Síndromes mielodisplásicos y sistema inmunitario / Myelodysplastic Syndrome and Immune System

Introducción: Los síndromes mielodisplásicos constituyen un grupo heterogéneo de desórdenes hematológicos clonales adquiridos, que afectan la célula madre. Se caracterizan morfológicamente por: hematopoyesis ineficaz, citopenias periféricas progresivas, displasia en uno o más linajes celulares y tendencia evolutiva a leucemia aguda. Los avances recientes en la comprensión de los mecanismos genéticos y moleculares de los síndromes mielodisplásicos, han revelado la asociación entre alteraciones inmunológicas y las mutaciones recurrentes. Las células de la respuesta inmune innata y adaptativa, así como diversos mediadores solubles liberados por ellas, pueden establecer una respuesta antitumoral protectora o, por el contrario, inducir eventos de inflamación crónica que favorezcan la promoción y progresión de esta enfermedad. Objetivos: Resumir los conocimientos actuales de la relación sistema inmune-síndromes mielodisplásicos, enfatizando en las células inmunes del microambiente de la médula ósea y su importancia en la clínica de la enfermedad. Métodos: Se realizó investigación bibliográfica-documental acerca del tema. Se consultaron las bases de datos Scielo y Pubmed. Conclusiones: La comprensión de la función dual que ejerce el sistema inmune en los síndromes mielodisplásicos, constituye un desafío y son necesarios estudios clínicos rigurosos para poder establecer el valor de la manipulación del sistema inmune como una forma posible de tratamiento de esta enfermedad(AU)

Introduction: Myelodysplastic syndromes (MDS) constitute a heterogeneous group of acquired clonal hematological disorders that affect the stem cell. These are characterized morphologically and clinically by: ineffective hematopoiesis, progressive peripheral cytopenia, dysplasia in one or more cell lineages, in most of cases and evolutionary tendency to acute leukemia. Recent advances in understanding the genetic and molecular mechanisms of MDS have revealed the association between immunological alterations and recurrent mutations. Cells of the innate and adaptive immune response, as well as various soluble mediators released by them, can establish a protective antitumor response or, on the contrary, induce events of chronic inflammation that favor the promotion and progression of this disease. Objective: To summarize the current knowledge of the immune system-MDS relationship, emphasizing the immune cells of the bone marrow microenvironment and their importance in the clinic of the disease. Methods: A bibliographic-documentary research was carried out on the subject. The Scielo and Pubmed databases were consulted. Conclusions: Understanding the dual role of the immune system in MDS constitutes a challenge and rigorous clinical studies are necessary to establish the value of manipulating the immune system as a possible form of treatment of this disease(AU)

Revisión bibliográfica sobre la COVID 19 en pacientes con cáncer de pulmón / Bibliographic review on COVID 19 in patients with lung cancer

RESUMEN La COVID 19 es una enfermedad pandémica producida por el virus SARS-CoV-2, tiene dentro de los grupos vulnerables al cáncer de pulmón por presentar una inmunodepresión adquirida por los tratamientos oncoespecíficos administrados y esto conlleva a una mayor exposición a complicaciones si se contrae esta terrible infección que azota al mundo en la actualidad. El objetivo fue exponer los riesgos y complicaciones que tienen los pacientes con cáncer de pulmón que reciben tratamientos oncoespecíficos si se infectan con el SARS-COV-2. Se realizó una revisión sistemática de los principales artículos publicados en inglés y en español por autores cubanos y extranjeros en revistas de alto impacto a nivel mundial, información reportada por la Organización Mundial de la Salud, la red de Infomed y el Ministerio de Salud Pública de Cuba. Se concluyó que los pacientes con cáncer de pulmón no presentan un riesgo superior a la población general para contraer la COVID 19, sí existe cierta evidencia de que estos pacientes puedan sufrir una infección más grave si la adquieren (AU).

SUMMARY COVID-19 is a pandemic disease produced by SARS-CoV-2 virus; the group of patients with lung cancer is vulnerable to this disease because of presenting an acquired immune depression due to administered oncospecific treatments, leading to higher exposition to complications if the patient gets this terrible disease striking worldwide nowadays. The objective of this review was exposing the risk and complications affronted by patients suffering lung cancer with oncospecific treatment if they get infected by SARS-CoV-2. The authors carried out a systematic review of the main articles published in Spanish and English by Cuban and foreign authors in high impact journals around the world, information reported by the World Health Organization, INFOMED and the Ministry of Public Health of Cuba. It was concluded that patients with lung cancer are not at a higher risk of catching COVID-19 than general population; it does exist certain evidence of that these patients could suffer a more serious infection if they get the disease (AU).

