Caracterização dos níveis plasmáticos e do polimorfismo +874T/A no gene IFN-γ em pacientes com diferentes formas clínicas da tuberculose

Considerando a importância do interferon gama (IFN-γ) na imunidade protetora contra o Mycobacterium tuberculosis e o papel funcional do polimorfismo de nucleotídeo único (SNP) IFNG +874T/A na produção de IFN-γ, no presente estudo investigamos a relação desse polimorfismo genético com suscetibilidade à tuberculose. Fizeram parte do estudo um total de 129 pacientes com tuberculose pulmonar (TBP), 33 com tuberculose extrapulmonar (TBEP) e em 156 profissionais da saúde, negativos para tuberculose, com resultados tuberculínicos (PPD+ e PPD-) dos quais foi coletada uma amostra de 5 mL de sangue total. As concentrações séricas de IFN-g foram mensuradas usando um ensaio imunoenzimático. O polimorfismo na posição +874A no gene IFN-g foi investigado por meio da técnica de ASO-PCR (allele specific oligonucleotide – polymerase chain reaction). Verificamos uma associação entre a presença do alelo +874A e do genótipo +874AA com a tuberculose ativa (p<0.0001, CI=95%, 1.64 - 3.22), ao mesmo tempo em que o alelo +874Te genótipo +874TT estiveram em maior freqüência nos indivíduos do grupo controle. A média das concentrações plasmáticas de IFN-g nos pacientes com tuberculose foi significativamente menor que aquela observada no grupo controle, como também foi menor no grupo com TBEP do que no grupo com TBP, sugerindo uma relação dos baixos níveis séricos dessa citocina na tuberculose ativa, bem como na progressão para as formas mais graves da doença. Ademais, foi observada a associação dos genótipos +874TT e +874AA com altas e baixas concentrações de IFN-γ, respectivamente, tanto nos pacientes com tuberculose quanto no grupo controle. Assim sendo, os resultados sugerem uma associação do polimorfismo do gene IFNG +874T/A com suscetibilidade à infecção pelo M. tuberculosis na população estudada.

Susceptibilidade experimental do Anopheles (Nyssorhynchus) nuneztovari Galbadon, 1940 ao Plasmodium vivax Grassi&Feletti, 1890 e Plasmodium falciparum Welch, 1897

A importância do An. nuneztovari como vetor primário de malária já foi comprovado em países da América do Sul como Venezuela, Colômbia e Peru. Na Amazônia brasileira, embora tenha sido encontrado naturalmente infectado com Plasmodium vivax e P. falciparum e em alta densidade, é ainda considerado vetor secundário desta doença. O objetivo deste presente trabalho foi avaliar a susceptibilidade do An. nuneztovari à infecção por plasmódios humanos. Para isso exemplares da geração F1, obtida em laboratório, de An. nuneztovari e An. darlingi (espécie controle) foram alimentados, em alimentador artificial, com sangue de pacientes com diagnóstico inicial de malária causada por P. falciparum, cuja revisão resultou no diagnóstico de infecção mista. Todas as amostras sangüíneas dos pacientes infectaram espécimes das duas espécies, não mostrando diferença significativa entre elas quanto à susceptibilidade. Para detecção de infecção malárica nos mosquitos foi usado o teste ELISA (Enzime – Linked Imunosorbent Assay) cujos resultados foram discordantes do diagnóstico laboratorial, já que o teste detectou infecções pelo P. falciparum, P. vivax VK210 ou P. vivax VK247entre os mosquitos positivos sugerindo que os pacientes apresentavam infecção mista. Também foi observado o curto período de desenvolvimento de oocistos e esporozoítos, de quatro a cinco dias, o que pode ser explicado pela alta temperatura (>30°C) que os mosquitos foram expostos. Assim nossos resultados sugerem possível envolvimento do An nuneztovari na transmissão de malária humana na área estudada e alertam para o papel deste, como possível vetor principal de malária humana na região amazônica brasileira.

