Cytokine expression in the duodenal mucosa of patients with visceral leishmaniasis

INTRODUCTION: Visceral leishmaniasis (VL) is a neglected tropical disease with a complex immune response in different organs. This pattern of organ-specific immune response has never been evaluated in the gastrointestinal tract. The aim of this study was to determine the in situ immune response in duodenal biopsies on patients with VL. METHODS: A case-control study was conducted on 13 patients with VL in comparison with nine controls. The immune response was evaluated using immunohistochemistry, for CD4, CD8, CD68, IL-4, IFN-γ, TNF-α and IL-10. Histological findings from the villi, crypts and inflammatory process were analyzed. RESULTS: All the cases of VL presented Leishmania antigens. No antigen was detected in the control group. The villus size was greater in the VL patients (p < 0.05). CD68 (macrophages) and CD4 levels were higher in the VL patients (p < 0.05). No differences in the expression of CD8, TNF-α, IL-10 or IL-4 were demonstrated. The number of cells expressing IFN-γ was lower in the VL patients (p < 0.05). CONCLUSIONS: Low levels of cytokines were found in the gastrointestinal tract of patients with VL. This pattern was not found in other organs affected by the disease. Immunotolerance of this tissue against Leishmania could explain these findings, as occurs with intestinal bacteria.

The effects of glutamine-supplemented diet on the intestinal mucosa of the malnourished growing rat

Glutamine is the most abundant amino acid in the blood and plays a key role in the response of the small intestine to systemic injuries. Mucosal atrophy is an important phenomenon that occurs in some types of clinical injury, such as states of severe undernutrition. Glutamine has been shown to exert powerful trophic effects on the gastrointestinal mucosa after small bowel resection or transplant, radiation injury, surgical trauma, ischemic injury and administration of cytotoxic drugs. Since no study has been performed on the malnourished animal, we examined whether glutamine exerts a trophic effect on the intestinal mucosa of the malnourished growing rat. Thirty-five growing female rats (aged 21 days) were divided into 4 groups: control - chow diet; malnutrition diet; malnutrition+chow diet; and malnutrition+glutamine-enriched chow diet (2%). For the first 15 days of the experiment, animals in the test groups received a malnutrition diet, which was a lactose-enriched diet designed to induce diarrhea and malnutrition. For the next 15 days, these animals received either the lactose-enriched diet, a regular chow diet or a glutamine-enriched chow diet. After 30 days, the animals were weighed, sacrificed, and a section of the jejunum was taken and prepared for histological examination. All the animals had similar weights on day 1 of experiment, and feeding with the lactose-enriched diet promoted a significant decrease in body weight in comparison to the control group. Feeding with both experimental chow-based diets promoted significant body weight gains, although the glutamine-enriched diet was more effective. RESULTS: The morphological and morphometric analyses demonstrated that small intestinal villous height was significantly decreased in the malnourished group, and this change was partially corrected by the two types of chow-based diet. Crypt depth was significantly increased by malnutrition, and this parameter was partially corrected by the two types of chow-based diet. The glutamine-enriched diet resulted in the greatest reduction of crypt depth, and this reduction was also statistically significant when compared with control animals. CONCLUSIONS: Enteral glutamine has some positive effects on body weight gain and trophism of the jejunal mucosa in the malnourished growing rat.

Weight loss and morphometric study of intestinal mucosa in rats after massive intestinal resection: influence of a glutamine-enriched diet

Short-bowel syndrome is responsible for significant metabolic alterations that compromise nutritional status. Glutamine is considered an essential nutrient for enterocytes, so beneficial effects from supplementation of the diet with glutamine are hypothesized. PURPOSE: In this study, the effect of a diet enriched with glutamine was evaluated in rats undergoing extensive small bowel resection, with analysis of postoperative weight loss and intestinal morphometrics of villi height, crypt depth, and thickness of the duodenal and remnant jejunal mucosa. METHODS: Three groups of male Wistar rats were established receiving the following diets: with glutamine, without glutamine, and the standard diet of laboratory ration. All animals underwent an extensive small bowel resection, including the ileocecal valve, leaving a remnant jejunum of only 25 cm from the pylorus that was anastomosed lateral-laterally to the ascendant colon. The animals were weighed at the beginning and end of the experiment (20th postoperative day). Then they were killed and the remnant intestine was removed. Fragments of duodenal and jejunal mucosa were collected from the remnant intestine and submitted to histopathologic exam. The morphometric study of the intestinal mucosa was accomplished using a digital system (KS 300) connected to an optic microscope. Morphometrics included villi height, crypt depth, and the total thickness of intestinal mucosa. RESULTS: The weight loss comparison among the 3 groups showed no significant loss difference. The morphometric studies showed significantly taller duodenal villi in the glutamine group in comparison to the without glutamine group, but not different from the standard diet group. The measurements obtained comparing the 3 groups for villi height, crypt depth, and thickness of the remnant jejunum mucosa were greater in the glutamine-enriched diet group than for the without-glutamine diet group, though not significantly different from with standard-diet group. CONCLUSIONS: In rats with experimentally produced short-bowel syndrome, glutamine-enrichment of an isonitrogenous test diet was associated with an improved adaptation response by the intestinal mucosa but not reduced weight loss. However, the adaptation response in the group receiving the glutamine-enriched diet was not improved over that for the group fed regular chow.

