931 resultados para LUPUS NEPHRITIS


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The Brazilian population represents an admixture of native Amerindians, Portuguese settlers and Africans who were brought as slaves during the colonization period that began in the 16th century and was followed by waves of immigrations of Europeans and Asians in the 20th century. The contribution of these different ethnic groups to the constitution of Brazilian populations from different geographic regions is variable and, in addition to environmental factors, might act by determining different allele profiles among Brazilian populations from different regions. We studied polymorphic sites at the 3' untranslated region of the HLA-G gene in individuals from a Northeastern Brazilian region and compared them to our previously published data about a Southeastern Brazilian region, located at a distance of 2589 km. Our results showed that most polymorphic sites present a similar distribution in both populations, except for the lower frequency of the +3003C allele in the Northeastern population compared to the Southeastern population. Although differences in genotypic distribution were only significant for the +3003 locus (P = 0.0201), the diversity of haplotypes was distinct for each population. These results are important for casecontrol studies on the association of human leucocyte antigen-G polymorphism with disease and also in terms of the genetic structure of two distinct Brazilian populations.

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Objective Various nonvalidated criteria for disease flare have been used in studies of gout. Our objective was to develop empirical definitions for a gout flare from patient-reported features. Methods Possible elements for flare criteria were previously reported. Data were collected from 210 gout patients at 8 international sites to evaluate potential gout flare criteria against the gold standard of an expert rheumatologist definition. Flare definitions based on the presence of the number of criteria independently associated with the flare and classification and regression tree approaches were developed. Results The mean +/- SD age of the study participants was 56.2 +/- 15 years, 207 of them (98%) were men, and 54 of them (26%) had flares of gout. The presence of any patient-reported warm joint, any patient-reported swollen joint, patient-reported pain at rest score of >3 (010 scale), and patient-reported flare were independently associated with the study gold standard. The greatest discriminating power was noted for the presence of 3 or more of the above 4 criteria (sensitivity 91% and specificity 82%). Requiring all 4 criteria provided the highest specificity (96%) and positive predictive value (85%). A classification tree identified pain at rest with a score of >3, followed by patient self-reported flare, as the rule associated with the gold standard (sensitivity 83% and specificity 90%). Conclusion We propose definitions for a disease flare based on self-reported items in patients previously diagnosed as having gout. Patient-reported flare, joint pain at rest, warm joints, and swollen joints were most strongly associated with presence of a gout flare. These provisional definitions will next be validated in clinical trials.

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Trata-se de um caso de uma paciente de 30 anos do sexo feminino, com prótese biológica valvar mitral em razão de estenose mitral sintomática e antecedentes de infarto agudo do miocárdio, episódios de convulsões tônico-clônicas generalizadas, alucinações visuais, eventos tromboembólicos cerebrais, apresentando no momento coreia e cardite aguda. Foram diagnosticados na paciente febre reumática em atividade, lúpus eritematoso sistêmico e síndrome do anticorpo antifosfolipídeo. A combinação de três diagnósticos incomuns em um mesmo paciente torna esse caso único, modificando o tratamento e seu prognóstico.

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A síndrome do anticorpo antifosfolípide (SAF) é uma trombofilia autoimune, caracterizada pela presença de anticorpos plasmáticos contra fosfolípides, associada a episódios recorrentes de trombose venosa e/ou arterial e morbidade gestacional (especialmente abortamento de repetição). Reportamos o caso de uma paciente feminina, jovem, com diagnóstico de lúpus eritematoso sistêmico (LES), associado à presença de anticorpos antifosfolípide de longa data, com apresentação de infarto agudo do miocárdio (IAM) por trombose proximal da artéria descendente anterior como primeira complicação clínica da SAF.

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O lupus eritematoso sistêmico (LES) é a mais comum das doenças auto-imunes sistêmicas, ocorrendo com maior freqüência no sexo feminino, usualmente na faixa etária entre 16 e 55 anos1,2. Embora os rins classicamente sejam os órgãos mais acometidos no LES, o coração e a circulação cardiopulmonar também podem ser afetados de forma significativa3. Nesse contexto, a ocorrência de edema agudo de pulmão associado à miocardite lúpica é rara e de tratamento imunossupressor específico ainda incerto.

