RESUMO
Immune defects, thyroid abnormalities, plasma zinc levels, and the presence of gastrointestinal disease were investigated in 43 children with Down's syndrome (DS). Peripheral T lymphocytes with the phenotype of helper cells or cluster of differentiation 4 (CD4) were decreased. Circulating activated T cells (CD3/HLA-DR-positive cells) and large granular lymphocytes (CD16/CD56 positive cells) were increased. Plasma levels of interleukin-6 were higher in DS children than in controls. Serum levels of thyroid-stimulating hormone were increased in DS. Coeliac disease was over-represented in the group of DS children and many of these children also showed increased serum levels of immunoglobulin-G (IgG) specific for gliadin antigen. The increment of serum interleukin-6 was age-related and correlated with anti-gliadin IgG levels in DS. Plasma zinc levels were lower in DS children with coeliac disease and in those with anti-gliadin IgG than in DS without detectable anti-gliadin IgG. Dietary antigens may represent a continuous stimulus for the immune system in this syndrome and interfere with normal immune responses. Altered intestinal absorption of nutrients may in turn affect endocrine functions, brain development, and cognitive performances.
Assuntos
Doença Celíaca/imunologia , Transtornos Cognitivos/imunologia , Síndrome de Down/sangue , Sistema Endócrino/fisiopatologia , Sistema Imunitário/fisiopatologia , Zinco/sangue , Adolescente , Relação CD4-CD8 , Doença Celíaca/sangue , Doença Celíaca/fisiopatologia , Criança , Pré-Escolar , Transtornos Cognitivos/sangue , Transtornos Cognitivos/fisiopatologia , Síndrome de Down/imunologia , Síndrome de Down/fisiopatologia , Humanos , Imunoglobulinas/sangue , Interleucina-6/sangue , Desempenho Psicomotor/fisiologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/imunologia , Glândula Tireoide/imunologia , Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/sangue , Tireotropina/sangueRESUMO
Patients with constipation differ not only from healthy subjects but can also be categorized into two groups: slow transit constipation (STC) and normal transit constipation (NTC) using measures of total intestinal transit time (TITT). We investigated the role of illness behavior and affective state in 45 NTC and 29 STC patients as compared with 20 healthy subjects. All subjects completed the Illness Behavior Questionnaire (IBQ), the Symptom Questionnaire (SQ), and the CES-D to assess illness behavior, psychological distress, and depression. The constipated patients reported more psychological distress than healthy subjects. Within the constipated group, the NTC subjects had significantly higher scores on the IBQ dimensions of hypochondriasis and disease affirmation. Our results suggest that even among constipated patients psychological distress is prominent and that measures of illness behavior help to discriminate among different pathophysiological groups.
