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1.
Nat Commun ; 14(1): 4174, 2023 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-37443074

RESUMO

Since the emergence of SARS-CoV-2, vaccines targeting COVID-19 have been developed with unprecedented speed and efficiency. CoronaVac, utilising an inactivated form of the COVID-19 virus and the mRNA26 based Pfizer/BNT162b2 vaccines are widely distributed. Beyond the ability of vaccines to induce production of neutralizing antibodies, they might lead to the generation of antibodies attenuating the disease by recruiting cytotoxic and opsonophagocytic functions. However, the Fc-effector functions of vaccine induced antibodies are much less studied than virus neutralization. Here, using systems serology, we follow the longitudinal Fc-effector profiles induced by CoronaVac and BNT162b2 up until five months following the two-dose vaccine regimen. Compared to BNT162b2, CoronaVac responses wane more slowly, albeit the levels remain lower than that of BNT162b2 recipients throughout the entire observation period. However, mRNA vaccine boosting of CoronaVac responses, including response to the Omicron variant, induce significantly higher peak of antibody functional responses with increased humoral breadth. In summary, we show that vaccine platform-induced humoral responses are not limited to virus neutralization but rather utilise antibody dependent effector functions. We demonstrate that this functionality wanes with different kinetics and can be rescued and expanded via boosting with subsequent homologous and heterologous vaccination.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Vacina BNT162 , SARS-CoV-2 , COVID-19/prevenção & controle , Vacinação , Fragmentos Fc das Imunoglobulinas , Anticorpos Neutralizantes , Anticorpos Antivirais
2.
bioRxiv ; 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35923313

RESUMO

Since the emergence of the SARS-CoV-2 virus, we have witnessed a revolution in vaccine development with the rapid emergence and deployment of both traditional and novel vaccine platforms. The inactivated CoronaVac vaccine and the mRNA-based Pfizer/BNT162b2 vaccine are among the most widely distributed vaccines, both demonstrating high, albeit variable, vaccine effectiveness against severe COVID-19 over time. Beyond the ability of the vaccines to generate neutralizing antibodies, antibodies can attenuate disease via their ability to recruit the cytotoxic and opsinophagocytic functions of the immune response. However, whether Fc-effector functions are induced differentially, wane with different kinetics, and are boostable, remains unknown. Here, using systems serology, we profiled the Fc-effector profiles induced by the CoronaVac and BNT162b2 vaccines, over time. Despite the significantly higher antibody functional responses induced by the BNT162b2 vaccine, CoronaVac responses waned more slowly, albeit still found at levels below those present in the systemic circulation of BNT162b2 immunized individuals. However, mRNA boosting of the CoronaVac vaccine responses resulted in the induction of significantly higher peak antibody functional responses with increased humoral breadth, including to Omicron. Collectively, the data presented here point to striking differences in vaccine platform-induced functional humoral immune responses, that wane with different kinetics, and can be functionally rescued and expanded with boosting.

3.
Ann Oncol ; 29(10): 2141-2142, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30032204
4.
Mucosal Immunol ; 9(6): 1528-1536, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26838048

RESUMO

Understanding vaginal and rectal HIV transmission and protective cellular and molecular mechanisms is critical for designing new prevention strategies, including those required for an effective vaccine. The determinants of protection against HIV infection are, however, poorly understood. Increasing evidence suggest that innate immune defenses may help protect mucosal surfaces from HIV transmission in highly exposed, uninfected subjects. More recent studies suggest that systemically administered type 1 interferon protects against simian immunodeficiency virus infection of macaques. Here we hypothesized that topically applied type 1 interferons might stimulate vaginal innate responses that could protect against HIV transmission. We therefore applied a recombinant human type 1 interferon (IFN-ß) to the vagina of rhesus macaques and vaginally challenged them with pathogenic simian/human immunodeficiency virus (SHIV). Vaginal administration of IFN-ß resulted in marked local changes in immune cell phenotype, increasing immune activation and HIV co-receptor expression, yet provided significant protection from SHIV acquisition as interferon response genes were also upregulated. These data suggest that protection from vaginal HIV acquisition may be achieved by activating innate mucosal defenses.


