[Prevalence of specific antibodies for celiac disease in children attended in the Nutritional Recovery Program in San Miguel de Tucumán, Argentina]. / Prevalencia de anticuerpos específicos para enfermedad celíaca en niños del Programa de Rehabilitación Nutricional en San Miguel de Tucumán, Argentina.

Celiac disease is a systemic autoimmune disease that affects 1.26% of the Argentine pediatric population. Our purpose was to study the prevalence of specific antibodies of celiac disease in a risk group and to find the association with specific factors. This was a cross-sectional study conducted in children ofa Nutritional Recovery Program from 1 year and 9 months to 6 years and 9 months old, from one Health Area of Tucumán Province, during 2010 and 2011, in a random cluster sample. It was studied a population of 175 children. We identified 3 cases with positive serology, equivalent to 1.7% of the study population. The association between cases with positive serology for celiac disease and other variables referred could not be established.

Attenuation of gentamicin-induced nephrotoxicity: trimetazidine versus N-acetyl cysteine.

Gentamicin (G) is a highly nephrotoxic aminoglucoside. It was used to experimentally induce nephrotoxicity in male Wistar rats. To find a drug capable of protecting the nephron we assayed a cardioprotector (trimetazidine, TMZ) and a hepatoprotector (N-acetyl cysteine, NAC). The rats were divided into six groups (n = 8): (A) control without drugs; (B) treated with 50 mg kg(-1) per day (i.p.) of G for 7 days; (C) diet supplemented with 20 mg kg(-1) per day of TMZ for 7 days; (D) treated with 10 mg kg(-1) per day (i.p.) of NAC for 7 days; (E) pretreated for 7 days with 20 mg kg(-1) per day of TMZ and during the following 7 days with G + TMZ; (F) pretreated for 7 days with 10 mg kg(-1) per day (i.p.) of NAC and during the following 7 days with G + NAC. Urea and creatinine as well as the excretion of urinary gamma-glutamyl transpeptidase (GGT(u)) and urinary N-acetyl-glucosaminidase (NAG(u)) were determined and structural and ultrastructural studies were carried out. Group B was used as a G-induced nephrotoxicity control. Pretreatment with TMZ (E) showed a protector effect against induced nephrotoxicity, with no biochemical or functional changes nor alterations in histoarchitecture or ultrastructure. Pretreatment with NAC (F) showed no protector effect against G-induced nephrotoxicity since no statistically significant differences were found with respect to the control group with G. We conclude that G-induced nephrotoxicity is attenuated by the cytoprotective effect of TMZ. We may infer that TMZ inhibits the reabsorption and consequently the accumulation of G in the proximal tubule cell.

Efecto de trimetazidina en la nefrotoxicidad por gentamicina / Trimetazidine effect on nephrotoxicity by gentamicyn

La Trimetazidina (TMZ) es una droga utilizada como cardioprotector, ya que previene la muerte celular secundaria a la isquemia miocárdica. Algunos investigadores le atribuyeron efecto reno-protector, actividad antioxidante y scavenger de radicales libres del oxígeno. El objetivo del presente trabajo es mostrar el efecto citoprotector de TMZ en las alteraciones inducidas por Gentamicina (G) a nivel de la célula del túbulo renal. Se diseñaron esquemas en animales de experimentación tratados con ambas drogas. Ratas macho Wistar de 180 a 200 g de peso fueron distribuidas en 5 grupos (n=8) y tratadas con: dieta estándar (A); suplementada con 20 mg/Kg/día de TMZ durante 27 días (B); suplementada con 50 mg/Kg/día de G durante 7 días(C); pretratadas 20 días con 20 mg/Kg/día de TMZ y los últimos 7 días con G (D) y tratadas simultáneamente durante 7 días con 20 mg/Kg/día de TMZ y 50 mg/Kg/día de G(E). Se midieron los compuestos nitrogenados urea y creatinina, la excreción de gamma glutamiltranspeptidasa urinaria y se efectuaron estudios estructurales con tinción de hematoxilina-eosina y ultraestructurales. Se utilizó el grupo C como testigo de nefrotoxicidad inducida por G. El pretratamiento durante 20 días con TMZ demostró el efecto protector para la nefrotoxicidad inducida, sin cambios bioquímicos-funcionales, ni alteración de la histoarquitectura, ni de la ultraestructura. El tratamiento simultáneo con TMZ y G no mostró efecto protector. Se concluye que en el modelo de ratas macho Wistar se demuestra el efecto citoprotector de TMZ en tratamiento previo por 21 días. El estudio histológico del tejido renal, bajo estas condiciones, presenta histoarquitectura conservada y función renal normal. Se infiere que el efecto citoprotector de TMZ que impide la nefrotoxicidad inducida por G se debe a la inhibición de la reabsorción y acumulación de Gentamicina en la célula del túbulo proximal del nefrón.