Resistance Training Safety during and after the SARS-Cov-2 Outbreak: Practical Recommendations.

In December of 2019, there was an outbreak of a severe acute respiratory syndrome caused by the coronavirus 2 (SARS-CoV-2 or COVID-19) in China. The virus rapidly spread into the whole world causing an unprecedented pandemic and forcing governments to impose a global quarantine, entering an extreme unknown situation. The organizational consequences of quarantine/isolation are absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, and inappropriate training conditions. The reduction of mobility imposed to contain the advance of the SARS-Cov-2 pandemic can negatively affect the physical condition and health of individuals leading to muscle atrophy, progressive loss of muscle strength, and reductions in neuromuscular and mechanical capacities. Resistance training (RT) might be an effective tool to counteract these adverse consequences. RT is considered an essential part of an exercise program due to its numerous health and athletic benefits. However, in the face of the SARS-Cov-2 outbreak, many people might be concerned with safety issues regarding its practice, especially in indoor exercise facilities, such as gyms and fitness centers. These concerns might be associated with RT impact in the immune system, respiratory changes, and contamination due to equipment sharing and agglomeration. In this current opinion article, we provide insights to address these issues to facilitate the return of RT practices under the new logistical and health challenges. We understand that RT can be adapted to allow its performance with measures adopted to control coronavirus outbreak such that the benefits would largely overcome the potential risks. The article provides some practical information to help on its implementation.

Soledad social en ancianos hospitalizados en el servicio de Geriatría. Hospital "Comandante Faustino Pérez" / Social loneliness in elder people hospitalized in the Geriatrics service. Clinical Surgical Hospital "Comandante Faustino Pérez"

RESUMEN Introducción: la soledad social se define como la experiencia subjetiva de insatisfacción frente a la sociedad en la que se vive; en términos de estilos de vida, de valores y de uso de nuevas tecnologías, entre otros aspectos. Objetivo: caracterizar la soledad social en los adultos mayores hospitalizados. Materiales y método: se realizó un estudio observacional, descriptivo, transversal en pacientes que ingresaron en el servicio de Geriatría del Hospital Clínico Quirúrgico "Comandante Faustino Pérez", provincia Matanzas, desde octubre 2015 - 2016. El universo estuvo constituido por 212 pacientes que vivían en compañía y no padecían de demencia, confusión mental ni enfermedades graves. Para la recogida de la información se aplicó al universo de estudio la Escala ESTE II de soledad social, validada a nivel nacional e internacional para identificar el nivel de soledad social. Se utilizaron métodos de estadística descriptiva. Los resultados se presentaron en tablas. Resultados: alto nivel de soledad social en los ancianos estudiados, en el grupo atareo de 60-70 años, sin pareja, de bajo nivel de escolaridad y con enfermedades crónicas. Insuficiente percepción de apoyo y participación social, así como un limitado uso de las nuevas tecnologías. Conclusiones: predominó alto nivel de sentimiento de soledad en los ancianos, asociado a insuficiente percepción de apoyo y participación social, más un bajo acceso a las nuevas tecnologías (AU).

ABSTRACT Introduction: social loneliness is defined as the subjective experience of dissatisfaction toward society in which one lives, in terms of lifestyles, values ​​and use of new technologies among others. Objective: to characterize social loneliness in hospitalized elder adults. Material and Method: a cross-sectional, observational, descriptive, study was conducted in patients admitted to the Geriatrics Service of the Clinical Surgical Hospital "Comandante Faustino Pérez", province of Matanzas, in the period October 2015 - 2016. The universe was formed by 212 patients who lived accompanied and did not suffer from dementia, mental confusion nor serious illnesses. For collecting the information of the studied universe, the authors used the ESTE II Scale of social loneliness validated at national and international level to identify the level of social loneliness. Descriptive statistical methods were used and the results were shown in tables. Results: high level of social loneliness in studied elder people of the 60-70 years-old group, without a partner, with a low level of scholarship and with chronic diseases. They had an insufficient perception of support and social participation, as well as made a limited use of the new technologies. Conclusions: a high level of the loneliness feeling predominated in elder people, associated to an insufficient perception of support and social participation, plus a low access to the new technologies (AU).

Evidence for a More Disrupted Immune-Endocrine Relation and Cortisol Immunologic Influences in the Context of Tuberculosis and Type 2 Diabetes Comorbidity.