Estudo morfológico e imunológico da encefalite induzida pelo vírus juruaçá em modelo murino

Muitos estudos têm sido realizados para o entendimento da neuropatogênese das encefalites virais a partir de trabalhos experimentais, porém, nenhum estudo experimental foi dedicado à compreensão da neuropatogênese de membros da família Picornaviridae isolados de morcegos na região amazônica. O vírus Juruaçá, um desses agentes, parcialmente caracterizado como membro da família Picornaviridae por Araújo e colaboradores (2006), causou lesões no encéfalo de camundongos neonatos com presença de gliose reativa, apesar de não provocar efeito citopático (ECP) em cultivos primários de células do sistema nervoso central (SNC), sugerindo que este agente viral seja responsável pela morte dos animais devido a uma intensa resposta imune. O objetivo desse trabalho foi investigar a resposta imune no SNC e alterações celulares causadas pelo vírus Juruaçá em camundongos albinos da linhagem BALB/c neonatos a partir de análises histopatológicas, de ativação microglial e da expressão de citocinas, óxido nítrico (NO) e espécies reativas de oxigênio (ROS). Para tanto, foram realizados processamento de amostras para histopatologia, ensaios imunoenzimáticos, imunohistoquímicos e de imunofluorescência, além de testes para quantificação de NO e ROS e análises estatísticas. Nossos resultados demonstraram que o vírus Juruaçá induz lesões por todo o encéfalo, com maior intensidade no parênquima cortical. Os testes imunohistoquímicos demonstraram a presença de antígenos virais e de micróglias reativas distribuídos por todo o encéfalo e região anterior da medula espinhal. Micróglias com aspecto ameboide, demonstrando intensa ativação, foram observadas principalmente no córtex cerebral, bulbo olfatório, núcleo olfatório anterior, prosencéfalo e diencéfalo próximo ao ventrículo lateral. A produção das citocinas anti-inflamatórias (IL-10, IL-4) diminuiu ao longo do tempo, enquanto que as pró-inflamatórias (IL-12, IL-6, IL-1β, TNF-α, IFN-γ) aumentaram significativamente a partir do 8º dia. Os ensaios para detecção de ROS demonstraram grande produção de radicais superóxido desde o 4º dia, já a produção de NO foi sempre menor nos animais infectados. Provavelmente, a ativação das células gliais, principalmente micróglias, e consequente produção de citocinas pró-inflamatórias e ROS promoveram uma ação devastadora sobre as células do SNC, que coincide com a intensificação dos sinais clínicos. Diante do exposto, ficou evidente que os nossos resultados indicam que o vírus Juruaçá é responsável por uma doença de cunho inflamatório que leva a óbito 100% de camundongos neonatos infectados.

Intraocular pressure, specular microscopy, and prostaglandin E-2 concentration in dogs with mature and hypermature cataract

This study aimed to evaluate and correlate intraocular pressure (IOP), endothelial cell density (CD), and hexagonality (HEX), and the aqueous humor prostaglandin E-2 (PGE(2)) concentration in dogs with mature (MG, n = 8) and hypermature (HG, n = 8) cataracts. Eight laboratory beagles with no ocular abnormalities were included as a control group (CG). The IOP was measured using a digital applanation tonometer. Noncontact specular microscopy was used to evaluate CD and HEX. Samples of aqueous humor were used to determine prostaglandin E-2 concentration using enzyme-linked immunoassay. Data were compared by ANOVA and Bonferroni's multiple comparison test, and possible correlations among the PGE(2) aqueous concentration and corneal endothelium cell parameters were assessed by Person's test (P < 0.05). Average values of IOP (P = 0.45) and CD (P = 0.39) were not significantly different between MG, HM, and CG. Average values of HEX were lower, and PGE(2) concentration was increased in the MG and HG in comparison with CG (P < 0.05); however, such parameters did not change significantly between MG and HG (P > 0.05). PGE(2) values did not correlate with IOP, CD, and HEX in any group (P > 0.05). Although there were a small number of dogs studied, our results demonstrated that cataract progression from mature to hypermature did not have a significant change in PGE(2) aqueous concentration, IOP, corneal endothelial cell count, or morphology. In addition, PGE(2) concentration was not correlated with parameters of the corneal endothelium or IOP in dogs with mature or hypermature cataracts.