Assuntos
Antivirais/administração & dosagem , Interferon beta/administração & dosagem , Síndrome de Imunodeficiência Adquirida dos Símios/prevenção & controle , Síndrome de Imunodeficiência Adquirida dos Símios/transmissão , Vírus da Imunodeficiência Símia/efeitos dos fármacos , Administração Intravaginal , Administração Tópica , Animais , Biomarcadores , Antígenos CD4/metabolismo , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Ativação Linfocitária/imunologia , Macaca mulatta , Macrófagos/imunologia , Macrófagos/metabolismo , Células Mieloides/efeitos dos fármacos , Células Mieloides/imunologia , Células Mieloides/metabolismo , Fenótipo , Receptores CCR5/metabolismo , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Vírus da Imunodeficiência Símia/imunologia , Subpopulações de Linfócitos T/efeitos dos fármacos , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismo , Vagina/imunologia , Vagina/virologia , Carga Viral
5.
Mucosal Immunol ; 9(6): 1584-1595, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-26883728

RESUMO

Although the development of a fully protective HIV vaccine is the ultimate goal of HIV research, to date only one HIV vaccine trial, the RV144, has successfully induced a weakly protective response. The 31% protection from infection achieved in the RV144 trial was linked to the induction of nonneutralizing antibodies, able to mediate antibody-dependent cell-mediated cytotoxicity (ADCC), suggestive of an important role of Fc-mediated functions in protection. Similarly, Fc-mediated antiviral activity was recently shown to play a critical role in actively suppressing the viral reservoir, but the Fc effector mechanisms within tissues that provide protection from or after infection are largely unknown. Here we aimed to define the landscape of effector cells and Fc receptors present within vulnerable tissues. We found negligible Fc receptor-expressing natural killer cells in the female reproductive and gastrointestinal mucosa. Conversely, Fc receptor-expressing macrophages were highly enriched in most tissues, but neutrophils mediated superior antibody-mediated phagocytosis. Modifications in Fc domain of VRC01 antibody increased phagocytic responses in both phagocytes. These data suggest that non-ADCC-mediated mechanisms, such as phagocytosis and neutrophil activation, are more likely to play a role in preventative vaccine or reservoir-eliminating therapeutic approaches.


Assuntos
Vacinas contra a AIDS/imunologia , Infecções por HIV/imunologia , Infecções por HIV/metabolismo , HIV-1/imunologia , Fagocitose/imunologia , Receptores Fc/metabolismo , Adulto , Anticorpos Monoclonais/imunologia , Biomarcadores , Anticorpos Amplamente Neutralizantes , Citocinas/metabolismo , Feminino , Expressão Gênica , Anticorpos Anti-HIV/imunologia , Infecções por HIV/prevenção & controle , Infecções por HIV/virologia , Humanos , Imunidade Inata , Mediadores da Inflamação/metabolismo , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/metabolismo , Macrófagos/imunologia , Macrófagos/metabolismo , Pessoa de Meia-Idade , Mucosa/imunologia , Mucosa/metabolismo , Mucosa/virologia , Neutrófilos/imunologia , Neutrófilos/metabolismo , Receptores Fc/genética , Adulto Jovem
6.
Clin Exp Immunol ; 183(3): 419-30, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26439909

RESUMO

Killer immunoglobulin-like receptors (KIRs) interact with human leucocyte antigen (HLA) class I ligands and play a key role in the regulation and activation of NK cells. The functional importance of KIR-HLA interactions has been demonstrated for a number of chronic viral infections, but to date only a few studies have been performed in the context of acute self-limited viral infections. During our investigation of CD8(+) T cell responses to a conserved HLA-B57-restricted epitope derived from dengue virus (DENV) non-structural protein-1 (NS1), we observed substantial binding of the tetrameric complex to non-T/non-B lymphocytes in peripheral blood mononuclear cells (PBMC) from a long-standing clinical cohort in Thailand. We confirmed binding of the NS1 tetramer to CD56(dim) NK cells, which are known to express KIRs. Using depletion studies and KIR-transfected cell lines, we demonstrated further that the NS1 tetramer bound the inhibitory receptor KIR3DL1. Phenotypical analysis of PBMC from HLA-B57(+) subjects with acute DENV infection revealed marked activation of NS1 tetramer-binding natural killer (NK) cells around the time of defervescence in subjects with severe dengue disease. Collectively, our findings indicate that subsets of NK cells are activated relatively late in the course of acute DENV illness and reveal a possible role for specific KIR-HLA interactions in the modulation of disease outcomes.