Expresión de las proteínas relacionadas con la proliferación celular y la apoptosis en lesiones blancas de la mucosa oral, como precursoras de la cancerización en el epitelio escamoso oral.

El cáncer de la mucosa oral es una patología muy frecuente que llega en muchos casos a conformar entre el 8 y el 10% de los tumores malignos del hombre. La baja concientización de la población general sobre el tema es un factor importante que hace que estas lesiones sean detectadas en forma tardía y cuando ya se trata de lesiones avanzadas de muy mal pronóstico. Si bien ha habido grandes avances en el diagnóstico y tratamiento de lesiones blancas de la mucosa oral como el liquen plano oral, estas lesiones siguen siendo entidades con muchos interrogantes para todos los expertos en medicina oral, sobre todo en lo referente a su proceso de aparición y a su tratamiento. Es importante la diferenciación correcta de estas lesiones, ya que el carcinoma epidermoide bucal puede aparecer también como una lesión blanca. No hay suficiente conocimiento de lo que ocurre en otras lesiones blancas de la mucosa oral no liquen plano. Para evaluar el verdadero potencial de transformación maligna de leucoplasias, liquen plano oral, reacciones liquenoides y lesiones escamosas intraepiteliales (incluídas las inducidas por acción viral) se evaluará la expresión de las proteínas relacionadas con la proliferación celular y la apoptosis en estas lesiones. Se evaluará con técnicas inmunohistoquímicas la relación de bcl-2 como marcador apoptótico en leucoplasias, liquen plano oral, lesiones escamosas intraepiteliales y carcinomas epidermoides orales, así como también en estas mismas lesiones la expresión proteica de MIB-1 (ki67), ciclina D1, p16 y p53 para valorar si las alteraciones en la expresión proteica de estos marcadores, suceden de forma secuencial a través de las distintas etapas en la cancerización del campo de cavidad oral, ya que no existe consenso en los resultados y las conclusiones obtenidas en los diferentes estudios efectuados sobre la influencia exclusiva de los marcadores apoptóticos en el desarrollo de las lesiones de algunas de las lesiones como el LPO.

Buccal apparatus and gastrointestinal tract dimensions associated to the diet of early life stages of Centropomus undecimalis (Centropomidae, Actinopterygii)

The present study aims to compare the buccal apparatus and gastrointestinal tract of early life stages of Centropomus undecimalis (Bloch, 1792), and relate them to its diet. A total of 190 individuals collected with a channel net in the Catuama estuary (07º40'9.9''S, 34º50'36.7''W), northern coast of the state of Pernambuco, were examined. Morphometrical and meristic data were analyzed for the two initial developmental periods (larval and juvenile). Their digestive tube was morphologically characterized and its content identified. The longest transverse axis of food items was measured, and compared to the standard length (SL) and mouth gape size (D) of the individuals. Body measurement regressions differed significantly (p<0.001) between larvae and juveniles. The stomachs with food content (n=118 individuals) presented a proportion of 62% full and 30% empty (being 8% damaged). They differed in relation to the fullness level and presented a coiled shape when empty. The number of food items in relation to SL and D did not present an evident correlation. Larvae (SL<10 mm) feed on small copepods, while juveniles (SL=11.1 to 64.7 mm) ingest larvae of various decapod species, showing a distinct diet between these initial developmental stages.