Oral Contraceptive Containing Chlormadinone Acetate and Ethinylestradiol Reduces Plasma Concentrations of Matrix Metalloproteinase-2 in Women with Polycystic Ovary Syndrome

Biochemical markers of cardiovascular disease, including matrix metalloproteinases (MMPs), are altered in women with polycystic ovary syndrome (PCOS), with many of these alterations thought to be due to excess androgen concentrations. Despite oral contraceptives (OCs) being the first-line pharmacological treatment in women with PCOS and the importance of MMPs in many physiological conditions and pathological states, including cardiovascular diseases, no study has yet evaluated whether OCs alter plasma concentrations of MMPs. We therefore assessed whether treatment with an OC containing the anti-androgenic progestogen alters MMP profiles in women with PCOS. We analysed 20 women with PCOS who wanted hormonal contraception (OC-PCOS group), 20 ovulatory women who required hormonal contraception (OC-control group) and 20 ovulatory women who wanted non-hormonal contraception (non-OC-control group). OC consisted of cyclic use of 2 mg chlormadinone acetate/30 mu g ethinylestradiol for 6 months. Plasma concentrations of MMP-2, MMP-9, TIMP-1 and TIMP-2 were measured by gelatin zymography or enzyme-linked immunoassays. OC treatment for 6 months significantly reduced plasma MMP-2 concentrations in the OC-control and OC-PCOS groups and TIMP-2 and TIMP-1 concentrations levels in the OC-control group (all p < 0.05), but had no effects on MMP-9 concentrations or on MMP-2/TIMP-2 and MMP-9/TIMP-1 ratios in any group (all p > 0.05). These findings indicated that long-term treatment with an OC containing chlormadinone acetate plus ethinylestradiol reduced plasma MMP-2 concentrations in both healthy and PCOS women. As the latter have imbalances in circulating matrix MMPs, treatment of these women with an OC may be beneficial.

OmpL1 Is an Extracellular Matrix- and Plasminogen-Interacting Protein of Leptospira spp.

Leptospirosis is a zoonosis with multisystem involvement caused by pathogenic strains of the genus Leptospira. OmpL1 is an outer membrane protein of Leptospira spp. that is expressed during infection. In this work, we investigated novel features of this protein. We describe that OmpL1 is a novel leptospiral extracellular matrix (ECM)-binding protein and a plasminogen (PLG) receptor. The recombinant protein was expressed in Escherichia coli BL21(DE3) Star/pLysS as inclusion bodies, refolded, and purified by metal-chelating chromatography. The protein presented a typical beta-strand secondary structure, as evaluated by circular dichroism spectroscopy. The recombinant protein reacted with antibodies in serum samples from convalescent leptospirosis patients with a high specificity compared to serum samples from individuals with unrelated diseases. These data strengthen the usefulness of OmpL1 as a diagnostic marker of leptospirosis. The characterization of the immunogenicity of recombinant OmpL1 in inoculated BALB/c mice showed that the protein has the capacity to elicit humoral and cellular immune responses, as denoted by high antibody titers and the proliferation of lymphocytes. We demonstrate that OmpL1 has the ability to mediate attachment to laminin and plasma fibronectin, with KD (equilibrium dissociation constant) values of 2,099.93 +/- 871.03 nM and 1,239.23 +/- 506.85 nM, respectively. OmpL1 is also a PLG receptor, with a KD of 368.63 +/- 121.23 nM, capable of generating enzymatically active plasmin. This is the first report that shows and characterizes OmpL1 as an ECM-interacting and a PLG-binding protein of Leptospira spp. that may play a role in bacterial pathogenesis when expressed during infection.