Pulmonary tuberculosis (PTB), caused by Mycobacterium tuberculosis (Mtb), is a major health problem worldwide, further aggravated by the convergence of type 2 diabetes mellitus (DM) which constitutes an important risk factor for TB development. The worse scenario of patients with PTB and DM may be partly related to a more unbalanced defensive response. As such, newly diagnosed PTB patients with DM (TB+DM, n = 11) or not (TB, n = 21), as well as DM (n = 18) patients and pair matched controls (Co, n = 22), were investigated for the circulating immuno-endocrine-metabolic profile (ELISA), along with studies in peripheral blood mononuclear cells (PBMC) analyzing transcript expression (RT-qPCR) of mediators involved in glucocorticoid functionality. Given the hyperglycemic/hypercortisolemic scenario of TB+DM patients, PBMC were also exposed to stress-related cortisol concentrations (0.1 and 1 µM) and supraphysiologic glucose doses (10, 20, and 40 mM) and assessed for the specific response against Mtb stimulation (lymphoproliferation, -thymidine incorporation-, and cytokine production -bead-cytometry). All TB patients displayed increased plasma amounts of cortisol, growth hormone -hGH-, and proinflammatory mediators. In turn, TB+DM showed even higher levels of interferon gamma -IFN-γ- and hGH (vs. TB), or IL-6, C reactive protein, cortisol and hGH (vs. DM). Both DM groups had equally augmented values of IL-10. All TB patients showed decreased dehydroepiandrosterone- sulfate concentrations, even more in TB+DM cases. Leptin was also decreased in both TB cases, particularly in the TB group, revealing a lower body mass index, as well. Unlike PBMC from TB cases showing a decreased relationship between the glucocorticoids receptor (GR) isoforms (GRα/GRß; functional isoform/negative isoform), cells from TB+DM patients had no changes in this regard, along with an increased expression of 11-beta hydroxysteroid dehydrogenase type-1, the enzyme facilitating intracellular cortisone to cortisol conversion. TB+DM patients also showed an increased Mtb antigen-driven lymphoproliferation. Compared to TB, DM and HCo counterparts, PBMC from TB+DM patients had a biased Th1 response to Mtb stimulation (increased IL-2 and IFN-γ production), even when exposed to inhibitory cortisol doses. TB+DM patients show a more unbalanced immuno-endocrine relationship, respect the non-diabetic counterparts, with a relative deficiency of cortisol immunomodulatory influences, despite their more favorable microenvironment for cortisol-mediated immune effects.

Use of probiotics in atopic dermatitis.

OBJECTIVE: Atopic dermatitis is a common skin disease. Its increased incidence has changed the focus of research on atopic dermatitis toward epidemiology, prevention, and treatment. METHODS: Evidence suggests that intestinal microbiota plays an important role in the pathogenesis of atopic dermatitis inducing immunosuppression, but its exact mechanism is still unclear. Probiotics have been widely reported to act on the immune system. They are living microorganisms with immunomodulatory effects that stimulate Th1 cytokines and suppress the Th2 response, which are being researched for the treatment of several diseases. Probiotics most commonly used are part of the intestinal microflora like lactobacilli, bifidobacteria, and enterococci. RESULTS: We describe here a case of evident response to the use of probiotics in a girl with severe atopic dermatitis, with a significant change in severity scores of atopic dermatitis (BSA/SCORAD/FDLQI). CONCLUSIONS: Modulation of the intestinal microbiota with probiotics may offer a way to prevent or treat allergic diseases, including atopic dermatitis.

Use of probiotics in atopic dermatitis

SUMMARY Atopic dermatitis is a common skin disease. Its increased incidence has changed the focus of research on atopic dermatitis toward epidemiology, prevention, and treatment. Evidence suggests that intestinal microbiota plays an important role in the pathogenesis of atopic dermatitis inducing immunosuppression, but its exact mechanism is still unclear. Probiotics have been widely reported to act on the immune system. They are living microorganisms with immunomodulatory effects that stimulate Th1 cytokines and suppress the Th2 response, which are being researched for the treatment of several diseases. Probiotics most commonly used are part of the intestinal microflora like lactobacilli, bifidobacteria, and enterococci. We describe here a case of evident response to the use of probiotics in a girl with severe atopic dermatitis, with a significant change in severity scores of atopic dermatitis (BSA/SCORAD/FDLQI). Modulation of the intestinal microbiota with probiotics may offer a way to prevent or treat allergic diseases, including atopic dermatitis.