Assuntos
Vírus da Dengue/química , Dengue/imunologia , Células Matadoras Naturais/imunologia , Fragmentos de Peptídeos/imunologia , Receptores KIR3DL1/imunologia , Receptores KIR3DL1/metabolismo , Proteínas não Estruturais Virais/imunologia , Doença Aguda , Adolescente , Criança , Pré-Escolar , Dengue/fisiopatologia , Dengue/virologia , Vírus da Dengue/imunologia , Epitopos de Linfócito T/imunologia , Feminino , Antígenos HLA-B/imunologia , Humanos , Lactente , Células Matadoras Naturais/fisiologia , Leucócitos Mononucleares/imunologia , Masculino , Fragmentos de Peptídeos/metabolismo , Ligação Proteica , Proteínas não Estruturais Virais/metabolismo
8.
Mucosal Immunol ; 5(6): 646-57, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22643849

RESUMO

Human immunodeficiency virus (HIV) and Simian immunodeficiency virus (SIV) disease progression is associated with multifocal damage to the gastrointestinal tract epithelial barrier that correlates with microbial translocation and persistent pathological immune activation, but the underlying mechanisms remain unclear. Investigating alterations in mucosal immunity during SIV infection, we found that damage to the colonic epithelial barrier was associated with loss of multiple lineages of interleukin (IL)-17-producing lymphocytes, cells that microarray analysis showed expressed genes important for enterocyte homeostasis, including IL-22. IL-22-producing lymphocytes were also lost after SIV infection. Potentially explaining coordinate loss of these distinct populations, we also observed loss of CD103+ dendritic cells (DCs) after SIV infection, which associated with the loss of IL-17- and IL-22-producing lymphocytes. CD103+ DCs expressed genes associated with promotion of IL-17/IL-22+ cells, and coculture of CD103+ DCs and naïve T cells led to increased IL17A and RORc expression in differentiating T cells. These results reveal complex interactions between mucosal immune cell subsets providing potential mechanistic insights into mechanisms of mucosal immune dysregulation during HIV/SIV infection, and offer hints for development of novel therapeutic strategies to address this aspect of AIDS virus pathogenesis.


Assuntos
Colo/imunologia , Células Dendríticas/imunologia , Enterócitos/imunologia , Imunidade nas Mucosas , Síndrome de Imunodeficiência Adquirida dos Símios/imunologia , Vírus da Imunodeficiência Símia/fisiologia , Células Th17/imunologia , Animais , Antígenos CD/imunologia , Diferenciação Celular , Linhagem da Célula , Técnicas de Cocultura , Colo/patologia , Colo/virologia , Células Dendríticas/patologia , Células Dendríticas/virologia , Enterócitos/patologia , Enterócitos/virologia , Regulação da Expressão Gênica , Cadeias alfa de Integrinas/deficiência , Cadeias alfa de Integrinas/imunologia , Interleucina-17/deficiência , Interleucina-17/genética , Interleucina-17/imunologia , Interleucinas/deficiência , Interleucinas/genética , Interleucinas/imunologia , Macaca mulatta , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/genética , Membro 3 do Grupo F da Subfamília 1 de Receptores Nucleares/imunologia , Síndrome de Imunodeficiência Adquirida dos Símios/patologia , Síndrome de Imunodeficiência Adquirida dos Símios/virologia , Células Th17/patologia , Células Th17/virologia , Interleucina 22
9.
Mucosal Immunol ; 5(1): 30-40, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21993602