N-glycome profiling of Bothrops jararaca newborn and adult venoms

Glycosylation is an important post-translational modification of snake venom proteins and contributes to venom proteome complexity. Many snake venom components are known to be glycosylated, however, very little is known about the carbohydrate structures present in venom glycoproteins. Previous studies showed that the ontogenetic shift in diet, from ectothermic prey in early life to endothermic prey in adulthood, and shift in animal size are associated with changes in the venom proteome of the snake Bothrops jararaca. In this study we explored the composition of the N-glycome released from newborn and adult B. jararaca venom proteins. We used an ion trap mass spectrometer (IT-MS) to disassemble glycan structures based on the use of several pathways of MS (MSn) and demonstrate the presence of some structural isomers in both newborn and adult venom B. jararaca N-glycans. The main N-glycans identified in both venoms are of the hybrid/complex type however some mannose-rich type structures were also detected. The N-glycan composition of newborn and adult venoms did not vary indicating that differences in the utilization of the N-glycosylation motif could be the explanation for the differences in the glycosylation levels indicated by the differential electrophoretic profiles previously reported for B. jararaca newborn and adult venoms. (C) 2011 Elsevier B.V. All rights reserved.

Role of Neutralizing Antibodies in Adults With Community-Acquired Pneumonia by Respiratory Syncytial Virus

Background. Respiratory syncytial virus (RSV) has been implicated in the etiology of adult community-acquired pneumonia (CAP). We investigated RSV infection in Chilean adults with CAP using direct viral detection, real-time reverse-transcription polymerase chain reaction (rtRT-PCR), and serology (microneutralization assay). Methods. RSV, other respiratory viruses, and bacteria were studied by conventional and molecular techniques in adults aged >= 18 years presenting with CAP to the healthcare facilities in Santiago, Chile from February 2005 through December 2007. Results. All 356 adults with CAP enrolled had an acute blood sample collected at enrollment, and 184 had a convalescent blood sample. RSV was detected in 48 cases (13.4%). Immunofluorescence assay and viral isolation each detected only 1 infection (0.2%), whereas rtRT-PCR was positive in 32 (8.9%) cases and serology was positive in 20 (10.8%) cases. CAP clinical characteristics were similar in RSV-infected and non-RSV-infected cases. RSV-specific geometric mean serum-neutralizing antibody titer (GMST) was significantly lower at admission in the 48 RSV-infected cases compared with 308 non-RSV-infected adults (GMST in log(2): RSV/A 8.1 vs 8.9, and RSV/B 9.3 vs 10.4; P < .02). Conclusions. RSV infection is frequent in Chilean adults with CAP. Microneutralization assay was as sensitive as rtRT-PCR in detecting RSV infection and is a good adjunct assay for diagnostic research. High RSV-specific serum-neutralizing antibody levels were associated with protection against common and severe infection. The development of a vaccine could prevent RSV-related CAP in adults.

Seasonal variations of melatonin in ram seminal plasma are correlated to those of testosterone and antioxidant enzymes

Abstract Background Some breeds of sheep are highly seasonal in terms of reproductive capability, and these changes are regulated by photoperiod and melatonin secretion. These changes affect the reproductive performance of rams, impairing semen quality and modifying hormonal profiles. Also, the antioxidant defence systems seem to be modulated by melatonin secretion, and shows seasonal variations. The aim of this study was to investigate the presence of melatonin and testosterone in ram seminal plasma and their variations between the breeding and non-breeding seasons. In addition, we analyzed the possible correlations between these hormones and the antioxidant enzyme defence system activity. Methods Seminal plasma from nine Rasa Aragonesa rams were collected for one year, and their levels of melatonin, testosterone, superoxide dismutase (SOD), glutathione reductase (GRD), glutathione peroxidase (GPX) and catalase (CAT) were measured. Results All samples presented measurable quantities of hormones and antioxidant enzymes. Both hormones showed monthly variations, with a decrease after the winter solstice and a rise after the summer solstice that reached the maximum levels in October-November, and a marked seasonal variation (P < 0.01) with higher levels in the breeding season. The yearly pattern of GRD and catalase was close to that of melatonin, and GRD showed a significant seasonal variation (P < 0.01) with a higher activity during the breeding season. Linear regression analysis between the studied hormones and antioxidant enzymes showed a significant correlation between melatonin and testosterone, GRD, SOD and catalase. Conclusions These results show the presence of melatonin and testosterone in ram seminal plasma, and that both hormones have seasonal variations, and support the idea that seasonal variations of fertility in the ram involve interplay between melatonin and the antioxidant defence system.