RESUMO A dermatite atópica é uma doença de pele comum. O aumento da incidência mudou o foco da pesquisa em dermatite atópica para epidemiología, prevenção e tratamento. Evidências sugerem que a microbiota intestinal desempenha um papel importante na patogênese da dermatite atópica, induzindo imunossupressão, mas o mecanismo exato ainda não está claro. Os probióticos foram amplamente divulgados para atuar no sistema imunológico. Eles são microrganismos vivos com efeitos imunomoduladores que estimulam as citocinas Th1 e suprimem a resposta Th2 que vem sendo pesquisada para o tratamento de diversas doenças. Probióticos mais comumente usados são parte da microflora intestinal como lactobacilos, bifidobactérias e enterococos. Descrevemos um caso de resposta evidente ao uso de probióticos em uma menina com dermatite atópica grave, com grande alteração nos escores de gravidade da dermatite atópica (BSA/Scorad/FDLQI). A modulação da microbiota intestinal com probióticos pode oferecer uma maneira de prevenir ou tratar doenças alérgicas, incluindo a dermatite atópica.

Insights into thermal stress in Japanese quail (Coturnix coturnix): dynamics of immunoendocrine and biochemical responses during and after chronic exposure.

Avian require comfortable temperatures for optimal development and heat stress is a high concern in warm weather countries. We aimed to assess the dynamics of immunoendocrine and biochemical variables responses of birds exposed to a heat stressor applied during daylight hours, during the chronic stress and the recovery periods. We hypothesize that variables involved in the birds response will be differentially and gradually modified during those periods. Female quail (n = 210) were housed in six rearing boxes. At 29 days of age, the temperature in three boxes was increased from 24 to 34 °C during the light period throughout the nine days (Stress Treatment). The other three boxes remained at 24 °C and were used as controls. The subsequent 12 days were considered as recovery period. Different sets of 12 birds/treatment were blood-sampled at 29 (basal), 32, 35, 38 (stress), 41, 44, 47, and 50 (recovery) days of age, respectively. Immunoendocrine (corticosterone, lymphoproliferation, heterophil/lymphocyte ratio (H/L), and antibody response) and biochemical (glucose, total proteins, globulins, and albumin) variables were assessed. During stress, progressive corticosterone and H/L increments, and antibody titers and lymphoproliferation decreases were detected. No clear pattern of changes was found in biochemical variables. During recovery, while corticosterone and lymphoproliferation had recovered three days after the stressor ended, H/L and antibody responses required respectively nine and 12 days to recover to their basal levels, respectively. Findings suggest that immunity is already threatened when heat stress is sustained for three or more days. However, the system appears resilient, needing six to 12 days to recover to their basal responses.

The Impact of Ghrelin in Metabolic Diseases: An Immune Perspective.

Obesity and insulin resistance have reached epidemic proportions. Obesogenic conditions are associated with increased risk for the development of other comorbidities and obesity-related diseases. In metabolic disorders, there is chronic low-grade inflammation induced by the activation of immune cells, especially in metabolic relevant organs such as white adipose tissue (WAT). These immune cells are regulated by environmental and systemic cues. Ghrelin is a peptide secreted mainly by X/A-like gastric cells and acts through the growth hormone secretagogue receptor (GHS-R). This receptor is broadly expressed in the central nervous system (CNS) and in several cell types, including immune cells. Studies show that ghrelin induces an orexigenic state, and there is increasing evidence implicating an immunoregulatory role for ghrelin. Ghrelin mainly acts on the innate and adaptive immune systems to suppress inflammation and induce an anti-inflammatory profile. In this review, we discuss the immunoregulatory roles of ghrelin, the mechanisms by which ghrelin acts and potential pharmacological applications for ghrelin in the treatment of obesity-associated inflammatory diseases, such as type 2 diabetes (T2D).

