Lupus eritematoso sistémico en una zona austral de Chile / Systemic lupus erythematosus in a southern zone of Chile

Introducción. El lupus eritematoso sistémico (LES) se caracteriza por un amplio espec-tro de manifestaciones clínicas y serológicas. La última serie de enfermos chilenos fue publicada el año 1994 y contempló un total de 218 pacientes. Objetivo. Contribuir con nuevos datos epidemiológicos en una cohorte de 67 enfer-mos con LES en una zona austral de nuestro país.Pacientes y métodos. De forma retrospectiva se revisaron 100 fichas de pacientes con diagnóstico de LES realizado por médico reumatólogo del Hospital de Puerto Montt (HPM), identificados a través de registros obtenidos a contar de julio de 2013 cuando esta patología se incluyó dentro de las Garantías Explícitas en Salud (GES). 67 cumplían al menos cuatro criterios Systemic Lupus International Collaborating Clinics (SLICC) 2012 y los datos obtenidos fueron sometidos a análisis estadístico utilizando el programa SPSS versión 15.0. Resultados: 63 (94%) son mujeres. La edad promedio al momento del diagnóstico fue 38,1 años y el tiempo transcurrido desde el inicio de los síntomas fue 12,3 me-ses. Las manifestaciones clínicas más frecuentes fueron sinovitis (65.7%), alopecia (47.8%), compromiso renal (43.3%) y alteraciones cutáneas (38.8%). Sesenta (90%) tenían ANA positivo, 34 (50.7%) anti-DNA positivo y 45 (67.2%) hipocomplementemia. Se identificaron 29 (43.3%) pacientes con compromiso clínico y/o histológico renal, de los cuales a 13 se les realizó biopsia renal, correspondiente en el 69% de los casos a nefritis lúpica membrano-proliferativa.Conclusiones. Nuestra cohorte no difiere sustantivamente de otras, salvo por la baja prevalencia de manifestaciones cutáneas. Se detectó la falta de acceso a biopsia renal y exámenes serológicos autoinmunes dado principalmente por falta de profesionales idóneos en nuestra zona que permitan el acceso universal a estos procedimientos.Este estudio permite proporcionar información actualizada de pacientes con LES en una zona austral de Chile.

Introduction. Systemic lupus erythematosus (SLE) is characterized by a broad spec-trum of clinical and serological manifestations. The last series of chilean patients was published in 1994 and included a total of 218 patients.Objective. To contribute with new epidemiological data in a cohort of 67 patients with SLE in a Southern area of our country.Patients and methods. In a retrospective way, 100 records of patients diagnosed with SLE were reviewed by a rheumatologist at the Hospital de Puerto Montt (HPM), identified through records obtained as of July 2013 when this pathology was included in the Explicit Health Guarantees. (GES) 67 met at least four criteria Systemic Lupus International Collaborating Clinics (SLICC) 2012 and the data obtained were subjected to statistical analysis using the SPSS program version 15.0.Results: 63 (94%) are women. The average age at diagnosis was 38.1 years and the time elapsed since the onset of symptoms was 12.3 months. The most frequent clinical manifestations were synovitis (65.7%), alopecia (47.8%), renal involvement (43.3%) and skin alterations (38.8%). Sixty (90%) had positive ANA, 34 (50.7%) positive anti-DNA and 45 (67.2%) hypocomplementemia. We identified 29 (43.3%) patients with clinical and / or renal histological involvement, of whom 13 were under-going a renal biopsy corresponding to 69% of the cases of membranous proliferative lupus nephritis.Conclusions. Our cohort does not differ substantively from others, except for the low prevalence of cutaneous manifestations.The lack of access to renal biopsy and self-immune serological tests was detected, mainly due to the lack of qualified professionals in our area that allow universal access to these procedures.This study allows us to provide updated information on patients with SLE in a Southern zone of Chile.

Anti-ACSA-2 defines a novel monoclonal antibody for prospective isolation of living neonatal and adult astrocytes.

Astrocytes are the most abundant cell type of the central nervous system and cover a broad range of functionalities. We report here the generation of a novel monoclonal antibody, anti-astrocyte cell surface antigen-2 (Anti-ACSA-2). Flow cytometry, immunohistochemistry and immunocytochemistry revealed that Anti-ACSA-2 reacted specifically with a not yet identified glycosylated surface molecule of murine astrocytes at all developmental stages. It did not show any labeling of non-astroglial cells such as neurons, oligodendrocytes, NG2+ cells, microglia, endothelial cells, leukocytes, or erythrocytes. Co-labeling studies of GLAST and ACSA-2 showed largely overlapping expression. However, there were also notable differences in protein expression levels and frequencies of single-positive subpopulations of cells in some regions of the CNS such as cerebellum, most prominently at early postnatal stages. In the neurogenic niches, the dentate gyrus of the hippocampus and the subventricular zone (SVZ), again a general overlap with slight differences in expression levels were observed. ACSA-2 was unlike GLAST not sensitive to papain-based tissue dissociation and allowed for a highly effective, acute, specific, and prospective purification of viable astrocytes based on a new rapid sorting procedure using Anti-ACSA-2 directly coupled to superparamagnetic MicroBeads. In conclusion, ACSA-2 appears to be a new surface marker for astrocytes, radial glia, neural stem cells and bipotent glial progenitor cells which opens up the possibility of further dissecting the characteristics of astroglial subpopulations and lineages.

Dynamic filopodia are required for chemokine-dependent intracellular polarization during guided cell migration in vivo.

Cell migration and polarization is controlled by signals in the environment. Migrating cells typically form filopodia that extend from the cell surface, but the precise function of these structures in cell polarization and guided migration is poorly understood. Using the in vivo model of zebrafish primordial germ cells for studying chemokine-directed single cell migration, we show that filopodia distribution and their dynamics are dictated by the gradient of the chemokine Cxcl12a. By specifically interfering with filopodia formation, we demonstrate for the first time that these protrusions play an important role in cell polarization by Cxcl12a, as manifested by elevation of intracellular pH and Rac1 activity at the cell front. The establishment of this polarity is at the basis of effective cell migration towards the target. Together, we show that filopodia allow the interpretation of the chemotactic gradient in vivo by directing single-cell polarization in response to the guidance cue.