Suppressive effect of low-level laser therapy on tracheal hyperresponsiveness and lung inflammation in rat subjected to intestinal ischemia and reperfusion

Intestinal ischemia and reperfusion (i-I/R) is an insult associated with acute respiratory distress syndrome (ARDS). It is not known if pro- and anti-inflammatory mediators in ARDS induced by i-I/R can be controlled by low-level laser therapy (LLLT). This study was designed to evaluate the effect of LLLT on tracheal cholinergic reactivity dysfunction and the release of inflammatory mediators from the lung after i-I/R. Anesthetized rats were subjected to superior mesenteric artery occlusion (45 min) and killed after clamp release and preestablished periods of intestinal reperfusion (30 min, 2 or 4 h). The LLLT (660 nm, 7.5 J/cm(2)) was carried out by irradiating the rats on the skin over the right upper bronchus for 15 and 30 min after initiating reperfusion and then euthanizing them 30 min, 2, or 4 h later. Lung edema was measured by the Evans blue extravasation technique, and pulmonary neutrophils were determined by myeloperoxidase (MPO) activity. Pulmonary tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), intercellular adhesion molecule-1 (ICAM-1), and isoform of NO synthase (iNOS) mRNA expression were analyzed by real-time PCR. TNF-α, IL-10, and iNOS proteins in the lung were measured by the enzyme-linked immunoassay technique. LLLT (660 nm, 7.5 J/cm(2)) restored the tracheal hyperresponsiveness and hyporesponsiveness in all the periods after intestinal reperfusion. Although LLLT reduced edema and MPO activity, it did not do so in all the postreperfusion periods. It was also observed with the ICAM-1 expression. In addition to reducing both TNF-α and iNOS, LLLT increased IL-10 in the lungs of animals subjected to i-I/R. The results indicate that LLLT can control the lung's inflammatory response and the airway reactivity dysfunction by simultaneously reducing both TNF-α and iNOS.

Synthese von tumorassoziierten Glycopeptiden basierend auf der epithelialen Struktur des MUC1

In epithelialen Tumorzellen zeigen Membranglycoproteine ein charakteristisch verändertes Glycosylierungsmuster, das durch eine veränderte Aktivität von Glycosyltransferasen hervorgerufen wird. Diese veränderte Aktivität führt zur Expression von stark verkürzten und frühzeitig sialylierten Kohlenhydratseitenketten der mucinartigen Glycoproteine auf Tumorzellen, welche als tumorassoziierte Antigene bezeichnet werden. Die tumorassoziierten Peptidepitope stellen eine wichtige Zielstruktur für eine potentielle selektive Immuntherapie dar. Das Ziel ist es, dass das Immunsystem zwischen den tumorassoziierten und den normal exprimierten Glycoproteinen unterscheiden kann, und damit in der Lage ist, eine selektiv gegen Tumorzellen gerichtete Immunantwort auszulösen. Daher ist eine Synthese von strukturell exakt definierten synthetischen Glycopeptiden und deren Einbau in Vakzine ein entscheidender Schritt für eine angestrebte Immuntherapie gegen Krebs. Ein Ziel dieser Arbeit war in diesem Zusammenhang die Synthese exakt definierter tumorassoziierter Glycopeptide, wobei Peptide aus der Tandem Repeat-Domäne des MUC1 synthetisiert wurden. Die verschiedenen Saccharidantigene wurden als glycosylierte Aminosäurebausteine in die immundominante Domäne der MUC1-Peptidsequenz eingebaut (TN-Antigen sowie das Sialyl-TN-Antigen, das (2,6)-Sialyl-T- und das (2,3)-Sialyl-T-Antigen). Zum einen wurden die MUC1-Glycopeptide anschließend über einen nicht immunogenen Triethylenglycol-Spacer an Carrier-Proteine wie Ovalbumin-OVA323-339-Sequenz und Rinderserumalbumin (BSA) konjugiert, so dass potenzielle Tumorvakzine erhalten wurden. Diese wurden in ersten ELISA-Experimenten untersucht und haben gezeigt, dass mit den synthetischen Glycopeptidantigenen feine Strukturunterschiede immunologisch differenziert werden können, was für die Unterscheidung zwischen Tumorzellen und gesunden Zellen bedeutsam ist. rnFür Immunisierungen ohne Freunds Adjuvanz wurde der TLR2-Agonist Pam3CSKKKK synthetisiert, der in einer Fragmentkondensation mit einem OVA-Spacer-MUC1-Glycopeptid konjugiert wurde. Die immunologischen Evaluierungen stehen noch aus.rnrn