Factores psicosocio-inmunogenéticos en pacientes diabéticos con complicaciones vasculares / Psychological, social and immunogenetic factors observed in diabetic patients with vascular complications

El desarrollo de la medicina, la ciencia y los medios científicos técnicos, permiten explicar de manera didáctica e integral con un enfoque dialéctico-materialista los fenómenos complejos y sus interrelaciones entre sistemas, en diferentes entidades clínicas como la diabetes mellitus, objeto del presente trabajo. Describir la interacción entre factores psicosocio-inmuno-genéticos en pacientes diabéticos con complicaciones vasculares, fue el objetivo de nuestro trabajo. Se trabajó con las bases de datos PubMed, MedLine, SciELO, Ebsco y artículos científicos publicados en revistas cubanas entre 2011-2015. Se revisaron trabajos en español, inglés y francés. Se analizó la interrelación dialéctica e indisoluble de la función integradora del sistema inmune con los sistemas nervioso y endocrino, la que descansa en las relaciones entre los fenómenos psíquicos y orgánicos, y esto solo puede comprenderse completamente cuando se tiene en cuenta la interacción del hombre con el medio social en que se desenvuelve, así como la relación de este con la naturaleza, que es en definitiva el centro de su actividad creadora y transformadora y sobre todo el análisis de las implicaciones prácticas que conlleva para el campo de la clínica y la ciencia. Podemos concluir que el conocimiento de las interacciones entre factores psicosocio-inmuno-genéticos en pacientes diabéticos tipo 2 con complicaciones vasculares, es imprescindible para comprender la dinámica de los fenómenos bioquímicos, así como entre los tres sistemas integradores: neurológico, endocrino e inmune que tienen lugar en estos pacientes, lo que posibilita el tratamiento más adecuado y eficaz y la prevención de la enfermedad hereditaria en familias portadoras(AU)

The development of medicine, science and technical scientific devices allow explaining didactically and comprehensively, with a dialectical-materialist approach, complex phenomena and their interrelationships in different clinical conditions such as diabetes mellitus The objectives of this paper were to describe the interaction among psychological, social, and immunogenetic factors in diabetic patients with vascular complications and to address how these factors are associated with immunosupression state of type 2 diabetic patients. For this purpose, worked with PubMed, MedLine, SciELO, EBSCO databases and scientific articles published in 2011-2015 journals were consulted. A number of papers in Spanish, English and French languages were reviewed. The dialectic and permanent interrelation of the integrative function of the immune system with the nervous and endocrine systems, which is based on the relationship between psychic and phenomena, was analyzed. All this can only be fully understood when one takes into account man's interaction with the social environment as well as his relationship with nature, which is ultimately the core of their creative and transforming activity and particularly, the analysis of the practical implications for the clinical and scientific fields. The knowledge of the interactions among systems is imperative to understand homeostasis and dynamics of biochemical phenomena that occur in humans, both in the relationship between the biological and the psychic areas, and in the biological and the socio environmental areas, thus allowing scientific advances in this field for the development of more effective therapeutic and prevention methods(AU)

Factores psicosocio-inmunogenéticos en pacientes diabéticos con complicaciones vasculares / Psychological, social and immunogenetic factors observed in diabetic patients with vascular complications

El desarrollo de la medicina, la ciencia y los medios científicos técnicos, permiten explicar de manera didáctica e integral con un enfoque dialéctico-materialista los fenómenos complejos y sus interrelaciones entre sistemas, en diferentes entidades clínicas como la diabetes mellitus, objeto del presente trabajo. Describir la interacción entre factores psicosocio-inmuno-genéticos en pacientes diabéticos con complicaciones vasculares, fue el objetivo de nuestro trabajo. Se trabajó con las bases de datos PubMed, MedLine, SciELO, Ebsco y artículos científicos publicados en revistas cubanas entre 2011-2015. Se revisaron trabajos en español, inglés y francés. Se analizó la interrelación dialéctica e indisoluble de la función integradora del sistema inmune con los sistemas nervioso y endocrino, la que descansa en las relaciones entre los fenómenos psíquicos y orgánicos, y esto solo puede comprenderse completamente cuando se tiene en cuenta la interacción del hombre con el medio social en que se desenvuelve, así como la relación de este con la naturaleza, que es en definitiva el centro de su actividad creadora y transformadora y sobre todo el análisis de las implicaciones prácticas que conlleva para el campo de la clínica y la ciencia. Podemos concluir que el conocimiento de las interacciones entre factores psicosocio-inmuno-genéticos en pacientes diabéticos tipo 2 con complicaciones vasculares, es imprescindible para comprender la dinámica de los fenómenos bioquímicos, así como entre los tres sistemas integradores: neurológico, endocrino e inmune que tienen lugar en estos pacientes, lo que posibilita el tratamiento más adecuado y eficaz y la prevención de la enfermedad hereditaria en familias portadoras(AU)