RESUMO

The human gut mucosa is a major site of human immunodeficiency virus (HIV) infection and infection-associated pathogenesis. Increasing evidence shows that natural killer (NK) cells have an important role in control of HIV infection, but the mechanism(s) by which they mediate antiviral activity in the gut is unclear. Here, we show that two distinct subsets of NK cells exist in the gut, one localized to intraepithelial spaces (intraepithelial lymphocytes, IELs) and the other to the lamina propria (LP). The frequency of both subsets of NK cells was reduced in chronic infection, whereas IEL NK cells remained stable in spontaneous controllers with protective killer immunoglobulin-like receptor/human leukocyte antigen genotypes. Both IEL and LP NK cells were significantly expanded in immunological non-responsive patients, who incompletely recovered CD4+ T cells on highly active antiretroviral therapy (HAART). These data suggest that both IEL and LP NK cells may expand in the gut in an effort to compensate for compromised CD4+ T-cell recovery, but that only IEL NK cells may be involved in providing durable control of HIV in the gut.


Assuntos
Infecções por HIV/imunologia , HIV/imunologia , Mucosa Intestinal/metabolismo , Células Matadoras Naturais/metabolismo , Subpopulações de Linfócitos/metabolismo , Terapia Antirretroviral de Alta Atividade , Biomarcadores Farmacológicos/metabolismo , Biópsia , Movimento Celular/efeitos dos fármacos , Movimento Celular/imunologia , Análise Mutacional de DNA , Genótipo , HIV/patogenicidade , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/genética , Antígenos HLA/genética , Antígenos HLA/metabolismo , Humanos , Mucosa Intestinal/imunologia , Mucosa Intestinal/patologia , Células Matadoras Naturais/efeitos dos fármacos , Células Matadoras Naturais/imunologia , Células Matadoras Naturais/patologia , Subpopulações de Linfócitos/efeitos dos fármacos , Subpopulações de Linfócitos/imunologia , Subpopulações de Linfócitos/patologia , Polimorfismo Genético , Receptores KIR/genética , Receptores KIR/metabolismo
10.
J Intern Med ; 265(1): 29-42, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19093958

RESUMO

Increasing evidence supports the notion that the innate immune response, and in particular, natural killer cells play a central role in determining the quality of the host immune response to infection. In this review we highlight recent evidence that suggests that NK cells influence the clinical fate of HIV-infected individuals.


Assuntos
Infecções por HIV/imunologia , HIV-1/fisiologia , Células Matadoras Naturais/fisiologia , Linfócitos T CD8-Positivos/imunologia , Feminino , Predisposição Genética para Doença , Genótipo , Antígenos de Histocompatibilidade Classe I/imunologia , Humanos , Imunidade Celular , Masculino , Receptores KIR/imunologia
11.
J Immunol ; 171(1): 477-88, 2003 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-12817033

RESUMO

Both the magnitude and breadth of HIV-specific immunity were evaluated longitudinally on samples collected from six subjects starting highly active antiretroviral therapy (HAART) preseroconversion (group 1), 11 recently infected subjects starting HAART postseroconversion (group 2), five subjects starting HAART in the second half of the first year of infection (group 3), and six persons starting treatment in the chronic phase of infection (group 4). HIV-specific immunity was measured by IFN-gamma ELISPOT, detecting the frequency of cells responding to a panel of HLA-restricted HIV-1 peptides. Intracellular cytokine staining was used to detect the frequency of HIV-1 Gag p55-specific CD4(+) and CD8(+) T cells in a subset of participants. The magnitude and breadth of HIV-specific responses persisted in all group 1 subjects and in 5 of 11 (45%) group 2 subjects. Both of these parameters declined in 6 of 11 (55%) group 2 and in all group 3 and 4 individuals. All persons who maintained detectable numbers of HIV-1 Gag p55-specific CD4(+) and CD8(+) T cells after starting HAART preserved the intensity and breadth of their HIV-specific effector response. Our results show that HIV-specific immunity can be preserved even if HAART is initiated beyond the acute phase of infection.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , HIV-1/imunologia , Adulto , Fatores Etários , Sequência de Aminoácidos , Relação CD4-CD8 , Linfócitos T CD4-Positivos/efeitos dos fármacos , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD4-Positivos/virologia , Linfócitos T CD8-Positivos/efeitos dos fármacos , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/metabolismo , Linfócitos T CD8-Positivos/virologia , Linhagem Celular Transformada , Feminino , Infecções por HIV/virologia , Humanos , Interferon gama/metabolismo , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Dados de Sequência Molecular , Estudos Retrospectivos , Carga Viral
12.
Biochim Biophys Acta ; 1530(1): 97-110, 2001 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-11341962

