RESUMO
Perineuronal nets (PNN) are highly specialized structures of the extracellular matrix around specific groups of neurons in the central nervous system (CNS). They play functions related to optimizing physiological processes and protection neurons against harmful stimuli. Traditionally, their existence was only described in the CNS. However, there was no description of the presence and composition of PNN in the enteric nervous system (ENS) until now. Thus, our aim was to demonstrate the presence and characterize the components of the PNN in the enteric nervous system. Samples of intestinal tissue from mice and humans were analyzed by RT-PCR and immunofluorescence assays. We used a marker (Wisteria floribunda agglutinin) considered as standard for detecting the presence of PNN in the CNS and antibodies for labeling members of the four main PNN-related protein families in the CNS. Our results demonstrated the presence of components of PNN in the ENS of both species; however its molecular composition is species-specific.
Assuntos
Sistema Nervoso Entérico , Matriz Extracelular , Animais , Sistema Nervoso Entérico/metabolismo , Humanos , Camundongos , Masculino , Feminino , Matriz Extracelular/metabolismo , Adulto , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Lectinas de Plantas/metabolismo , Idoso , Especificidade da Espécie , Receptores de N-Acetilglucosamina/metabolismo , Rede Nervosa/metabolismo , Rede Nervosa/química , Neurônios/metabolismoRESUMO
â¢Muscle strength decline is a crucial factor for the course of sarcopenia in inflammatory bowel disease (IBD) patients. â¢There is a need to discuss the association between IBD and sarcopenia focusing not only on changes of muscle mass, but also on muscle strength. â¢A narrative review was conducted in order to present the set of factors with impact in both muscle strength and IBD. â¢Inflammation, reduced nutrient intake and malabsorption, changes in body composition and gut microbiota dysbiosis are most likely the main factors with impact on muscle strength in IBD patients. Inflammation, changes in nutrient absorption and gut dysbiosis are common conditions in patients with inflammatory bowel disease. These factors may lead to variations in macro- and micronutrients and, particularly, to an imbalance of protein metabolism, loss of muscle mass and development of sarcopenia. This narrative review aims to present the set of factors with impact in muscle strength and physical performance that may potentially mediate the relation between inflammatory bowel disease and sarcopenia. Studies that associated changes in muscle strength, sarcopenia and inflammatory bowel disease were selected through a literature search in databases Medline, Pubmed and Scielo using relevant keywords: muscle strength, physical performance, sarcopenia and inflammatory bowel disease. Chronic inflammation is currently reported as a determinant factor in the development of muscle atrophy in inflammatory bowel disease. In addition, strength decline in inflammatory bowel disease patients may be also influenced by changes in body composition and by gut dysbiosis. Measures of muscle strength and physical performance should be considered in the initial identification of sarcopenia, particularly in patients with inflammatory bowel disease, for a timely intervention can be provided. Presence of proinflammatory cytokines, high adiposity, malabsorption and consequent deficits of macro and micronutrients, loss of muscle mass, and gut dysbiosis may be the main factors with impact in muscle strength, that probably mediate the relation between inflammatory bowel disease and sarcopenia.
Assuntos
Doenças Inflamatórias Intestinais , Sarcopenia , Humanos , Sarcopenia/complicações , Disbiose/complicações , Doenças Inflamatórias Intestinais/complicações , Força Muscular , Inflamação , MicronutrientesRESUMO
ABSTRACT Inflammation, changes in nutrient absorption and gut dysbiosis are common conditions in patients with inflammatory bowel disease. These factors may lead to variations in macro- and micronutrients and, particularly, to an imbalance of protein metabolism, loss of muscle mass and development of sarcopenia. This narrative review aims to present the set of factors with impact in muscle strength and physical performance that may potentially mediate the relation between inflammatory bowel disease and sarcopenia. Studies that associated changes in muscle strength, sarcopenia and inflammatory bowel disease were selected through a literature search in databases Medline, Pubmed and Scielo using relevant keywords: muscle strength, physical performance, sarcopenia and inflammatory bowel disease. Chronic inflammation is currently reported as a determinant factor in the development of muscle atrophy in inflammatory bowel disease. In addition, strength decline in inflammatory bowel disease patients may be also influenced by changes in body composition and by gut dysbiosis. Measures of muscle strength and physical performance should be considered in the initial identification of sarcopenia, particularly in patients with inflammatory bowel disease, for a timely intervention can be provided. Presence of proinflammatory cytokines, high adiposity, malabsorption and consequent deficits of macro and micronutrients, loss of muscle mass, and gut dysbiosis may be the main factors with impact in muscle strength, that probably mediate the relation between inflammatory bowel disease and sarcopenia.