The development of medicine, science and technical scientific devices allow explaining didactically and comprehensively, with a dialectical-materialist approach, complex phenomena and their interrelationships in different clinical conditions such as diabetes mellitus The objectives of this paper were to describe the interaction among psychological, social, and immunogenetic factors in diabetic patients with vascular complications and to address how these factors are associated with immunosupression state of type 2 diabetic patients. For this purpose, worked with PubMed, MedLine, SciELO, EBSCO databases and scientific articles published in 2011-2015 journals were consulted. A number of papers in Spanish, English and French languages were reviewed. The dialectic and permanent interrelation of the integrative function of the immune system with the nervous and endocrine systems, which is based on the relationship between psychic and phenomena, was analyzed. All this can only be fully understood when one takes into account man's interaction with the social environment as well as his relationship with nature, which is ultimately the core of their creative and transforming activity and particularly, the analysis of the practical implications for the clinical and scientific fields. The knowledge of the interactions among systems is imperative to understand homeostasis and dynamics of biochemical phenomena that occur in humans, both in the relationship between the biological and the psychic areas, and in the biological and the socio environmental areas, thus allowing scientific advances in this field for the development of more effective therapeutic and prevention methods(AU)

Immune System Dysfunction in the Elderly.

Human aging is characterized by both physical and physiological frailty that profoundly affects the immune system. In this context aging is associated with declines in adaptive and innate immunity established as immunosenescence. Immunosenescence is a new concept that reflects the age-associated restructuring changes of innate and adaptive immune functions. Thus elderly individuals usually present chronic low-level inflammation, higher infection rates and chronic diseases. A study of alterations in the immune system during aging could provide a potentially useful biomarker for the evaluation of immune senescence treatment. The immune system is the result of the interplay between innate and adaptive immunity, yet the impact of aging on this function is unclear. In this article the function of the immune system during aging is explored.

Immune System Dysfunction in the Elderly

ABSTRACT Human aging is characterized by both physical and physiological frailty that profoundly affects the immune system. In this context aging is associated with declines in adaptive and innate immunity established as immunosenescence. Immunosenescence is a new concept that reflects the age-associated restructuring changes of innate and adaptive immune functions. Thus elderly individuals usually present chronic low-level inflammation, higher infection rates and chronic diseases. A study of alterations in the immune system during aging could provide a potentially useful biomarker for the evaluation of immune senescence treatment. The immune system is the result of the interplay between innate and adaptive immunity, yet the impact of aging on this function is unclear. In this article the function of the immune system during aging is explored.

El sistema inmune en los linfedemas y linfangitis de los miembros inferiores / The immune system in lymphedema and lymphangitis of the lower limbs

El sistema inmune es el mecanismo de resistencia del organismo ante las infecciones. El sistema linfático juega un importante papel en el control fisiológico del fluido tisular y en la iniciación de la respuesta inmune. Nos proponemos describir la función de los componentes celulares del sistema inmune en las linfopatías de miembros inferiores no asociadas a cánceres tales como el linfedema y la linfangitis.Se revisaron las bases de datos PubMed, MedLine, SciELO, Clinical Key, Liliacs, Ebsco y artículos científicos publicados en revistas cubanas entre 2000-2015. Los estudios recientes muestran que el crecimiento de nuevos vasos linfáticos es una característica distintiva de las reacciones inflamatorias agudas y crónicas que caracterizan a las linfopatías, mediado por un incremento en el drenaje del fluido fuera del vaso y de células inflamatorias, así como de la modulación de las respuestas inmunes. Es apremiante continuar investigando, específicamente en lo concerniente al comportamiento de la inmunidad humoral y celular en los pacientes que padecen de linfedema o linfangitis, pues no se encontraron trabajos que aborden de manera específica la posible relación entre ambos. Se sugiere que las subpoblaciones de células T son un componente crítico en la respuesta celular inflamatoria crónica y subaguda en las linfopatías. La comprensión de la función reguladora del fluido linfático en la respuesta inflamatoria puede dar un importante paso en el desarrollo de tratamientos que puedan bloquear el inicio o la progresión de las consecuencias anómalas de las lesiones linfáticas(AU)

