Regulación de la expresión del co-receptor CCR5 en sujetos con virus de la inmunodeficiencia humana / Expression regulation of CCR5 co-receptor in human immunodeficiency virus subjects

Objetivos Estudiar la expresión diferencial del co-receptor CCR5, en superficie e intracelularmente, en T4 y T8 de pacientes VIH frente a controles. Evaluar causas y mecanismos de regulación de esa expresión en sujetos VIH. Pacientes Se analizaron muestras de 11 controles y 14 de VIH en terapia antirretroviral. Resultados La expresión de superficie del CCR5 en T4 y T8 depacientes VIH disminuyó un 38 y 53% respectivamentefr ente a controles, observándose diferencias estadísticamente significativas. El CCR5 intracelular en T8 fue similar al de controles, sinembargo, en T4 de VIH la proteína intracelular fue más abundante y, como consecuencia, la cantidad total de CCR5 similar a la total de controles. Conclusiones Existe una regulación diferencial en la expresión del CCR5 en T4 y T8 de VIH en relación a controles. En ambas subpoblaciones, la expresión de superficie se halla disminuida, hecho que parece responder a razones diferentes: en T4 se produce internalización de CCR5 quizá como consecuencia de ser arrastrado al interior celular en el proceso de infección por el virus, pero su expresión global es similar a la de controles, en T8 en cambio, no hay internalización sino regulación negativa del receptor en superficie, probablemente consecuencia de la sobreexpresión de interleuquinas ligando del co-receptor que se observaen estos pacientes. Son necesarios estudios que evalúen y expliquen el diferente comportamiento de estas subpoblaciones en la regulación del CCR5 para ampliar el conocimiento sobre la fisiopatología de la enfermedad y facilitar la elección de terapias más efectivas y menos agresiva

Objectives To study the differential expression of CCR5 co-receptor, in surface and intracellularly, in T4 and T8 cells of HIV patients respect to controls. To evaluate causes and mechanisms of that expression regulation in HIV subjects. Patients II controls and 14 HN patients with antirretroviral therapy were studied. Results CCR5 surface expression of HN, both in T4 and in T8, was diminished 38 and 53% respectively respect to controls with significant differences. CCR5 intracellular in T8 was similar to controls, never the less, the intracellular protein in T4 was more abundant and as a consequence, the total amount of CCR5 was similar to the total (surface+intracellular)in controls. Conclusions It exists a diferential regulation in the expression of CCR5 in T4 and T8 of HIV regard to controls. In both subpopulations, the surface expression is diminished,lact that seems to respond to different reasons: In T4 was produced a CCR5 internalization, perhaps as aresult 01 being dragged to the citosol in the virus infection process, but its global expression was similar to controls. However, in T8 there was not internalization but negative regulation of surface receptor, probably due to the sobreexpression of interleukins binding of the co-receptor, what is characteristic in these patients. They are necessary studies that evaluate and explain the different behavior of these subpopulations in the CCR5 regulation to extend the knowledge on the physiopathology of the disease and to facilitate the election of more effective and less aggressive therapies

[Monoclonal gammopathy: a frequently overlooked diagnosis]. / Gammapatía monoclonal: un diagnóstico frecuentemente soslayado.

OBJECTIVE: To know the rate of occurrence of monoclonal bands in a clinical laboratory as an estimate of monoclonal gammopathy incidence, and to detect the proportion of these bands in which an explicit clinical diagnosis or follow-up request is not established. Other objectives are to describe its distribution and the characteristics of the patients. PATIENTS AND METHODS: 200 patients were studied in which a monoclonal band had been detected de novo. RESULTS: The incidence was 6.59 x 10(-4) year(-1). In 59.5% a diagnostic assumption was not stated. Most frequent diagnosis in the group of patients with a diagnosis was monoclonal gammopathy with uncertain meaning. Average age of patients was 74.4 years and the difference between percentages by sex was statistically significant. DISCUSSION: The data suggest a lack of clinical effort when the result is the appearance of a monoclonal band. There is no discrepancy in the distribution of the bands and in the characteristics of the patients with regard to what is described in other studies.

[Diagnosis of Gilbert's syndrome: current status of the fasting test. Review of the literature]. / Diagnóstico del síndrome de Gilbert: situación actual del test del ayuno. Revisión de la literatura.

UNLABELLED: Gilbert's syndrome is a benign, often familial condition characterized by recurrent but asymptomatic jaundice. AIM: To describe the involvement of the reduced caloric intake test, used as a diagnostic test in Gilbert's syndrome. METHOD: 49 patients were diagnosed of Gilbert's syndrome for 6 years. 39 patients took 400 kcal/day for three days. The unconjugated bilirubinemia levels were measured at 0, 24, 48 and 72 hours. RESULTS: The 82.05% of test were diagnostics at 24 hours (p < 0.001), while it was necessary 48 hours to 100% of tests were diagnostics (p < 0.05). In any case was necessary to determinate the unconjugated bilirubinemia at 72 hours (p < 0.5). CONCLUSIONS: The best diagnostic efficiency of the reduced caloric intake test is at 48 hours, while the 24 hours determination could be considered diagnostic in a big percentage of the cases. It is not necessary the determination at 72 hours in any case.