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Os autores revisaram a influência dos fatores nutricionais sobre o lúpus eritematoso sistêmico (LES) e abordaram uma alternativa complementar em seu tratamento. A autoimunidade e o processo inflamatório do LES estão relacionados à presença de dislipidemias, obesidade, hipertensão arterial sistêmica e síndrome metabólica, que devem ser adequadamente consideradas para diminuir o risco cardiovascular. Uma alimentação com moderado teor energético e proteico, mas rica em vitaminas, minerais (principalmente os antioxidantes) e ácidos graxos mono/poli-insaturados, pode promover ação benéfica protetora contra danos tissulares e supressão da atividade inflamatória, além de auxiliar no tratamento dessas comorbidades. A dietoterapia é uma abordagem promissora, e algumas recomendações podem oferecer melhor qualidade de vida aos pacientes com LES.

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OBJETIVO: Avaliar a presença de anticorpos anti-C1q, anticromatina/nucleossomo e anti-DNA de duplo filamento (dsDNA) em pacientes com lúpus eritematoso sistêmico juvenil (LESJ) e controles. MÉTODOS: Foram analisados 67 pacientes com LESJ e 34 controles saudáveis para presença de anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA pelo método ELISA. Os níveis de C1q foram avaliados por imunodifusão radial. RESULTADOS: Na época, a média de idade era similar entre os pacientes com LESJ e os controles (14,6 ± 3,86 vs. 13,6 ± 2,93 anos; P = 0,14). Foram observadas frequências mais altas de anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA em pacientes com LESJ em relação aos controles (20% vs. 0%; P = 0,0037; 48% vs. 0%; P < 0,0001 e 69% vs. 3%; P < 0,0001, respectivamente). A mediana dos anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA também foi significativamente mais alta em pacientes com LESJ em relação aos controles [9,6 (5,5-127) vs. 7,5 (5-20) unidades, P = 0,0006; 18 (1,9-212) vs. 3,2 (1,7-17) unidades, P < 0,0001; e 111 UI/mL (6-741) vs. 14 (6-33) UI/mL, P < 0,0001, respectivamente]. A sensibilidade para os anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA foi: 21% (IC: 11-33), 49% (IC: 36-62) e 70% (IC: 57-81). A especificidade foi de 100% (IC: 88-100), 100% (88-100) e 97% (IC: 83-99), respectivamente. Foi observada uma correlação positiva entre os níveis de anti-dsDNA e tanto anticorpos anti-C1q (r = 0,51; IC: 0,29-0,68; P < 0,0001) como anticromatina/nucleossomo (r = 0,87; IC: 0,79-0,92; P < 0,0001). Foi observada uma correlação negativa entre os níveis de anti-C1q e C1q (r = -0,33; IC: -0,56-0,05; P = 0,018). A frequência de anti-dsDNA foi mais alta em pacientes com SLEDAI-2K > 1 (P = 0,0047), e não foram observadas diferenças nas frequências desses três autoanticorpos e nefrite (P > 0,05). CONCLUSÃO: Nosso estudo demonstrou elevada especificidade para diagnóstico de lúpus envolvendo os três autoanticorpos, especialmente anti-C1q e anticromatina/nucleossomo.

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Adenine overload promotes intratubular crystal precipitation and interstitial nephritis. We showed recently that these abnormalities are strongly attenuated in mice knockout for Toll-like receptors-2, -4, MyD88, ASC, or caspase-1. We now investigated whether NF-κB activation also plays a pathogenic role in this model. Adult male Munich-Wistar rats were distributed among three groups: C (n = 17), receiving standard chow; ADE (n = 17), given adenine in the chow at 0.7% for 1 wk and 0.5% for 2 wk; and ADE + pyrrolidine dithiocarbamate (PDTC; n = 14), receiving adenine as above and the NF-κB inhibitor PDTC (120 mg•kg-1•day-1 in the drinking water). After 3 wk, widespread crystal deposition was seen in tubular lumina and in the renal interstitium, along with granuloma formation, collagen accumulation, intense tubulointerstitial proliferation, and increased interstitial expression of inflammatory mediators. Part of the crystals were segregated from tubular lumina by a newly formed cell layer and, at more advanced stages, appeared to be extruded to the interstitium. p65 nuclear translocation and IKK-α increased abundance indicated activation of the NF-κB system. PDTC treatment prevented p65 migration and normalized IKK-α, limited crystal shift to the interstitium, and strongly attenuated interstitial fibrosis/inflammation. These findings indicate that the complex inflammatory phenomena associated with this model depend, at least in part, on NF-κB activation, and suggest that the NF-κB system may become a therapeutic target in the treatment of chronic kidney disease.