Pineal melatonin synthesis is altered in Period1 deficient mice

Melatonin is an important endocrine signal for darkness in mammals. Transcriptional activation of the arylalkylamine-N-acetyltransferase gene encoding for the penultimate enzyme in melatonin synthesis drives the daily rhythm of the hormone in the pineal gland of rodents. Rhythmic arylalkylamine-N-acetyltransferase expression is controlled by the cAMP-signal transduction pathway and involves the activation of ?-adrenergic receptors and the inducible cAMP early repressor. In addition, the rat arylalkylamine-N-acetyltransferase promoter contains an E-box element which can interact with clock proteins. Moreover, the pineal gland of mice shows a circadian rhythm in clock proteins such as the transcriptional repressor Period1, which has been shown to control rhythmic gene expression in a variety of tissues. However, the role of Period1 in the regulation of pineal melatonin synthesis is still unknown. Therefore, circadian rhythms in arylalkylamine-N-acetyltransferase, ?-adrenergic receptor, and inducible cAMP early repressor mRNA levels (real time PCR), arylalkylamine-N-acetyltransferase enzyme activity (radiometric assay) and melatonin concentration radio immuno assay (RIA) were analyzed in the pineal gland of mice with a targeted deletion of the Period1 gene (Per1-/-) and the corresponding wildtype. In Per1-/- the amplitude in arylalkylamine-N-acetyltransferase expression was significantly elevated as compared to wildtype. In contrast, ?-adrenergic receptor and inducible cAMP early repressor mRNA levels were not affected by the Period1-deficiency. This indicates that the molecular clockwork alters the amplitude of arylalkylamine-N-acetyltransferase expression. In vitro, pineal glands of Per1-/- mice showed a day night difference in arylalkylamine-N-acetyltransferase expression with high levels at night. This suggests that a deficient in Period1 elicits similar effects as the activation of the cAMP-signal transduction pathway in wildtype mice.

Stromal cell-associated expression of kallikrein-related peptidase 6 (KLK6) indicates poor prognosis of ovarian cancer patients

Several members of the human kallikrein-related peptidase family, including KLK6, are up-regulated in ovarian cancer. High KLK6 mRNA or protein expression, measured by quantitative polymerase chain reaction and enzyme-linked immunoassay, respectively, was previously found to be associated with a shortened overall and progression-free survival (OS and PFS, respectively). In the present study, we aimed at analyzing KLK6 protein expression in ovarian cancer tissue by immunohistochemistry. Using a newly developed monospecific polyclonal antibody, KLK6 immunoexpression was initially evaluated in normal tissues. We observed strong staining in the brain and moderate staining in the kidney, liver, and ovary, whereas the pancreas and the skeletal muscle were unreactive, which is in line with previously published results. Next, both tumor cell- and stromal cell-associated KLK6 immunoexpression were analyzed in tumor tissue specimens of 118 ovarian cancer patients. In multivariate Cox regression analysis, only stromal cell-associated expression, besides the established clinical parameters FIGO stage and residual tumor mass, was found to be statistically significant for OS and PFS [high vs. low KLK6 expression; hazard ratio (HR), 1.92; p=0.017; HR, 1.80; p=0.042, respectively]. These results indicate that KLK6 expressed by stromal cells may considerably contribute to the aggressiveness of ovarian cancer.