RESUMO

Utilizing the transphosphatidylation reaction catalyzed by phospholipase D (PLD) in the presence of a primary alcohol and the short-chain phospholipid PC8, we have characterized the enzyme from human neutrophils. A pH optimum of 7.8-8.0 was determined. PIP(2), EDTA/EGTA, and ATP were found to enhance basal PLD activity in vitro. Inhibitory elements were: oleate, Triton X-100, n-octyl-beta-glucopyranoside, divalent cations, GTPgammaS and H(2)O(2). The apparent K(m) for the butanol substrate was 0.1 mM and the V(max) was 6.0 nmol mg(-1) h(-1). Immunochemical analysis by anti-pan PLD antibodies revealed a neutrophil PLD of approximately 90 kDa and other bands recognized minimally by anti-PLD1 or anti-PLD2 antibodies. The 90-kDa protein is tyrosine-phosphorylated upon cell stimulation with GM-CSF and formyl-Met-Leu-Phe. Protein partial purification using column liquid chromatography was performed after cell subfractionation. Based on the enzyme's regulatory and inhibitory factors, and its molecular weight, these data indicate an enzyme isoform that might be different from the mammalian PLD1/2 forms described earlier. The present results lay the foundation for further purification of this granulocyte PLD isoform.


Assuntos
Neutrófilos/enzimologia , Fosfolipase D/análise , Trifosfato de Adenosina , Cátions Bivalentes , Cromatografia por Troca Iônica , Clonagem Molecular , Detergentes , Ditiotreitol , Inibidores Enzimáticos/farmacologia , Guanosina 5'-O-(3-Tiotrifosfato) , Humanos , Peróxido de Hidrogênio , Concentração de Íons de Hidrogênio , Cinética , Ácido Oleico/farmacologia , Fosfolipase D/genética , Fosfolipase D/isolamento & purificação , Fosfolipase D/metabolismo
13.
Biochim Biophys Acta ; 1545(1-2): 132-45, 2001 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-11342039

RESUMO

Cytoplasmic malate dehydrogenase (cMDH) is a key enzyme in several metabolic pathways. Though its activity has been examined extensively, there are lingering mechanistic uncertainties involving substrate and cofactor binding. To more completely understand this enzyme's interactions with cofactor and substrate ligands, a fluorescent reporter group was introduced into the enzyme's structure. This was accomplished by selective modification of Cys 110. The reaction placed an aminonaphthaline sulfonic acid group near the enzyme's active site. Substrate, inhibitor, and NAD binding activities were characterized using changes in this label's fluorescence. Results demonstrated that both substrate and cofactor molecules bound to the enzyme in the absence of their companion ligands. This is in contrast to strictly ordered cofactor then substrate binding as has been suggested by kinetic analyses of closely related enzymes. Binding results also indicated that the cofactor, NAD, bound to cMDH in a negatively cooperative manner, but substrates and the inhibitor, hydroxymalonate, bound non-cooperatively. Multiple substrate binding modes were identified and interactions between substrate and cofactor binding were found.


Assuntos
Isoenzimas/metabolismo , Malato Desidrogenase/metabolismo , NAD/metabolismo , Animais , Sítios de Ligação , Ligação Competitiva , Citoplasma/enzimologia , Inibidores Enzimáticos/farmacologia , Corantes Fluorescentes , Fluorometria , Isoenzimas/antagonistas & inibidores , Ligantes , Malato Desidrogenase/antagonistas & inibidores , Malatos/metabolismo , Modelos Moleculares , Proteínas Musculares/antagonistas & inibidores , Proteínas Musculares/metabolismo , Miocárdio/enzimologia , Naftalenossulfonatos , Oxaloacetatos/metabolismo , Fragmentos de Peptídeos/química , Ligação Proteica , Suínos , Tartronatos/farmacologia
14.
Belg Tijdschr Nieuwste Geschied ; 31(3-4): 453-95, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-18551800
15.
Biochim Biophys Acta ; 1478(2): 248-56, 2000 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-10825536