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Several viruses have been identified in recent years in the intestinal contents of chickens and turkeys with enteric problems, which have been observed in commercial farms worldwide, including Brazil. Molecular detection of these viruses in Brazil can transform to a big threat for poultry production due to risk for intestinal integrity. This disease is characterized by severely delayed growth, low uniformity, lethargy, watery diarrhea, delayed feed consumption, and a decreased conversion rate. Chicken astrovirus (CAstV), rotavirus, reovirus, chicken parvovirus (ChPV), fowl adenovirus of subgroup I (FAdV-1), and avian nephritis virus (ANV) were investigated using the conventional polymerase chain reaction (PCR) and the reverse transcription polymerase chain reaction (RT-PCR). In addition, the infectious bronchitis virus (IBV), which may play a role in enteric disease, was included. The viruses most frequently detected, either alone or in concomitance with other viruses, were IBV, ANV, rotavirus, and CAstV followed by parvovirus, reovirus, and adenovirus. This study demonstrates the diversity of viruses in Brazilian chicken flocks presenting enteric problems characterized by diarrhea, growth retard, loss weight, and mortality, which reflects the multicausal etiology of this disease

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Editorial: La gestión del personal docente e investigador. Actualidad institucional: Llegan más de 600 estudiantes de intercambio 1.616 Profesores e investigadores para cubrir la docencia universitaria. La ULPGC facilita información a los representantes de la comunidad universitaria sobre la Gripe A. La ULPGC impartirá Enfermería en Fuerteventura. Concurso de emprendedores Universitarios. Reportaje: Acto de Apertura del Curso Académico 2009-2010. La ULPGC investiga: Mención Especial de Honor en un concurso internacional de Arquitectura. Descubren un corredor de remolinos oceánicos en Canarias. Los científicos desarrollan una terapia que frena el Lupus en ratones. Comunidad universitaria: Ayudas para la mejora de la Gestión Ambiental y la Sostenibilidad. III Olimpiada Iberoamericana de Biología. Campeonas de Europa en el Universitario de Kárate

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The labyrinthum Capella quoted in the title (from a Prudentius of Troyes epistle) represents the allegory of the studium of the liberal arts and the looking for knowledge in the early middle age. This is a capital problem in the early Christianity and, in general, for all the western world, concerning the relationship between faith and science. I studied the evolution of this subject from its birth to Carolingian age, focusing on the most relevant figures, for the western Europe, such Saint Augustine (De doctrina christiana), Martianus Capella (De Nuptiis Philologiae et Mercurii) and Iohannes Scotus Eriugena (Annotationes in Marcianum). Clearly it emerges that there were two opposite ways about this relatioship. According to the first, the human being is capable of get a knowledge about God thanks to its own reason and logical thought processes (by the analysis of the nature as a Speculum Dei); on the other way, only the faith and the grace could give the man the possibility to perceive God, and the Bible is the only book men need to know. From late antiquity to Iohannes Scotus times, a few christian and pagan authors fall into line with first position (the neoplatonic one): Saint Augustine (first part of his life, then he retracted some of his views), Martianus, Calcidius and Macrobius. Other philosophers were not neoplatonic bat believed in the power of the studium: Boethius, Cassiodorus, Isidorus of Seville, Hrabanus Maurus and Lupus of Ferriéres. In order to get an idea of this conception, I finally focused the research on Iohannes Scotus Eriugena's Annotationes in Marcianum. I commented Eriugena's work phrase by phrase trying to catch the sense of his words, the reference, philosophical influences, to trace antecedents and its clouts to later middle age and Chartres school. In this scholastic text Eriugena comments the Capella's work and poses again the question of the studium to his students. Iohannes was a magister in schola Palatina during the time of Carl the Bald, he knew Saint Augustine works, and he knew Boethius, Calcidius, Macrobius, Isidorus and Cassiodorus ones too. He translated Pseudo-Dionysius the Areopagite and Maximus the Confessor. He had a neoplatonic view of Christianity and tried to harmonize the impossibility to know God to man's intellectual capability to get a glimpse of God through the study of the nature. According to this point of view, Eriugena's comment of Martianus Capella was no more a secondary work. It gets more and more importance to understand his research and his mystic, and to understand and really grasp the inner sense of his chief work Periphyseon.