RESUMO Inflamação, alterações na absorção de nutrientes e a disbiose intestinal são condições comuns em indivíduos com doença inflamatória intestinal. Estes fatores podem levar a variações corporais do teor de macro e micronutrientes e, em particular, a um desequilíbrio no metabolismo de proteínas com perda de massa muscular e desenvolvimento de sarcopenia. Esta revisão narrativa visa apresentar o conjunto de fatores com impacto na força e função muscular que podem potencialmente mediar a relação entre doença inflamatória intestinal e sarcopenia. Estudos que associaram as alterações de força muscular, sarcopenia e doença inflamatória intestinal foram selecionados, através de uma pesquisa bibliográfica nas bases de dados Medline, Pubmed e Scielo, usando palavras-chave relevantes: força muscular, desempenho físico, sarcopenia e doença inflamatória intestinal. A inflamação crónica é atualmente citada como um fator determinante no desenvolvimento de atrofia muscular nos casos de doença inflamatória intestinal. Além disso, o declínio de força em indivíduos com doença inflamatória intestinal, também pode ser influenciado pelas alterações na composição corporal e pela disbiose instestinal. Indicadores de força muscular e de desempenho físico devem ser considerados na identificação inicial de sarcopenia, principalmente em indivíduos com doença inflamatória intestinal, para que uma intervenção precoce possa ocorrer. A presença de citocinas pró-inflamatórias, elevada adiposidade corporal, má absorção intestinal com consequente déficit de macro e micronutrientes, perda de massa muscular e disbiose intestinal poderão ser os principais fatores com impacto na força muscular, que provavelmente medeiam a relação entre doença inflamatória intestinal e sarcopenia.
RESUMO
AIMS: Inflammatory bowel disease is recurrent inflammation that affects the gastrointestinal tract causing changes in intestinal motility. The evolution of these changes is not completely understood. The aim of this study was to evaluate anatomical and functional changes in the colon during the development of acute and chronic DSS-induced ulcerative colitis (UC) in C57Bl/6 mice. MATERIALS AND METHODS: Mice were relocated into 5 groups: control (GC) and groups exposed to DSS 3 % for 2 (DSS2d), 5 (DSS5d) and 7 DSS7d) days (acute UC) or 3 cycles (DSS3C; Chronic UC). Mice were monitored daily. After euthanasia, colonic tissue was assessed with histological, immunofluorescence and colon manometry methods. KEY FINDINGS: Ulcerative Colitis is a chronic disease characterized by overt inflammation of the colon. Here we investigate whether the morphological changes caused by UC in the colonic wall, in tuft cells and in enteric neurons also promote any alteration in colonic motility patterns. UC Promotes thickening in the colonic wall, fibrosis, reduction in the number of tuft cells and consequently goblet cells also, without promoting neuronal death however there is a change in the chemical code of myenteric neurons. All of these morphological changes were responsible for causing a change in colonic contractions, colonic migration motor complex, total time of gastrointestinal transit and therefore promoting dysmotility. Further studies stimulating a hyperplasia of tuft cells may be the way to try to keep the colonic epithelium healthy, reducing the damage caused by UC. SIGNIFICANCE: Increasing disease pathology of DSS-induced UC induces structural and neuroanatomical changes and driven damage to cholinergic neurons causes colonic dysmotility, including increase of cholinergic myenteric neurons, followed by variations in the motility pattern of different regions of the colon that taking together characterize colonic dysmotility.
