percent (51) men. Predominant histological type was Transitional Cell Carcinoma (69,2 percent). 52.5 percent (41/78 patients)under went Radical Cystectomy. The rest of the patients only received palliative procedures for the local control of the disease. According to staging (TNM-AJCC classification), 40 percent of the patients were diagnosed at stage II, 20 percent at stage III and 4 at stage IV. Mean follow up time was 22.1 months. Cancer specific survival estimated with Kaplan-Maier method was 54.3 percent, 34.6 percent, 25.9 percent for 1, 3 and 5 years respectively. Most important variable that correlates with survival was stage at diagnosis. Conclusion: In our series invasive bladder cancer is diagnosed at advanced stages (III and IV), which reduces the possibilities of getting effective procedures with curative intention, resulting in a low survival rates. It is mandatory improve the efforts in order to obtain a early diagnosis and to offer an active treatment to those patients.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano de 80 o más Años , Cistectomía , Neoplasias de la Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/mortalidad , Análisis de Supervivencia , Estudios Retrospectivos , Estudios de Seguimiento , Invasividad Neoplásica , Neoplasias de la Vejiga Urinaria/patología , PronósticoRESUMEN
BACKGROUND: Ionic dialysance may be equivalent to blood-water urea clearance corrected for recirculation (effective urea clearance); however, this is controversial. The aims of our study were (1) to verify in vivo whether the value of ionic dialysance is affected by the method of determination, given the effect of cardiopulmonary recirculation on inlet plasma water conductivity when the inlet dialysate conductivity is changed; and (2) to define the operative modalities for determining ionic dialysance to obtain an adequate estimate of effective urea clearance. METHODS: Thirty-three hemodialysis patients were studied during 186 dialysis sessions with low-flux polysulfone dialyzers using a modified Fresenius Medical Care 4008 B machine equipped with meters to measure inlet and outlet dialysate conductivities. This machine varied inlet dialysate conductivity (Cdi) according to the following pattern: starting from baseline (step 0), Cdi was increased by 8% (step 1). After Cdi had reached the target value, which took 8 to 10 minutes, it was lowered to 8% below the baseline value (step 2). After 8 to 10 minutes, when Cdi had reached the new target, it was returned to its starting value (step 3). Four values of conventional ionic dialysance (using the standard formula) and actual ionic dialysance (taking into account cardiopulmonary recirculation) were obtained for each cycle and were compared among them and with effective urea clearance (Kde). RESULTS: Mean conventional dialysance values at steps 0 to 2 and 2 to 3 (190 and 189 mL/min) were similar and higher than those at steps 0 to 1 and 1 to 2 (171 and 181 mL/min). Mean conventional ionic dialysance values underestimated Kde, particularly at steps 0 to 1 (-22.2 mL/min, P < 0.001) and 1 to 2 (-12.6 mL/min, P < 0.001). The actual dialysance values underestimated Kde by no more than 4.3 mL/min (P < 0.001). In steps 0 to 1 and 1 to 2, the underestimate of Kde by conventional dialysance increased at higher values of Kde, but this relationship did not exist when considering actual dialysance. CONCLUSIONS: The value of ionic dialysance is affected by the method of determination, given the effect of cardiopulmonary recirculation on inlet plasma water conductivity when inlet dialysate conductivity is changed. As a consequence, to provide a correct and direct estimate of effective urea clearance, ionic dialysance must be determined by changing inlet dialysate conductivity in such a way as to keep inlet plasma water conductivity constant by means of two symmetrical high and low dialysate conductivity steps.
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Soluciones para Diálisis/química , Diálisis Renal , Terapia Asistida por Computador , Humanos , Iones , Métodos , Urea/sangreRESUMEN
A 39-year-old woman, with proteinuria and microhematuria, at about the 8th week of pregnancy showed a reduction in proteinuria. After the 16th week, proteinuria disappeared. In the 40th week, the patient spontaneously delivered a 1.990-kg still-born female. Six days later, blood pressure increased (to 150/100 mm Hg), and laboratory examinations showed that proteinuria was 2.7 g/24 h. Given that urinalysis confirmed the presence of proteinuria, 6 weeks later, a renal biopsy was performed. The final diagnosis was IgA nephropathy. It is possible that the presence of the fetus may have led to changes in the maternal immunological system which may have attenuated the immunopathogenic mechanisms responsible for IgA nephropathy.
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Glomerulonefritis por IGA/complicaciones , Complicaciones del Embarazo/inmunología , Adulto , Femenino , Muerte Fetal/complicaciones , Muerte Fetal/inmunología , Glomerulonefritis por IGA/inmunología , Humanos , Periodo Posparto , Embarazo , Proteinuria/complicaciones , Recurrencia , Remisión EspontáneaAsunto(s)
Metilprednisolona/efectos adversos , Ciclofosfamida/uso terapéutico , Quimioterapia Combinada , Humanos , Enfermedades Renales/inducido químicamente , Enfermedades Renales/tratamiento farmacológico , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Mieloma Múltiple/tratamiento farmacológico , Prednisolona/uso terapéutico , Vincristina/uso terapéuticoRESUMEN
There are reports that 1,2-dichloropropane, a constituent of many commercial solvents and stain removers in Italy, has caused severe liver damage and, sometimes, acute renal failure. Between 1980 and 1983 three cases of 1,2-dichloropropane intoxication (1 by ingestion, 2 by inhalation) were observed. Clinical features included severe liver damage, acute renal failure (2 patients), haemolytic anaemia, and disseminated intravascular coagulation. The most surprising features were haemolytic anaemia and disseminated intravascular coagulation which have not been reported before. The clinical picture was similar despite different modes of exposure.