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Introduction: Anti-TNF-alfa therapy has been effective in the treatment of patients with refractory psoriasis and psoriasic arthritis. However, the risk of developing autoantibodies in these patients undergoing this therapy is not clear. Objective: To evaluate the induction of specific autoantibodies after anti-TNFα therapy in patients with psoriasis and psoriasic arthritis and, to evaluate the influence of the use of methotrexate on the values of autoantibodies developed during this therapy. Patients and methods: Serum samples from 120 patients, obtained before(baseline) the introduction of anti-TNF-alpha therapy and approximately each 3-6 months during the therapy.O f these 120 patients, 113 were found negative for autoantibodies before starting anti -TNFalpha therapy, 7 were found positive for ANA. The analysis included detection of antinuclear antibodies (ANA) and anti-dsDNA antibodies (indirect immunofluorescence on Hep-2 cells and Crithidia luciliae, respectively); anti extractable nuclear antigens antibodies( ENA)(ELISA). RESULTS: Infliximab is associated with the highest occurrence rate of ANA, anti-dsDNA, ENA with approximately 69,2%, 11,5%, 7,6% of patients treated testing positive. In comparison, only 20%, 6,6%, 2,2% of patients treated with Adalimumab, and 19%, 2,3%, 2,3% of patients treated with Etanercept were positive for ANA, Anti-dsDNA, ENA respectively. As regard the seven patients who were positive at baseline, six of them (85.7%) in addition to being remained positive during the therapy they have also increased the autoantibodies ’s titers. Conclusion: our study have shown that Infliximab is associated with the highest rate of autoantibodies. The concomitant treatment with methotrexate did not modify the titers of autoantibodies developed during the therapy anti-TNFalph. The incidence of ANA, anti-dsDNA antibodies did not correlate with development of Lupus-like syndromes. The difference in the frequency of autoantibodies between psoriasis and psoriatic arthritis was not statistically significant (p = 0.867).

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INTRODUCTION. Late chronic allograft disfunction (CAD) is one of the more concerning issues in the management of patients (pts) with renal transplant (tx). Humoral immune response seems to play an important role in CAD pathogenesis. AIM OF THE STUDY. To identify the causes of late chronic allograft disfunction. METHODS. This study (march 2004-august 2011) enrolled pts who underwent renal biopsy (BR) because of CAD (increase of creatininemia (s-Cr) >30% and/or proteinuria >1g/day at least one year after tx). BR were classified according to 1997/2005 Banff classification. Histological evaluation of C4d (positive if >25%), glomerulitis, tubulitis, intimal arteritis, atrophy/fibrosis and arteriolar-hyalinosis were performed. Ab anti-HLA research at BR was an inclusion criteria. Pts were divided into two groups: with or without transplant glomerulopathy (CTG). RESULTS. Evaluated BR: 93/109. BR indication: impaired s-Cr (52/93), proteinuria (23/93), both (18/93). Time Tx-BR: 7.4±6.3 yrs; s-Cr at BR: 2.7±1.4 mg/dl. CTG group(n=49) not-CTG group(n=44) p Time tx-BR (yrs) 9.3±6.7 5.3±5.2 0.002 Follow-up post-BR (yrs) 2.7±1.8 4.1±1.4 0.0001 s-Cr at BR (mg/dl) 2.9±1.3 2.4±1.5 NS Rate (%) of pts: Proteinuria at BR 61% 25% 0.0004 C4d+ 84% 25% <0.0001 Ab anti-HLA+ 71% 30% 0.0001 C4d+ and/or Ab antiHLA 92% 43% 0.0001 Glomerulitis 76% 16% <0.0001 Tubulitis 6% 32% 0.0014 Intimal arteritis 18% 0% 0.002 Arteriolar hyalinosis 65% 50% NS Atrophy/fibrosis 80% 77% NS Graft survival 45% 86% 0.00005 Histological Diagnosis: CTG group (n=49:Chronic rejection 94%;IgA recurrence + humoral activity 4%;IIA acute rejection + humoral activity 2%. Not-CTG group (n=44: GN recurrence 27%;IF/TA 23%; acute rejection 23%;BKV nephritis 9%; mild not specific alterations 18%. CONCLUSIONS: CTG is the morphological lesion mainly related to CAD. In the 92% of the cases it is associated with markers of immunological activity. It causes graft failure within five years after diagnosis in 55% of pts.