Assuntos
Colite Ulcerativa , Colite , Camundongos , Animais , Colite Ulcerativa/patologia , Colite/induzido quimicamente , Colite/patologia , Colo/patologia , Inflamação/patologia , Doença Crônica , Sulfato de Dextrana/toxicidade , Modelos Animais de Doenças , Camundongos Endogâmicos C57BLRESUMO
RESUMO A neuropatia óptica hereditária de Leber é uma doença mitocondrial hereditária neurodegenerativa. A taxa potencial de recuperação espontânea é controversa na literatura. A terapia genética tem sido estudada como suporte aos pacientes. O objetivo desta revisão foi avaliar qualitativamente a segurança, os efeitos adversos e a eficácia da terapia gênica disponível. Trata-se de uma revisão sistemática de artigos indexados nas bases de dados PubMed®, Biblioteca Virtual em Saúde, SciELO, Cochrane, ScienceDirect, Scopus e Lilacs no primeiro semestre de 2021. Os critérios de inclusão e filtros foram: artigos relacionados ao tema, estudos randomizados, ensaios clínicos, trabalhos em humanos, últimos 5 anos, nas línguas portuguesa, inglesa e espanhola e texto completo disponível gratuitamente. Os parâmetros de exclusão foram: artigos duplicados, fuga ao tema, artigos de revisão, trabalhos não disponíveis e que fugiam aos critérios de inclusão. O coeficiente de kappa foi 0,812. A terapia não apresentou efeitos adversos sérios em nenhum dos artigos selecionados, e os efeitos menores sofreram 100% de remissão espontânea após o tratamento. Apesar de NAbs terem sido encontrados no soro de alguns pacientes, não houve associação entre a resposta imune adaptativa e a injeção do vetor viral. O tratamento foi eficaz na melhora da acuidade e campo visual. Vários estudos confirmaram a eficácia da terapia gênica, em doses baixas e médias, na melhora da acuidade visual e também sobre os efeitos adversos comuns relacionados à altas doses. A resposta imune humoral e a variação dos NAbs no soro foi citada em mais de um artigo. A terapia foi eficaz na melhora da acuidade visual e os efeitos adversos que surgiram foram tratados facilmente. No entanto, a resposta imune humoral ainda precisa ser estudada.
ABSTRACT Leber's Hereditary Optic Neuropathy (LHON) is an inherited neurodegenerative mitochondrial disease. The potential rate of spontaneous recovery is controversial in the literature. Gene therapy has been studied to support patients. The objective of this review was to qualitatively assess the safety, adverse effects, and efficacy of available gene therapy. This is a systematic review of articles indexed in PubMed®, VHL, SciELO, Cochrane, ScienceDirect, Scopus, and Lilacs databases, in the first half of 2021. Inclusion criteria and filters were: articles related to the topic, randomized studies, clinical trials, work in humans, last 5 years, in Portuguese, English, and Spanish and full text available for free. The exclusion parameters were: duplicate articles, not related to the topic, review articles, not available works, and works that did not meet the inclusion criteria. The kappa coefficient was 0.812. The therapy had no serious adverse effects in any of the selected articles, and minor effects experienced 100% spontaneous remission after treatment. Although NAbs were found in the serum of some patients, there was no association between the adaptive immune response and the injection of the viral vector. The treatment was effective in improving acuity and visual field. Several studies have confirmed the effectiveness of gene therapy, at low and medium doses, in improving visual acuity and also on common adverse effects related to high doses. The humoral immune response and the variation in serum NAbs was cited in more than one article. The therapy was effective in improving visual acuity and the adverse effects that arose were easily treated. However, the humoral immune response still needs to be studied.
Assuntos
Humanos , Terapia Genética/métodos , Atrofia Óptica Hereditária de Leber/genética , Atrofia Óptica Hereditária de Leber/terapia , Terapia Genética/efeitos adversos , Adenoviridae , Resultado do Tratamento , Injeções Intravítreas , NADH Desidrogenase/genética , NADH Desidrogenase/uso terapêuticoRESUMO
Fundamentos: O Acidente Vascular Encefálico (AVE) é uma síndrome de déficit neurológico agudo atribuído à lesão vascular do Sistema Nervoso (SN). As técnicas de Inteligência Artificial (IA) na Medicina como algoritmos de Redes Neurais Artificiais (RNAs) têm ajudado na tomada de decisões clínicas voltadas para essa condição. Objetivo: o objetivo desta revisão será avaliar como as redes neurais artificiais estão sendo utilizadas para a predição de diagnóstico de AVE. Métodos: Trata-se de uma revisão sistemática de artigos indexados nas bases de dados PubMed, BVS, SciELO, Cochrane e SpringerLink, entre janeiro e fevereiro de 2022. Os critérios de inclusão e filtros para esse trabalho foram: artigos relacionados ao tema, estudos randomizados, coorte e ensaios clínicos, trabalhos em humanos, realizados nos últimos 5 anos, apenas nos idiomas Português, Inglês e Espanhol e com texto completo disponível gratuitamente. Os parâmetros de exclusão foram: artigos duplicados, fuga ao tema, artigos de revisão e trabalhos que não preenchiam todos os critérios de inclusão. Resultados: As RNAs estão sendo utilizadas, principalmente, para avaliação de áreas de lesões isquêmicas e hemorrágicas por métodos de segmentação e os exames mais utilizados para a modelagem dos programas têm sido Ressonância Magnética (RM) e Tomografia Computadorizada (TC). Além da TC e RM, a angiorressonância e angiotomografia também estão sendo utilizadas para o modelamento do algoritmo e são úteis por apresentarem maior sensibilidade para detecção de infartos. Conclusão: Algoritmos de segmentação e classificação aplicados nas RNAs fazem parte da medicina personalizada e servem de base para médicos na prática clínica.