Trimetazidine (TMZ) is a drug used as a cardioprotector since it prevents cell death secondary to myocardial ischemia. Some investigators have attributed protective effect, antioxidant activity and oxygen free radical scavenging abilityt to TMZ. The aim of the present work is to show the cytoprotective effect of TMZ on Gentamicin (G)-induced alterations at the level of the renal tubular cell. Schemes were designed in experimental animals treated with both drugs. Male Wistar rats weighing 200 to 260 g were divided into 5 groups (n=8) and treated with: standard diet (A); standard diet supplemented with 20 mg/Kg/day of TMZ for 27 days (B); standard diet supplemented with 50 mg/Kg/day of G for 7 days (C), pretreated for 20 days with 20 mg/Kg/day of TMZ and for the last 7 days with G (D), and treated simultaneously for 7 days with 20 mg/Kg/day of TMZ and 50 mg/Kg/day of G (E). The nitrogen compounds urea and creatinine were measured and so was the excretion of urinary gamma-glutamyl transpeptidase. Structural studies with hematoxilin and eosin staining and ultrastructural studies were also performed. Gentamicin was used as a control for nephrotoxicity (group C). Pretreatment with TMZ showed a protective effect against induced nephrotoxicity, with no biochemical changes or alterations in the histoarchitecture. Simultaneous treatment with TMZ and G (group E) showed no protective effect. Conclusions: the cytoprotective effect of TMZ on G-induced nephrotoxicity would take place at the level of the proximal tubular cell of the brush border by inhibiting G reabsorption and accumulation.

Cambios en el sistema de defensa antioxidante inducido por Ciclosporina A / Changes in the antioxidant defence system induced by Cyclosporin A

La Ciclosporina A (CyA) es un inmunosupresor que presenta efectos adversos como la hepatotoxicidad. Se estudió el efecto de CyA sobre el sistema de defensa antioxidante (SDA), su relación con la lipoperoxidación y la función hepática. Ratas machos wistar de 200-260 g de peso fueron tratadas durante 7 días (agudo) y 120 días (crónico) con dosis orales de CyA de 5 y 20 mg/kg/ día. Se estudió el SDA midiendo el contenido hepático total de glutatión (GSH), glutatión peroxidasa (GPx) y catalasa (CAT); el perfil de funcionamiento hepático (PFH) se realizó determinando aspartato aminotransferasa (AST), alanín aminotransferasa (ALT) y bilirrubina total (Bt) y para la lipoperoxidación se midieron las sustancias reactivas al ácido tiobarbitúrico (SRAT). Los resultados fueron confirmados con estudios histológicos. El tratamiento agudo con 20 mg/kg/día de CyA mostró aumento significativo de SRAT (30,51±1,97 nmol/g), pérdida de GSH (2,47±0,06 µmol/g), incremento significativo de GPx (663,25±1,88 mU/mg) y CAT (290,65±3,31 mU/mg). El tratamiento crónico con 5 mg/kg/día de CyA mostró disminución tiempo-dependiente del SDA con disminución de GSH (3,19±0,05 µmol/g), GPx (569,6±2,67 mU/mg) y CAT (223,3±2,78 mU/mg), sin cambios en SRAT. Los resultados del tratamiento crónico y agudo con 20 mg/kg/día de CyA son coincidentes y sólo en esta dosis se observaron alteraciones de la histo-arquitectura del parénquima hepático. Se concluye que dosis de 20 mg/kg/día de CyA en tratamiento agudo y crónico provocan lipoperoxidación con compromiso del SDA y alteración del hepatocito; dosis de 5 mg/kg/día de CyA en tratamiento crónico producen deterioro reversible del SDA sin lipoperoxidación. La inmunosupresión aplicada en clínica con dosis de 3 a 8 mg/kg/día produciría disminución del SDA sin cambios en la histo-arquitectura del parénquima hepático.