The immune system is the body´s mechanism of resistance to infections. The lymph system plays an important role in the physiological control of the tissue fluid and in the onset of the immune response. We intended to describe the function of the cell components of the immune system in the cancer-unrelated lymphopathies of the lower limbs such as lymphedema and lymphangitis. To this end, Pubmed, Medline, Scielo, Clinical Key, Liliacs, Ebsco and scientific articles published in Cuban medical journals from 2000 to 2015 were reviewed. The recent studies show that the growth of new lymphatic vessels is a distinctive characteristic of the acute and chronic inflammatory reactions of lymphopathies, mediated by increase of the fluid drainage outside the vessel and of inflammatory cells as well as the immune response modulations. It is urgent to continue studying this topic, mainly the behavior of the humoral and cell immunity in patients suffering from lymphedema or lymphangitis, since no research papers dealing with the possible relation between both aspects were found. It is suggested that the T-cell subpopulations are a key component of the chronic and sub-acute inflammatory response in lymphopaties. Hence, understanding of the regulating function of the lymph fluid in the inflammatory response may represent an important step in the development of therapies that might block the onset or progression of the anomalous consequences of lymphatic injures(AU)

The Immune System and the Role of Inflammation in Perinatal Depression.

Major depression during pregnancy is a common psychiatric disorder that arises from a complex and multifactorial etiology. Psychosocial stress, sex, hormones, and genetic vulnerability increase the risk for triggering mood disorders. Microglia and toll-like receptor 4 play a crucial role in triggering wide and varied stress-induced responses mediated through activation of the inflammasome; this leads to the secretion of inflammatory cytokines, increased serotonin metabolism, and reduction of neurotransmitter availability along with hypothalamic-pituitary-adrenal axis hyperactivity. Dysregulation of this intricate neuroimmune communication network during pregnancy modifies the maternal milieu, enhancing the emergence of depressive symptoms and negative obstetric and neuropsychiatric outcomes. Although several studies have clearly demonstrated the role of the innate immune system in major depression, it is still unclear how the placenta, the brain, and the monoaminergic and neuroendocrine systems interact during perinatal depression. Thus, in the present review we describe the cellular and molecular interactions between these systems in major depression during pregnancy, proposing that the same stress-related mechanisms involved in the activation of the NLRP3 inflammasome in microglia and peripheral myeloid cells in depressed patients operate in a similar fashion in the neuroimmune placenta during perinatal depression. Thus, activation of Toll-like receptor 2 and 4 signaling and the NLRP3 inflammasome in placental immune cells may promote a shift of the Th1/Th2 bias towards a predominant Th1/Th17 inflammatory response, associated with increased secretion of pro-inflammatory cytokines, among other secreted autocrine and paracrine mediators, which play a crucial role in triggering and/or exacerbating depressive symptoms during pregnancy.

Lipopolysaccharide-induced sickness behavior in lactating rats decreases ultrasonic vocalizations and exacerbates immune system activity in male offspring.

OBJECTIVE: The present study analyzed the effects of lipopolysaccharide (LPS) on maternal behavior during lactation and possible correlations with changes in emotional and immune responses in offspring. METHODS: Lactating rats received 100 µg/kg LPS, and the control group received saline solution on lactation day (LD) 3. Maternal general activity and maternal behavior were observed on LD5 (i.e. the day that the peak of fever occurred). In male pups, hematological parameters and ultrasonic vocalizations (USVs) were assessed on LD5. At weaning, an additional dose of LPS (50 µg/kg, i.p.) was administered in male pups, and open-field behavior, oxidative burst and phagocytosis were evaluated. RESULTS: A reduction in the time in which dams retrieved the pups was observed, whereas no effects on maternal aggressive behavior were found. On LD5, a reduction of the frequency of USVs was observed in pups, but no signs of inflammation were found. At weaning, an increase in immune system activity was observed, but no differences in open-field behavior were found. CONCLUSION: These results indicate that inflammation in lactating mothers disrupted mother/pup interactions and may have produced short- and long-term effects on pup behavior as well as biological pathways that modulate inflammatory responses to bacterial endotoxin challenge in pups.

Status epilepticus: immunologic and inflammatory mechanisms.

Status epilepticus (SE) can be difficult to treat, particularly if refractory, and lead to significant morbidity and mortality. Prolonged seizures are also a risk factor for the subsequent diagnosis of epilepsy. Activation of the immune system and inflammation are areas of recent interest in the field of epilepsy, and there is growing evidence that these may be involved in the pathogenesis of ongoing SE and subsequent epileptogenesis. We review the current data on this topic in both animal models and human disease. We conclude that there is evidence suggesting a role for immunologic and inflammatory mechanisms in SE. Further research, especially human studies, is necessary to determine whether targeting the immune system would improve control of SE and prevent sequelae such as epileptogenesis.

[Cytokines and the nervous system: the relationship between seizures and epilepsy]. / Citocinas y sistema nervioso: relacion con crisis convulsivas y epilepsia.