RESUMO

Gel exclusion chromatographic studies demonstrate that cytosolic and mitochondrial malate dehydrogenases (cMDH and mMDH) dissociate into subunits in the presence of 0.1% of the non-ionic detergent Triton X-100 (TX-100). The presence of cofactor and catalytically competent cofactor-substrate pairs does not protect mMDH against this dissociation. In contrast, cMDH dimers resist dissociation in the presence of either addition. Since steady state kinetic studies indicate both enzymes are fully active in the presence of 0.1% TX-100, we conclude that quaternary structure is not a kinetically important feature of mMDH structure and cooperativity does not account for mMDH kinetic anomalies. In contrast, cooperativity is a reasonable explanation for cMDH kinetic properties even in the presence of 0.1% TX-100, since this enzyme's subunits associate in the presence of active site ligands. The existence of fully active mMDH subunits raises the possibility that this species rather than the dimer may be a constituent of proposed multi-enzyme complexes of the mitochondrion. Preliminary chromatographic experiments involving gently disrupted mitochondria have found MDH activity in differently sized complexes, all with molecular weights larger than the mMDH dimer but smaller than complexes anticipated for multi-enzyme complexes involving other enzymes and the mMDH dimer.


Assuntos
Malato Desidrogenase/química , Mitocôndrias/enzimologia , Animais , Cromatografia em Gel , Citosol/enzimologia , Cinética , Mitocôndrias Cardíacas/enzimologia , Peso Molecular , Octoxinol , Suínos
17.
J Urol ; 161(2): 455-9, 1999 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9915425

RESUMO

PURPOSE: A phenomenon known as hidden penis has numerous origins, including congenital buried penis and obesity with descent of the escutcheon. No previous report to our knowledge mentions abnormal hypermobility of ventral skin and dartos fascia, which is a major cause of surgical treatment failures. Because the skin and dartos fascia are inadequately attached to Buck's fascia, the corporeal bodies telescope proximally inside the scrotum and pubis. Therefore, the subdermis of the penoscrotal junction must also be tacked to the tunica albuginea ventrally to stabilize the proximal penile skin and prevent the penis from retracting into the scrotum. The surgical technique for correction of the hidden penis in adult and pediatric patients with adequate penile shaft skin is described. MATERIALS AND METHODS: Surgery for hidden penis from multiple causes was performed in 6 adults and 7 children. Tacking sutures were taken from the subdermis of the ventral penoscrotal junction to the tunica albuginea in all cases. A combination procedure with either suprapubic dermatolipectomy, tacking of the penopubic subdermis to the rectus fascia, penoscrotal Z plasty, circumcision revision or lateral penile shaft Z plasty also was performed in some patients. RESULTS: Improvement was noted in all cases. One child requires suprapubic lipectomy for optimal improvement and 3 minor wound problems occurred. CONCLUSIONS: Surgery for hidden penis achieves marked aesthetic and often functional improvement. Surgical failure can be diminished by placing ventral tacking sutures from the tunica albuginea to the subdermis of the penoscrotal junction.


Assuntos
Pênis/anormalidades , Pênis/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Criança , Humanos , Masculino , Pessoa de Meia-Idade
19.
Ann Demogr Hist (Paris) ; (2): 31-62, 1999.
Artigo em Francês | MEDLINE | ID: mdl-19338102
20.
Tech Urol ; 4(2): 70-6, 1998 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9623619

RESUMO

Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.


Assuntos
Pênis/cirurgia , Cirurgia Plástica/métodos , Adulto , Humanos , Ligamentos/cirurgia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão/fisiologia , Ereção Peniana/fisiologia , Cuidados Pós-Operatórios , Retalhos Cirúrgicos/fisiologia , Dispositivos para Expansão de Tecidos
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