RESUMO
BACKGROUND: Immune response failure against hepatitis C virus (HCV) has been associated with an increased regulatory T cell (Treg) activity. After liver transplantation (LT), 80% of patients experience an accelerated progression of hepatitis C recurrence. The aim of this work was to assess the involvement of Tregs, T helper (Th) 1, 2 and 17 cells in recurrent hepatitis C. METHODS: Peripheral blood cells obtained before and one month after LT from 22 recipients were analysed. Forty-four key molecules related to Treg, Th1, 2 and 17 responses, were evaluated using qRT-PCR. Liver recipients were classified in two groups according to graft fibrosis evaluated by the METAVIR score on the biopsy performed one year after LT (mild: F ≤ 1, n = 13; severe: F > 1, n = 9). Patients developing a severe recurrence were compared with patients with a mild recurrence. RESULTS: mRNA levels of Treg markers obtained one month after LT were significantly increased in patients with a severe disease course when compared to patients with a mild recurrence. Markers of the Th1 response were elevated in the same group. No differences in the markers determined before LT were observed. CONCLUSION: These findings suggest that Treg, induced by a multifactorial process, which could include a strong Th1 response itself, may play a role in suppressing the early antiviral response, leading to a severe recurrence of hepatitis C.
Assuntos
Hepatite C Crônica/diagnóstico , Transplante de Fígado , Linfócitos T Auxiliares-Indutores/metabolismo , Linfócitos T Reguladores/metabolismo , Idoso , Biomarcadores/metabolismo , Antígenos CD28/genética , Antígenos CD28/metabolismo , Ligante de CD40/genética , Ligante de CD40/metabolismo , Antígeno CTLA-4/genética , Antígeno CTLA-4/metabolismo , Progressão da Doença , Feminino , Humanos , Interferon gama/genética , Interferon gama/metabolismo , Subunidade alfa de Receptor de Interleucina-10/genética , Subunidade alfa de Receptor de Interleucina-10/metabolismo , Subunidade beta de Receptor de Interleucina-10/genética , Subunidade beta de Receptor de Interleucina-10/metabolismo , Interleucina-2/genética , Interleucina-2/metabolismo , Subunidade alfa de Receptor de Interleucina-2/genética , Subunidade alfa de Receptor de Interleucina-2/metabolismo , Interleucina-23/genética , Interleucina-23/metabolismo , Masculino , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Recidiva , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Proteínas com Domínio T/genética , Proteínas com Domínio T/metabolismo , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismo , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/genética , Membro 7 da Superfamília de Receptores de Fatores de Necrose Tumoral/metabolismoRESUMO
OBJECTIVE: To study the clinical risk factors for preterm premature rupture of membranes (PROM). METHOD: We conducted a case-control study of 138 patients with PROM between 24 and 35 weeks' gestation and 267 control subjects. RESULTS: In stepwise multiple logistic regression models, the population of cases was more likely to be of low social class. Other risk factors for PROM were smoking in pregnancy, 1st or 2nd-3rd trimester hemorrhages, cervical incompetence and a documented cervico-vaginal infection during index pregnancy. First trimester hemorrhage and a documented cervico-vaginal infection during index pregnancy were associated with preterm PROM both in nulliparous and in multiparous women. CONCLUSION: Few potentially remediable risk factors are associated with the occurrence of preterm PROM.
