Ação do prebiótico sobre as proteínas de fase aguda de pacientes com neoplasia hematológica / Action of prebiotics on proteins in the acute phase of hematologic neoplasia

Os pacientes com neoplasias hematológicas são submetidos a tratamento quimioterápico que induz uma intensa alteração na integridade da mucosa intestinal, favorecendo um aumento da sua morbi-mortalidade. O presente trabalho foi desenvolvido na Unidade de Transplante de Medula Óssea do Centro de Pesquisas Oncológicas em Florianópolis - SC e teve como objetivo estudar a ação do prebiótico na resposta de proteína da fase aguda de pacientes com neoplasias hematológicas submetidos à quimioterapia. Foi realizado um estudo clínico randomizado duplo cego envolvendo 25 pacientes divididos em dois grupos que receberam por 15 dias: 12g de FOS (n=14) ou placebo (maltodextrina) (n=11). Todas as variáveis foram determinadas antes e após a suplementação. Foram avaliados os níveis séricos das proteínas de fase aguda negativas (albumina e pré-albumina) e a proteína de fase aguda positiva, proteína C reativa (PCR). Verificaram-se a presença de diarréia e de constipação, bem como a quantidade de bifidobactérias e valores de pH fecal. A redução dos níveis séricos de proteínas de fase aguda negativas (albumina e pré-albumina) comprovam o intenso catabolismo protéico, priorizando a síntese de proteína de fase aguda positiva (PCR). O grupo suplementado apresentou um aumento significante na quantidade de bifidobactérias e o pH fecal não foi alterado em ambos os grupos. Os níveis séricos de PCR foram estatisticamente superiores no grupo controle, indicando a ocorrência de processos inflamatórios e maior demanda metabólica, sugerindo que a quantidade de bifidobactérias pode ter favorecido a redução deste quadro no grupo suplementado, confirmado pela correlação negativa entre estas variáveis.

Patients with hematologic neoplasias are submitted to chemotherapeutic treatment that induces intense alterations in the integrity of the intestinal mucous membrane, favoring an increase in the morbimortality rate. The current work was developed in the Bone Marrow Transplantation Unit of the Oncology Research Center in Florianopolis and was aimed at studying the action of prebiotic agents on protein response in the acute phase of hematologic neoplastic patients submitted to chemotherapy. A double-blind randomized clinical trial was performed involving 25 patients divided into two groups. Patients received 12 g FOS (n=14) or placebo (maltdextrine) (n=11) over 15 days. All the variables were determined before and after supplementation. The serum levels of negative acute phase proteins, albumin and pre-albumin, and positive acute phase proteins, C-reactive protein, were evaluated. The presence of diarrhea and constipation are reported, as are the quantity of bifidobacteria and fecal pH measurements. Reductions in the serum levels of negative acute phase proteins (albumin and pre-albumin) show intense proteic catabolism thereby, favoring the synthesis of protein in the positive acute phase. The supplemented group presented with a significant increase in the quantity of bifidobacteria. The fecal pH levels were affected in both groups. The serum levels of positive acute phase proteins were statistically higher in the control group indicating the occurrence of inflammatory processes and a higher metabolic demand suggesting that the quantity of bifidobacteria may favor a reduction of these adverse conditions in the supplemented group as was confirmed by the negative correlation between variables.

Detection of Torque teno virus in Epstein-Barr virus positive and negative lymph nodes of patients with Hodgkin lymphoma.

The age-specific incidence of Hodgkin lymphoma (HL) is bimodal with peaks occurring among young adults (15 - 34 years old) and people older than 45 years. Epstein-Barr virus (EBV) is associated with only one-third of HL cases. This study sought to determine if Torque teno virus (TTV) might be independently associated with HL. The presence of EBV was appraised by in situ hybridization and immunohistochemistry in lymph node biopsies from 46 patients (3 - 81 years old) with HL. TTV DNA was assessed by PCR amplification. EBV was detected in 22 (48%) patients. TTV DNA was detected in 24/46 (52%) patients, as well as in 12/20 (60%) control patients with lymphoid unspecific hyperplasia. TTV DNA was not significantly more frequent in EBV negative (54%) than in EBV positive (50%) nodes. However, it was observed that the group of young adults (15 - 34 years, n = 19) showed the lowest EBV frequency (21%) but the highest TTV occurrence (60%). This may suggest an involvement of TTV infection in the pathogenesis of HL in young adults. Further large population-based studies are required to confirm our findings.

Mixed infections of adults and children with multiple TTV-like mini virus isolates.

Testing of the DNA of TTV-like mini virus (TLMV) was done with serum samples obtained from 184 patients (children and adults) who visited different outpatient clinics at a university hospital in Florianopolis, south of Brazil. TLMV DNA was detected by PCR primers from the non-coding region of the genome. A global TLMV prevalence of 78% was found (94% among children below 11 years). PCR products from three serum samples (patients A-C) were cloned, and the sequences with a length of 201-227 nucleotides were determined for 16-19 clones derived from each of the sera. Among the 16 clones derived from patient C, 15 were identical, and the remaining one had a sequence homology of 99%. In contrast, eight different sequences were obtained among the 19 clones derived from patient A, and 10 distinct sequences were depicted among the 17 clones derived from the serum of patient B. Additionally, 13 clones derived from a saliva sample of patient B were sequenced, and seven different nucleotide sequences obtained. One particular sequence was predominant in both serum (8/17 clones) and saliva (7/13 clones) of patient B. On a phylogenetic tree, sequences derived from patient A (a 6-year-old boy), as well as those derived from patient B (a 24-year-old man), were located in five distinct evolutionary branches, taking a minimum divergence of 5% between branches. This suggested that adults and children are coinfected frequently with several TLMV isolates of different origins.

TT virus infection in children and adults who visited a general hospital in the south of Brazil for routine procedure

TT virus (TTV) is a newly described nonenveloped human virus, with a circular, negative-stranded DNA genome, that was first identified in the blood of a patient with posttransfusion hepatitis of unknown etiology. PCR primers and conditions used for TTV DNA amplification may greatly influence the level of TTV detection in serum. Three PCR assays, with different regions of the genome as targets, were used to test TTV DNA in 130 sera from children and adults visiting a hospital in the south of Brazil, most of them for routine procedure. Forty-four percent of adult sera and 73 percent of sera from children aged 0-10 years were TTV positive with at least one PCR assay. However, the three assays were able to detect only 33 percent, 35 percent, and 70 percent of the total positive samples. Our results showed a high prevalence of TTV infection in the south of Brazil, particularly among young children, and confirmed the necessity of performing several PCR assays to assess the true TTV prevalence in a determined population