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Untersuchungen zur autoimmunen Genese der thrombotisch thrombozytopenischen Purpura. rnEinführung: Die idiopathische thrombotisch thrombozytopenische Purpura (TTP) ist eine lebensbedrohliche Mikroangiopathie und wird durch ein Autoantikörper-induziertes Defizit der ADAMTS13-Protease ausgelöst. Eine Assoziation zwischen Krankheitsprädisposition und Vorliegen bestimmter humaner Leukozytenantigene (HLA) wird vermutet. Untersuchungen zu diesem Zusammenhang stellen einen Teil dieser Arbeit dar. rnAutoimmunkrankheiten tendieren zum gemeinsamen Auftreten innerhalb eines Individuums. Im zweiten Teil dieser Arbeit wird untersucht, ob eine solche Kookkurrenz verschiedener Autoimmunkrankheiten auch bei Patienten mit idiopathischer TTP beobachtet werden kann.rnMethodik: Zur Untersuchung der ersten Fragestellung werden die HLA-Klasse I und II-Merkmale von 54 deutschen TTP-Patienten bestimmt. Alle Patienten weisen Autoantikörper gegen ADAMTS13 und eine Protease-Aktivität <5% vor. Die Blutproben werden mittels Sequence Specific Primer-Polymerase Chain Reaction (PCR) und Sequence Specific Oligonucleotid-PCR auf HLA-DRB1, -DRB3-5 und –DQB1 untersucht. Als Referenz dienen die Werte deutscher Knochenmark- und Blutspender, erhalten über www.allelefrequencies.net. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest und die resultierenden p-Werte werden nach Benjamini-Hochberg korrigiert.rnZur Beantwortung der zweiten Fragestellung werden 76 deutsche TTP-Patienten anhand eines standardisierten Fragebogens nach Begleiterkrankungen befragt. Als Vergleichswerte dient die Prävalenz der jeweiligen Erkrankung in der Allgemeinbevölkerung. Die statistische Auswertung erfolgt mittels zweiseitigem Binomialtest. Da die p-Werte nicht korrigiert werden, sind die Ergebnisse nur deskriptiv zu verstehen.rnErgebnis: Der Vergleich der HLA-Frequenzen ergibt ein signifikant gehäuftes Vorkommen von HLA-DQB1*02:02 (p<0,001) und -DRB1*11 (p=0,003) innerhalb des Patientenkollektivs. 20% (DQB1*02:02) bzw. 48,1% (DRB1*11) der TTP-Patienten sind im Gegensatz zu nur 1,2% (DQB1*02:02) bzw. 23,5% (DRB1*11) innerhalb der Vergleichsgruppe für das jeweilige HLA-Merkmal positiv.rnDie Befragung der TTP-Patienten bezüglich weiterer Erkrankungen ergab im Vergleich mit der Allgemeinbevölkerung fünf auffällig häufig im Patientenkollektiv vorkommende Autoimmunkrankheiten: Hashimoto Thyreoiditis (23,5% in der Patientengruppe zu 0,7% in der Allgemeinbevölkerung; p<0,001), systemischer Lupus erythematodes (6,5% der Patienten im Gegensatz zu 0,025% in der Allgemeinbevölkerung, p<0,001), Immunthrombozytopenie (6,3% der Patienten zu 0,02% in der Allgemeinbevölkerung; p<0,001), Psoriasis (9,4% der Patienten zu 2,5% in der Allgemeinbevölkerung; p=0,005) und glutensensitive Enteropathie (3,1% der Patienten zu 0,2% in der Allgemeinbevölkerung; p=0,007). rnSchlussfolgerung: Das vermehrte Vorkommen bestimmter HLA-Merkmale im Patientenkollektiv spricht für eine prädisponierende Wirkung dieser Antigene im Krankheitsgeschehen. Eine mögliche HLA-vermittelte Assoziation zwischen TTP und den genannten Autoimmunkrankheiten wird vermutet, kann jedoch nicht in allen Fällen die beobachtete Kookkurrenz ausreichend erklären. Insgesamt bestätigt die vorliegende Arbeit die Assoziation verschiedener Autoimmunkrankheiten untereinander und spricht für eine genetische Prädisposition zur Ausbildung autoimmuner Störungen. rn