Doença de peixes fluviaes do Brasil

Nos ultimos annos teem sido observadas mortandades de peixes nos rios do Estado de S. Paulo. Vê-se, das informações obtidas pelo autor e por outros pesquisadores, que o phenomeno não parece novo entre nós; elle tem sido tambem verificado em outros rios do Brasil, embora não repetido com tanta regularidade como agora. Ficou demonstrado no presente trabalho, tratar-se de uma doença contagiosa, causada por um virus filtravel. Apparecem, a principio, alguns peixes doentes ou mortos; seu numero cresce muito nos dias seguintes. Parece serem atacados logo a maioria dos peixes do local onde ella surge porque, em 2 a 3 dias adoecem milhares e, em poucos, 8 a 15, decresce rapidamente o numero de animaes doentes e mortos. Nesse tempo a doença propagou-se a outros rios, relacionados com o primeiro, a montante ou a jusante delle, até muito distante do ponto onde começou a doença. A doença caracterisa-se clinicamente pela diminuição da capacidade motora dos peixes, que se movem com pouca actividade, deixando-se levar pela correnteza ou procurando permanecer nos pontos remansosos do rio; e pela tendencia a subir á superficie das aguas, em posição vertical ou obliqua, differente dos peixes sãos, que sobem horizontalmente. No inicio da doença os peixes defendem-se da captura, mais tarde são facilmente apprehendidos com a mão. As lesões se resumem em manchas, de tamanho variavel, situadas de cada lado do dorso. Essas manchas nem sempre são presentes. Mais constante é a congestão das nadadeiras, principalmente das nadadeiras peitoraes. Internamente ha augmento de muco na garganta, pallidez do figado e congestão da vesicula biliar, cuja bile é amarellada. Essas lesões internas tambem não são constantes. A doença transmitte-se: directamente, pela cohabitação de peixes seguramente sãos com peixes doentes, ou pela juncção de virus á água contendo peixes sãos; indirectamente, pela agua contaminada, ou pela agua filtrada em vela Chamberland F, cuja integridade foi verificada bacteriologicamente. O virus causador da doença é attenuado e destruido em temperaturas acima de 15° ou só age bem sobre peixes conservados em agua com temperaturas proximas de 12°. Conserva-se perfeitamente a 0°. Esta particularidade explica a coincidencia da doença sempre no inverno e nos rios de menor volume, onde as mudanças bruscas de temperatura são possiveis. Entretanto, a agua fria por si só não reproduz a doença nos animaes testemunhas, collocados em aquarios ao lado dos infectados, em todas as experiencias. A vista desta particularidade foi dada á doença a denominação de cryoichtyozoose. Verificações histologicas revelaram nos peixes doentes um processo inflammatorio na mucosa buccal, cujas cellulas apresentavam inclusões acidophilas, suggerindo-se então o nome estomatite contagiosa dos peixes, mais apropriado que o nome anterior, porque tem um substracto anatomico para a especificação da doença. Essas lesões permittem um diagnostico da doença a posteriori e á distancia. Investigações feitas sobre a etiologia permittiram afastar todas as outras causas conhecidas de mortandades em peixes: bacteiras, protozoarios, agentes physicos, incluindo o frio, e agentes chimicos, occasionando todos lesões bem conhecidas nesses animaes. Além disso, taes causas são facilmente constatadas por technicas simples de laboratorio ou pelo aspecto dos peixes atacados. Na «discussão» do assumpto ficou patente haver analogias dessa doença com certas mortandades observadas em outros paizes, particularmente com a estudada por Huxley, nos rios do Sul da Escossia, observada durante varios annos. Não é impossivel, tambem, que algumas das doenças descriptas em peixes como causadas por bacterias ou parasitos, sem prova segura da pathogenia desses agentes pathogenicos, tenham sua origem em agentes da mesma natureza da doença de S. Paulo.

Diagnóstico histopatológico de la leishmaniasis cutánea y cutáneo-mucosa en Bolivia

En 98 casos de Leishmaniasis cutánea y cutáneo-mucosa, se encontró relación importante entre infiltrado plasmocitario y la presencia del parásito; en cuanto el infiltrado linfocitario y/o granulomatoso, aparecia en los casos donde el parásito estaba ausente. Por otra parte no se encontró diferencia entre los tipos histopatológicos predominantes en relación con el tiempo de evolución de las lesiones. Estos aspectos son una contribución para la interpretación de material de biopsias en las áreas endémicas de Leishmianiasis.

The plasminogen system in microdissected colonic mucosa distant from an isolated adenoma.

