Análisis de marcadores de superficie celular de utilidad en el diagnóstico de la sepsis neonatal: Reporte preliminar / Utility of the cellular surface markers in the diagnosis of neonatal sepsis: Preliminary report

La cuantificación de poblaciones leucocitarias en sangre periférica puede realizarse con ayuda del análisis por citometría de flujo. Los valores de poblaciones leucocitarias en neonatos son frecuentemente contrastados con sangre periférica de adultos. El presente reporte preliminar muestra el análisis de tres muestras de sangre de cordón umbilical de pacientes sanos y tres muestras de sangre periférica de neonatos con diagnóstico de sepsis tardía. Los resultados obtenidos muestran que CD69, CD71 y CD45RO pueden ser de utilidad para diferenciar estados de sepsis en neonatos. En un estudio futuro, la propuesta es realizar un análisis multiparamétrico por citometría de flujo que permita un análisis integral de la sepsis neonatal.

Quantification of leukocyte populations in peripheral blood can be performed using flow cytometry. The leukocyte populations are often contrasted between neonate and adult peripheral blood. This preliminary report shows the analysis of three samples of umbilical cord blood of healthy subjects and three peripheral blood samples of newborns diagnosed with late sepsis. Our results show that CD69, CD71 and CD45RO could be useful to differentiate states of sepsis in neonates. We propose a subsequent study to generate a multiparametric flow cytometry analysis that will allow a comprehensive analysis of neonatal sepsis.

[Response of fetal macrophages in the placenta of pregnant HIV-positive patients with and without antiretroviral treatment]. / Respuesta de los macrófagos fetales en placentas de pacientes embarazadas VIH-1 positivas con tratamiento y sin tratamiento antiretroviral.

We studied the cellular answer of placentary macrophages in pregnant women seropositive to the virus of human immunodefficiency (VIH-1) treated with zidovudina (AZT) and didanosine (ddl). Twenty eight pregnant women were studies; there were four groups of seven patients each: The control group; the group with seropositive women without treatment; the group given AZT, and the group that recieved AZT and ddl. Placentary specimens were obtained immediately after delivery. One hundred and fifty chorionic vellosities of cells. The control group showed an average of 26 Hofbauer cells; the seropositive women without antiretroviral treatment, was 115; the patients who received only AZT, the average was 65; and the ones who received a combine therapy AZT and ddl, cellular average was 44. There were no differences in the weight of the products in all the groups, nor congenital malformations in the newborns. The use of medication antiretroviral suppress viral replication, and so, there is a significant answer in the amount and size of Hofbauer cells. The administration of two medicaments is more effective in the cellular immune answer.

[Ultrastructural analysis of placentas with villitis. Retrospective study]. / Análisis ultraestructural de placentas con villitis. Estudio retrospectivo.

A villitis is a focal or multifocal inflammatory reaction of chorionic villi with infiltration of mononuclear cells and usually is associated with fibrinoid necrosis. The aetiology of villitis could be a transplacental infection of the fetus, especially with virus (VIV), in normal placentae however, the presence of villitis is referred as villitis of unknown ethiology (VED). This study was designed to characterize villitis lesions of 11 placentae, four VIV and seven VED, ultrastructural descriptive comparisons of both types of villitis are discussed. Biopsies were processed with the conventional optic and electronic microscopy techniques. Our ultrastructural observations confirmed the presence of virus in four placentae whereas no virus or bacteria were found in seven placentae. Microvilli were absent or markedly diminished, this finding was associated to the presence of fibrinoid necrosis in the stroma and clinically to intrauterine growth retardation, 4 preterm pregnancies and one obitus. Trophoblast alterations were found in both types of villitis, basal membrane thickness, is some cases associated to electrodense material similar to calcium deposites, vascuolization and the presence of edema in the stroma was observed. In some cases we noted the presence of focal fibrin deposits associated to necrosis zones in the stroma, calcium precipitates and mielinic bodies. Fetal vessels obliteration and intravascular thrombi were found in the syncitiotrophoblast placentae with viral particles CMV or rubivirus associated to an increment in Hofbauer cells and basal membrane calcifications. From our ultrastructural observations, we conclude that both types of villitis are associated to a typic immunologic reaction that induce lose of trophoblast microvilli, mononuclear infiltration and edema. This placental alterations reduce dramatically the maternofetal exchange of gases, nutrients and other active peptides and could be the cause of fetal growth retardation, inmadurity or death.

[Comparative study of the placenta from HIV+ mothers. Ultrastructural analysis]. / Estudio comparativo de la placenta de madres seropositivas a VIH. Análisis ultraestructural.

Perinatal vertical transmission has increased in all the world; it is considered that at the present time there are about one million of children with HIV. Variation goes from 12 to 40%, at different countries. During the last years antiretroviral drugs as AZT, ddI and others have been used to diminish the virus passage via transplacentary. Eighteen placentaes from HIV seropositive women, three corresponded to first trimester, and 15 to the third trimester of gestation; in four cases they were treated with AZT in weeks fourteen (two patients), 26 and 35 of gestation; and one patient received AZT and ddI at week 28. Control group was with ten normal placentaes. Ultraestructural analysis and immuno-peroxidase and immuno-oro with antibody anti gp 41, were done. Ultraestructurally there were different localizations of HIV virus, at sincitiotrophoblast, decidual cells and umbilical vessels (six cases). In 13 cases there was hyperplasia and hypertrophy of macrophages containing a great amount of lysosomes. In one case, where a girl was seropositive many viriones HIV, were identified in macrophages. With immuno-oro viral proteins were seen in cytoplasm an plasmatic membrane, in endothelium of fetal capillars and trophoblast. With immunoperoxidase, four cases were positive. Placentaes with antiretroviral treatment since week 14, trophoblast was more dense by philaments increment. Placentaes with treatment during the third trimester, showed normal morphology with slight increase of philaments. In the cases treated with AZT and ddI, there were not macrophages hyperplasia and hypertrophy, nor viral particles. It is concluded that in seropositive mothers without treatment, the virus may be present in any part of chorionic villi, and in patients with treatment, virus is not identified, but a viral proteins synthesis.