Background: Stroke is an acute neurological deficit syndrome attributed to vascular injury to the Nervous System (NS). Artificial Intelligence (AI) techniques in Medicine such as Artificial Neural Networks (ANNs) algorithms have helped in making clinical decisions aimed at this condition. Objective: the objective of this review will be to evaluate how artificial neural networks are being used to predict the diagnosis of stroke. Methods: This is a systematic review of articles indexed in PubMed, VHL, SciELO, Cochrane and SpringerLink databases, between January and February 2022. The inclusion criteria and filters for this work were: articles related to the topic, studies randomized, cohort and clinical trials, studies in humans, carried out in the last 5 years, only in Portuguese, English and Spanish and with full text available free of charge. The exclusion parameters were: duplicate articles, escape from the topic, review articles and works that did not meet all the inclusion criteria. Results: ANNs are being used mainly for the evaluation of areas of ischemic and hemorrhagic lesions by segmentation methods and the most used exams for modeling the programs have been Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). In addition to CT and MRI, magnetic resonance angiography and tomography angiography are also being used to model the algorithm and are useful because they have greater sensitivity for detecting infarctions. Conclusion: Segmentation and classification algorithms applied in ANNs are part of personalized medicine and serve as a basis for physicians in clinical practice.
RESUMO
BACKGROUND: Toxoplasma gondii infection causes intestinal inflammation and diarrhea indicating possible intestinal motor dysfunction. Anatomical studies have shown alterations in the colonic myenteric plexus, but it is unknown whether this impacts motility and therefore whether motility is a target for treatment. We determined whether colonic coordinated movements are compromised by toxoplasmic infection and how it is associated with anatomical changes. METHODS: Male Wistar rats were evaluated at 6, 12, 24, 48, and 72 hours and 30 days postinfection (dpi) and controls. Infected rats received orally 5 × 103 sporulated oocysts of strain ME-49 (genotype II) of T gondii. The colon was collected for anatomical analysis (including the myenteric plexus immunolabeled with HuC/D, nNOS, and ChAT) and motility analysis in vitro (conventional manometry). Fecal output was measured daily. KEY RESULTS: At 12 hours postinfection, T gondii caused hypertrophy of the muscularis externa layer of the distal colon. There was loss of total, nitrergic, and cholinergic myenteric neurons in the proximal colon at 30 day postinfection (dpi); however, only loss of cholinergic neurons was found in the distal colon. Contractile complexes in the middle and distal colon were longer in duration in infected animals, which was associated with slower migration of the colonic motor complex. However, gastrointestinal transit time and fecal pellet output remained unchanged during the T gondii infection. CONCLUSIONS AND INFERENCES: Toxoplasma gondii caused myenteric neuronal loss in the proximal and distal colon and altered the motility pattern in the middle and distal colon to a more propulsive phenotype.