INTRODUCTION. The immune system and the peripheral and central nervous system are in constant communication by means of messengers and signalling molecules released, such as cytokines, neuropeptides, neurohormones and neurotransmitters, among others. Seizures are defined as the transitory appearance of signs and symptoms that trigger an abnormally excessive neuronal activity in the brain. Following seizures the generation of a neuroinflammatory process has been observed to occur, with the consequent release of proinflammatory cytokines and inflammation-mediating molecules, which make the patient more prone to epilepsy. AIM. To offer evidence suggesting and supporting the role of cytokines in the appearance of seizures and in epilepsy, since these molecules have proven to have dual properties. DEVELOPMENT. The central nervous system, by means of the blood-brain barrier, restricts the flow of activated cells and inflammation mediators released from the peripheral system towards the brain parenchyma. Moreover, there is also another series of mechanisms that contributes to the 'selective and modified' immunity of the central nervous system. The purpose of all this series of events is to limit the responses of the immune system at central level, although it has been shown that in the central nervous system they are permanently under the control and regulation of the immune system. CONCLUSIONS. Cytokines in epilepsy play a dual role with pro- and anti-convulsive properties. Seizures do not induce the expression of cytokines only inside the brain, but also peripherally.

TITLE: Citocinas y sistema nervioso: relacion con crisis convulsivas y epilepsia.Introduccion. El sistema inmune y el sistema nervioso periferico y central se encuentran en constante comunicacion a traves de mensajeros y moleculas de señalizacion liberadas, como las citocinas, los neuropeptidos, las neurohormonas y los neurotransmisores, entre otros. Las convulsiones se definen como la aparicion transitoria de signos y sintomas que inducen una actividad neuronal excesiva anormal en el cerebro; despues de una crisis convulsiva, se ha observado la generacion de un proceso neuroinflamatorio, con la consecuente liberacion de citocinas proinflamatorias y de moleculas mediadoras de inflamacion, que predisponen a la epilepsia. Objetivo. Mostrar la evidencia que sugiere y apoya el papel de las citocinas en la aparicion de crisis convulsivas y en la epilepsia, ya que estas moleculas han demostrado propiedades duales. Desarrollo. El sistema nervioso central, a traves de la barrera hematoencefalica, restringe el flujo de celulas activadas y de mediadores de inflamacion liberados desde el sistema periferico hacia el parenquima cerebral; ademas, existe otra serie de mecanismos que contribuyen a la inmunidad 'selectiva y modificada' del sistema nervioso central. Toda esta serie de eventos tiene la finalidad de limitar respuestas del sistema inmune a nivel central, aunque se ha demostrado que en el sistema nervioso central se encuentran de manera permanente bajo el control y la regulacion del sistema inmune. Conclusiones. Las citocinas en la epilepsia muestran un papel dual con propiedades pro y anticonvulsionantes. Las convulsiones no solamente inducen la expresion de citocinas dentro del cerebro, sino tambien perifericamente.

Pathophysiology of bacterial infection of the central nervous system and its putative role in the pathogenesis of behavioral changes.

Invasion of the central nervous system (CNS) by microorganisms is a severe and frequently fatal event during the course of many infectious diseases. It may lead to deafness, blindness, cerebral palsy, hydrocephalus, cognitive impairment or permanent neurological dysfunction in survivors. Pathogens can cross the blood-brain barrier by transcellular migration, paracellular migration and in infected macrophages. Pathogens may breach the blood-brain barrier and be recognized by antigen-presenting cells through the binding of Toll-like receptors. This induces the activation of nuclear factor kappa B or mitogen-activated protein kinase pathways and subsequently induces leukocyte infiltration and proliferation and the expression of numerous proteins involved in inflammation and the immune response. Many brain cells can produce cytokines, chemokines and other pro-inflammatory molecules in response to bacteria stimuli; as a consequence, polymorphonuclear cells are attracted and activated, and release large amounts of superoxide anion and nitric oxide, leading to peroxynitrite formation and oxidative stress. This cascade leads to lipid peroxidation, mitochondrial damage and blood-brain barrier breakdown, contributing to cellular injury during neuronal infection. Current evidence suggests that bacterial CNS infections can play a role in the etiopathogenesis of behavioral disorders by increasing pro-inflammatory cytokines and bacterial virulence factors. The aim of this review is to summarize the current knowledge of the relevant pathophysiologic steps in CNS infections.