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Die medikamentöse Standardtherapie entzündlich-rheumatischer Erkrankungen wie der rheumatoider Arthritis (RA) und des systemischen Lupus erythematodes (SLE) sind oft unzureichend und erlauben keine nebenwirkungsarme beziehungsweise -freie Behandlung. Daher ist es von großem Interesse für diese Indikationsgebiete, wirkungsvolle Substanzen zu entwickeln, die für eine Langzeittherapie geeignet sind. Naturstoffe wie Oxacyclododecindion (Oxa) können dabei als mögliche Leitstruktur dienen. Oxa wurde bereits in in-vitro Untersuchungen als ein potenter Inhibitor der Expression von proinflammatorischen und profibrotischen Genen identifiziert. rnZiel dieser Arbeit war es in in-vivo Modellen der RA und des SLEs das therapeutische Potential des Naturstoffes Oxa aufzuklären. Da eine Etablierung der Kollagen-induzierten Arthritis im untersuchten murinen RA-Modell, dem HLA-DR4.AE° Stamm, nicht möglich war, wurden die Untersuchungen ausschließlich im MRL Faslpr Mausstamm, einem anerkannten SLE-Modell durchgeführt. MRL Faslpr Mäuse entwickeln wie SLE-Patienten unter anderem eine schwerwiegende Glomerulonephritis. rnIn den Nieren weiblicher MRL Faslpr Mäuse konnte die Oxa-Behandlung die Expression zahlreicher proinflammatorischer Mediatoren beeinflussen, die in Zusammenhang mit der Pathogenese des humanen SLE gebracht werden. So reduziert der Naturstoff die Expression von Zytokinen wie TNFα, IFNγ und IL6 als auch Chemokinen wie CCL2, CSF-1 und RANTES auf mRNA- und Proteinebene. Dabei war die Wirkung von Oxa in den in-vivo Analysen ähnlich gut wie die des potenten Glukokortikoids Dexamethason. Die Reduktion chemotaktischer Moleküle durch die Oxa-Behandlung führte nachweislich zu einer reduzierten Akkumulation von Immunzellen. Die anti-inflammatorischen und immunmodulatorischen Effekte von Oxa waren so ausgeprägt, dass klinisch-pathologische Marker der Glomerulonephritis, wie die Ablagerung von Immunkomplexen, die vermehrte Bildung von Kollagenfasern und die Ausscheidung von Proteinen im Urin gemildert wurden. Weiterführende Untersuchungen im SLE Modell konnten neue Zielmoleküle von Oxa identifizieren, wie KIM1 und zahlreiche SLE-assoziierte microRNAs (miR 19a, 29c und 369). Diese Befunde legen nahe, dass Oxa eine vielversprechende anti-entzündliche und -fibrotische Verbindung darstellt. rnDie Entschlüsselung des Wirkmechanismus von Oxa steht erst am Anfang. Die Analysen im Rahmen dieser Arbeit zeigten jedoch, dass Oxa einen Einfluss auf die Phosphorylierung und somit Aktivierung der p38 MAPK sowie auf die mRNA-Stabilität von proinflammatorischen Zytokinen wie TNFα zu haben scheint.rn