Assuntos
Colo/inervação , Motilidade Gastrointestinal/fisiologia , Músculo Liso/inervação , Neurônios/patologia , Toxoplasmose/fisiopatologia , Animais , Colo/fisiopatologia , Músculo Liso/fisiopatologia , Plexo Mientérico , Complexo Mioelétrico Migratório/fisiologia , Ratos , Toxoplasmose/patologiaRESUMO
Introdução: O cuidador informal (CI) presta cuidados a pessoas dependentes, não sendo recompensado economicamente. São inúmeros os fatores de estresse inerentes à tarefa de cuidar, com consequente desgaste físico e emocional. Estudos indicam que as abordagens que englobam a realização de atividade física apresentam um impacto positivo na diminuição da depressão, estresse, raiva e sobrecarga apresentados pelo CI. Objetivo: Reduzir a sobrecarga do CI, com vista à capacitação da tarefa de cuidar, pela aquisição de ferramentas na gestão da sobrecarga. Métodos: De uma listagem de 90 utentes com a codificação "demência" e 50 com "atraso mental" realizou-se o diagnóstico de situação através da aplicação da escala de Zarit que avalia a sobrecarga dos CI. Destes, 13 mostraram interesse em participar na intervenção, que consistiu em sessões de educação para a saúde, sessões de yoga e dinamização de um grupo de apoio. Foi avaliado o grau de sobrecarga dos participantes e a sua satisfação. Resultados: Os CI eram maioritariamente mulheres (92%), com idade média de 62 anos. Foram realizadas 100% das sessões previstas, com 23% de desistência dos participantes. A sobrecarga moderada a severa ou severa diminuiu de 92.3% para 60% no final da intervenção. Todos os CI classificaram o projeto como "bom" ou "muito bom". Discussão: O projeto cumpriu a planificação inicial, tendo-se verificado uma diminuição do grau de sobrecarga do CI como evidenciado em outros estudos. Destaca-se como limitação a dificuldade do CI na realização de outras atividades além de cuidar do seu dependente. Conclusão: A intervenção teve um impacto positivo nos CI, tendo cumprido os objetivos inicialmente propostos. A equipa de saúde deu continuidade a este projeto através de uma parceria com uma cooperativa de solidariedade social local.
Introduction: The informal caregiver (IC) provides assistance to disabled people without any financial gratification. Many stress factors are associated with the task of taking care of others, leading to physical and emotional deterioration. Studies indicate that approaches involving physical activity have a positive impact on the reduction of depression, stress, anger and overload presented by the IC. Objective: To reduce IC overload with a view to enabling the task of caring by acquiring tools for overload management. Methods: The data collection of ICs overload was made using Zarit scale from a previous database of 90 patients classified as "dementia" and 50 as "mental retardation". 13 IC's express their interest to be part of the project. The intervention consisted in health education sessions; yoga classes; establishment of a support group. The participant's degree of overload and their satisfaction were assessed. Results: IC were mainly women (92%), with average age of 62 years. All scheduled sessions took place, with 23% participants withdrawing. Moderate to severe or severe overload level reduced from 92.3% to 60% at the end of the intervention and all participants classified the project as "good" or "very good". Discussion: The project fulfilled the initial planning. Decrease of the IC overload was noted as evidenced in other studies. The limitation is the difficulty of IC in performing other activities besides then taking care of its dependent. Conclusions: The intervention had a positive impact in the ICs and the main goals were achieved. The health team continued this project through a partnership with a local social solidarity cooperative.
Introducción: El cuidador informal (CI) presta cuidados a las personas dependientes, no siendo recompensado económicamente. Son innumerables los factores de estrés inherentes a la tarea de cuidar, con consiguiente desgaste físico y emocional. Los estudios indican que los enfoques que incluyen la actividad física tienen un impacto positivo en la reducción de la depresión, el estrés, la ira y la sobrecarga que presenta el CI. Objetivo: Reducir la sobrecarga del CI, con miras a la capacitación de la tarea de cuidar y la adquisición de herramientas en la gestión de la sobrecarga. Métodos: De una lista de 90 pacientes con la clasificación "demencia" y 50 con "retraso mental" se realizó el diagnóstico de sobrecarga del CI, aplicándose la escala de Zarit. De ellos, 13 mostraron interés en participar en la intervención, que consistió en sesiones de educación para la salud, sesiones de yoga y dinamización de un Grupo de Apoyo. Se evaluó el grado de sobrecarga de los participantes y su satisfacción. Resultados: Los CI fueron en su mayoría mujeres (92%), con una edad promedio de 62 años. El 100% de las sesiones se llevaron a cabo, y el 23% de los participantes se rindieron. La sobrecarga moderada a severa o severa disminuyó del 92,3% al 60% al final de la intervención. Todos los CIs calificaron el proyecto como "bueno" o "muy bueno". Discusión: El proyecto cumplió la planificación inicial, habiéndose comprobado una disminución del grado de sobrecarga del CI como lo demuestran otros estudios. Se destaca como limitación la dificultad del CI en la realización de otras actividades además de cuidar de su dependiente. Conclusión: La intervención tuvo un impacto positivo en los CI, habiendo cumplido los objetivos inicialmente propuestos. El equipo de salud continuó este proyecto a través de una asociación con una cooperativa de solidaridad social local.