Increase in substance P precursor mRNA in noninflamed small-bowel sections in patients with Crohn's disease

BACKGROUND: Neuropeptides, such as substance P (SP), are mediators of neurogenic inflammation and play an important role in inflammatory disorders. To further investigate the role of the SP pathway in inflammatory bowel disease (IBD), we analyzed the following in normal intestinal tissue specimens and in tissue specimens from patients with Crohn's disease (CD) and ulcerative colitis (UC): neurokinin receptor-1 (NK-1R); its isoforms (NK-1R-L and NK-1R-S); its ligand SP, encoded by preprotachykinin-A (PPT-A); and the SP-degradation enzyme, neutral endopeptidase (NEP). METHODS: Real-time quantitative reverse transcription-polymerase chain reaction was used to simultaneously determine the expression of NK-1R-L, NK-1R-S, and PPT-A. Protein levels of NK-1R and NEP were determined by immunoblot analysis. RESULTS: In noninflamed small-bowel tissue samples of CD patients, PPT-A mRNA expression was significantly increased, whereas there was no difference between inflamed or noninflamed UC and normal intestinal tissue samples. Examining subgroups of diverse intestinal segments from CD and UC samples with various levels of inflammation revealed no differences in NK-1R-L and NK-1R-S mRNA expression, whereas there was a tendency toward overall lower NK-1R-S mRNA copy numbers. Immunoblot analysis showed upregulation of NK-1R protein levels in cases of IBD, with more pronounced enhancement in cases of CD than in UC. For NEP, there were no differences in protein levels in normal, CD, and UC intestinal tissues. COMMENTS: These observations suggest a contribution of SP and its receptor, NK-1R, in the local inflammatory reaction in IBD and particularly in ileal CD. Moreover, significant upregulation of PPT-A mRNA in the noninflamed ileum of these patients suggests an influence of inflamed intestines on their healthy counterparts.

High extracellular potassium and its correlates after severe head injury: relationship to high intracranial pressure

Disturbed ionic and neurotransmitter homeostasis are now recognized to be probably the most important mechanisms contributing to the development of secondary brain swelling after traumatic brian injury (TBI). Evidence obtained from animal models indicates that posttraumatic neuronal excitation via excitatory amino acids leads to an increase in extracellular potassium, probably due to ion channel activation. The purpose of this study was therefore to measure dialysate potassium in severely head injured patients and to correlate these results with intracranial pressure (ICP), outcome, and also with the levels of dialysate glutamate, lactate, and cerebral blood flow (CBF) so as to determine the role of ischemia in this posttraumatic ionic dysfunction. Eighty-five patients with severe TBI (Glasgow Coma Scale score < 8) were treated according to an intensive ICP management-focused protocol. All patients underwent intracerebral microdialyis. Dialysate potassium levels were analyzed by flame photometry, as were dialysate glutamate and dialysate lactate levels, which were measured using high-performance liquid chromatography and an enzyme-linked amperometric method in 72 and 84 patients respectively. Cerebral blood flow studies (stable Xenon--computerized tomography scanning) were performed in 59 patients. In approximately 20% of the patients, potassium values were increased (dialysate potassium > 1.8 mmol). Mean dialysate potassium (> 2 mmol) was associated with ICP above 30 mm Hg and fatal outcome. Dialysate potassium correlated positively with dialysate glutamate (p < 0.0001) and lactate levels (p < 0.0001). Dialysate potassium was significantly inversely correlated with reduced CBF (p = 0.019). Dialysate potassium was increased after TBI in 20% of measurements. High levels of dialysate potassium were associated with increased ICP and poor outcome. The simultaneous increase of potassium, together with dialysate glutamate and lactate, supports the hypothesis that glutamate induces ionic flux and consequently increases ICP due to astrocytic swelling. Reduced CBF was also significantly correlated with increased levels of dialysate potassium. This may be due to either cell swelling or altered potassium reactivity in cerebral blood vessels after trauma.