In the colon, the urokinase-type plasminogen activator (uPA), its receptor (uPAR), and plasminogen activator inhibitors, PAI-1 and PAI-2, are implicated in the transition from mucosa to adenoma and tumour progression. However, expression in the mucosa adjacent, or distant, to an adenoma has not yet been investigated. Three biopsies from mucosae adjacent (20 cm, ipsilateral) and distant (contralateral) to an isolated tubular adenoma were analysed in 14 patients and 8 controls. Laser microdissection isolated stromal and epithelial crypt components, and quantitative RT-PCR analyses of uPA, uPAR, PAI-1 and PAI-2 mRNA levels were performed. Among controls, no significant differences in the markers were noted. With left colon isolated tubular adenoma, uPA, uPAR, and PAI-2 mRNA levels were significantly increased in the adjacent mucosal stroma compared to epithelial crypt levels (p < 0.05). In right colon adenoma, the mRNA levels of these 3 molecular markers were significantly increased only in the adjacent mucosal stromal samples (p < 0.05). Isolated tubular adenoma in the colon increases significantly the mRNA levels of 3 proteolysis-associated molecular markers in the stromal, but not in the epithelial, components of adjacent mucosa. These results suggest the presence of regional and dynamic interactions in apparently non-involved mucosae.

Leishmania braziliensis ssp. in the nasal mucosa of guinea pigs inoculated in the tarsi

Two lots of 20 young male guinea pigs were inoculated subcutaneously in the tarsi with 10 (elevated to fourth potency) amastigotes of Leishmania braziliensis or L. b. guyanensis to study the susceptibility of this Neotropical hystricomorph rodent the autochthonous parasites. Almost 50% of the animals showed lesions in the inoculation site and had parazitations that were infective to hamsters, as shown by inoculating homogenates of the dermal lesion, of the spleen, of the liver, and of the nasal mucosa into hamsters at 20, 40, 60 and 120 days after inoculation of the guinea pig. Smears of the above organs showed the presence of amastigotes. Parasites inoculated into the tarsi were detected early in the skin, spleen, and liver of the guinea pig host. Blood cultures made by cardiopuncture on sacrifice of the guinea pigs were uniformly negative. The nasal mucosa of nearly all animals positive in the skin or viscera was invaded early by the parasites, although with grater frequency between 60 and 120 days post-inoculation. The use of this model for the study of mucocutaneous parasitism by L. brasiliensis is discussed, together with the phenomena of parasitism at a distance from the inoculation site, the temperature of the body regions affected, and the possible genetic influence on susceptibility of the guinea pig to L. brasiliensis.

Epithelium-Intrinsic NAIP/NLRC4 Inflammasome Drives Infected Enterocyte Expulsion to Restrict Salmonella Replication in the Intestinal Mucosa.

The gut mucosal epithelium separates the host from the microbiota, but enteropathogens such as Salmonella Typhimurium (S.Tm) can invade and breach this barrier. Defenses against such acute insults remain incompletely understood. Using a murine model of Salmonella enterocolitis, we analyzed mechanisms limiting pathogen loads in the epithelium during early infection. Although the epithelium-invading S.Tm replicate initially, this intraepithelial replicative niche is restricted by expulsion of infected enterocytes into the lumen. This mechanism is compromised if inflammasome components (NAIP1-6, NLRC4, caspase-1/-11) are deleted, or ablated specifically in the epithelium, resulting in ∼100-fold higher intraepithelial loads and accelerated lymph node colonization. Interestingly, the cytokines downstream of inflammasome activation, interleukin (IL)-1α/β and IL-18, appear dispensable for epithelial restriction of early infection. These data establish the role of an epithelium-intrinsic inflammasome, which drives expulsion of infected cells to restrict the pathogen's intraepithelial proliferation. This may represent a general defense mechanism against mucosal infections.

Pseudomonas aeruginosa adhesion to normal and injured respiratory mucosa

Human nasal polyps outgrowth culture were used to study the adhesion of Pseudomonas aeruginosa to respiratory cells. By transmission electron microscopy, bacteria associated with ciliated cells were identified trapped at the extremities of cilia, usually as aggregates of several bacterial cells. They were never seen at the interciliary spaces or attached along cilia. Bacteria were also seen to adhere to migrating cells of the periphery of the outgrowth culture. Using a model of repair of wounded respiratory epithelial cells in culture, we observed that the adhesion of P. aeruginosa to migrating cells of the edges of the repairing wounds was significantly higher than the adhesion to non-migrating cells and that adherent bacteria were surrounded by a fibrocnectin-containing fibrillar material The secretion of extracellular matrix components is involved in the process of epithelium repair following injury. To investigate the molecular basis of P. aeruginosa adhesion to migrating cells, bacteria were treated with a fibronectin solution before their incubation with the respiratory cells. P. aeruginosa treatment by fibronectin significantly increased their adhesion to migrating cells. Accordingly, we hypothesize that during cell migration, fibronectin secreted by epithelial cells may favour P. aeruginosa adhesion by establishing a bridge between the bacteria and the epithelial cell receptors. Such a mechanism may represent a critical step for P. aeruginosa infection of healing injured epithelium.