Cyclosporin A (CyA), an immunosuppressive agent, exerts adverse effects such as hepatotoxicity. The effect of CyA on the Antioxidant Defence System(ADS), its relation to lipoperoxidation, and liver function were studied. Assays were performed on male wistar rats weighing 200-260 g during acute (7 days) and chronic (120 days) treatment with oral doses of CyA of 5 and 20 mg/kg/day. ADS was studied in rat liver homogenate by measuring the liver content of total glutathion (GSH), glutathion peroxidase(GPx) and catalase (CAT); the Liver Profile Test (LPT) was measured by determining aspartate amino transferase (AST), alanin amino transferase (ALT) and total bilirubin (TB), and lipoperoxidation by determining thiobarbituric acid reactive substances (TRAS). The results were confirmed by histological studies. In the acute treatment, 20 mg/kg/day with CyA, a significant increase in TRAS (30.51±1.97 nmol/g), a loss of GSH (2.47±0.06 µmol/g) and a significant increase in GPx (663.25±1.88 mU/mg) and CAT (290.65±3.31 mU/mg) were observed. In the chronic treatment, 5 mg/kg/day with CyA, a time-dependent decrease in the ADS with a diminution in GSH (3.19±0.05 µmol/g), GPx (569.6±2.67 mU/mg) and CAT (223.3±2.78 mU/mg) were observed, with no changes in TRAS. The results for the chronic and acute treatment with 20 mg/kg/day of CyA are coincident, only this dose causing alterations in liver parenchyma histoarchitecture. CyA doses of 20 mg/kg/day during acute and chronic treatment cause lipoperoxidation with ADS involvement and hepatocyte alteration. CyA doses of 5 mg/kg/day during chronic treatment cause deterioration in the ADS with no lipoperoxidation, hepatotoxicity being reversible. Immunosuppression in human patients with 3 to 8 mg/kg/day doses, would cause a decrease in the ADS with no structural or functional changes in the hepatocyte.

Hepatotoxic effect of cyclosporin A in the mitochondrial respiratory chain.

UNLABELLED: Cyclosporin A (CyA), a potent immunosuppressant, was used to determine the hepatotoxic effect in long-term treatments. Male Wistar rats were used in these experiments. They were given CyA chronically at doses used in patients for 120 days, and at doses of 5, 10, 15 and 20 mg kg(-1) day(-1). These doses amount to CyA values in blood of 200 +/- 24, 314 +/- 40, 445 +/- 33 and 598 +/- 53 ng ml(-1), respectively. A significant increase in glutamate dehydrogenase (GLDH) was found in the groups treated with 15 and 20 mg kg(-1) day(-1), which would point to mitochondria as the potential target of the toxic action of CyA. The mitochondrial respiratory chain of rat livers was studied in enzyme complexes I and II. Enzyme complex I was determined by spectrophotometry at 340 nm using NADH oxidase with the respirable substrate 10 mm NADH; enzyme complex II was determined by monitoring succinate dehydrogenase by oxymetry using the respirable substrate 10 mm succinate. The results show the inhibition of NADH oxidase in the groups treated with 10, 15 and 20 mg kg(-1) day(-1), an effect dependent both on time and on CyA concentration. Enzyme complex II showed a decrease in oxygen consumption. These findings were confirmed by histological studies (hematoxylin-eosin technique). CONCLUSIONS: Long-term treatment with CyA at doses of 15 and 20 mg kg(-1) day(-1), amounting to concentrations in blood of 445 +/- 33 and 598 +/- 53 ng ml(-1), causes alterations in the mitochondria, revealed by the increase in serum GLDH and by the functional alteration of enzyme complexes I and II of the mitochondrial respiratory chain.