Respuesta biológica en las pacientes con cáncer de mama tratadas con radioterapia intraoperatoria / Biological response in breast cancer patients using intraoperative radiotherapy

Introducción: el tratamiento conservador de la mama junto con la radioterapia es de elección en las pacientes con cáncer de mama precoz. Gracias a un mayor conocimiento de la radiobiología tumoral, la tendencia actual consiste en utilizar técnicas de irradiación parcial acelerada, entre las que destaca la radioterapia intraoperatoria (RIO). Métodos: estudio prospectivo multicéntrico dividido en 2 grupos comparativos con casos consecutivos de las pacientes a que han recibido una cirugía conservadora por cáncer de mama asociada o no a RIO. Se valora la relación de esta terapia con los valores de las proteínas involucradas en la respuesta biológica (IL6, IL8, CXCL10, IL1β y TNF- α) en muestras de suero preoperatorio y a las 24 h desde la cirugía, y de drenaje quirúrgico a las 6 y 24 h desde la cirugía. Resultados: se ha objetivado en las pacientes tratadas con RIO una disminución significativa de IL6 e IL8, así como un aumento de CXCL10 favorable para la lucha contra la progresión del tumor (p valor < 0,05). Las alteraciones del sistema inmunológico se manifiestan tanto en suero como en débito del drenaje quirúrgico a las 6 y 24 h desde la cirugía. Conclusiones: la RIO modifica la respuesta biológica en las pacientes con cáncer de mama. A pesar de que se deben desarrollar más líneas de investigación, la comprensión de los mecanismos de desarrollo del tumor, abre una nueva etapa en el desarrollo de tratamientos perioperatorios dirigidos a dianas concretas que compensen las consecuencias dañinas de la cirugía. (AU)

Introduction: Breast conserving surgery with radiotherapy is the treatment of choice in patients with early breast cancer. Due to a better understanding of tumour radiobiology, the current trend is to use accelerated partial irradiation techniques, among which intraoperative radiotherapy (RIO) stands out. Methods: Prospective multicentre study divided into two comparative groups with consecutive cases of patients who have undergone conservative surgery for breast cancer associated or not with RIO. The relation of this therapy with the values of proteins involved in the biological response (IL6, IL8, CXCL10, IL1β y TNF- α) is assessed in serum samples preoperative and 24 hours after surgery, and surgical drainage samples at 6 and 24 hours after surgery. Results: A significant decrease in IL6 and IL8, as well as an increase in CXCL10 favourable for the fight against tumour progression (p-value < 0.05) was observed in patients treated with RIO. Immune system alterations are manifested in both serum and surgical drainage debit at 6 and 24 hours after surgery. Conclusions: RIO modifies the biological response in breast cancer patients. Although more lines of research need to be developed, the understanding of the mechanisms of tumour development opens a new stage in the development of perioperative treatments directed at specific targets that compensate for the harmful consequences of surgery. (AU)

Momordica charantia extract modulates inflammatory response in human lymphocytes via suppression of TNF-a / El extracto de Momordica charantia modula la respuesta inflamatoria en linfocitos humanos a través de la supresión de TNF-a

Introducción: Momordica charantia L. es ampliamente utilizada para consumo y medicina tradicional debido a sus actividades biológicas. Sin embargo, se sabe poco sobre los efectos del melón amargo en las células sanas. Por lo tanto, nuestro objetivo fue evaluar los efectos del extracto de Momordica charantia en linfocitos humanos aislados, especialmente en aspectos inflamatorios, citotóxicos, genotóxicos y mutagénicos. Método : Para ello se preparó un extracto hidroetanólico con frutos y semillas y se procedió a la identificación y cuantificación fitoquímica. Los linfocitos humanos purificados se expusieron a 12,5; 25; 50 μg/mL de extracto de Momordica charantia durante 24 horas y después de este período. Resultados : Los datos mostraron que el extracto de Momordica charantia no indujo citotoxicidad, alteraciones en la frecuencia de micronúcleos, ni actividad de interleucina-6, interleucina-10 ciclooxigenasa-2 y producción de óxido nítrico; sin embargo, causó daño en el ADN y una disminución de TNF-α en las condiciones experimentales y células aplicadas. Conclusiones : Nuestros datos proponen un proceso antiinflamatorio generado por Momordica charantia mediado por la reducción de TNF-α. (AU)

Introduction: Momordica charantia L. is widely used for consumption and traditional medicine due to its biolog-ical activities. Nevertheless, little is known about the effects of bitter melon on healthy cells. Hence, we aimed to evaluate the effects of Momordica charantia extract in human isolated lymphocytes, especially on inflammatory, cytotoxicity, genotoxicity, and mutagenicity aspects. Method: For this, we prepared a hydroethanolic extract with fruits and seeds and proceeded with phytochemical identification and quantification. The human purified lymphocytes were exposed to 12.5, 25, and 50 μg/mL of Mo-mordica charantia extract for 24h and, after this period. Results: The data showed that the Momordica charantia extract did not induce cytotoxicity, micronucleus frequen-cy alterations, or interleukin-6, interleukin-10 cyclooxygenase-2 activity and the production of nitric oxide; however, it caused DNA damage and a decrease of TNF-α under the experimental conditions and cells applied. Conclusions: Our data propose an anti-inflammatory process generated by Momordica charantia mediated by TNF-α reduction. (AU)

Nemolizumab: un innovador tratamiento biológico para el control de la interleuquina 31 (IL-31) clave en la dermatitis atópica y el prurigo nodular / Nemolizumab: An Innovative Biologic Treatment to Control Interleukin 31, a Key Mediator in Atopic Dermatitis and Prurigo Nodularis

La citoquina IL-31 es una neurocitoquina que estimula las neuronas sensoriales relacionadas con el picor, contribuye a la inflamación, la disfunción y remodelación de la barrera epidérmica. Al interrelacionar los sistemas inmunológico y nervioso constituye un factor clave en el tratamiento de dermatitis atópica y del prurigo nodular. Nemolizumab es un anticuerpo monoclonal humanizado que bloquea la subunidad α del receptor de la IL-31 y modula la respuesta neuroinmunitaria, bloquea directamente la señalización del prurito y alivia rápidamente el prurito, controlando la inflamación y reduciendo la gravedad del eccema en dermatitis atópica y las lesiones pruriginosas del prurigo nodular al restaurar la función epitelial y promover la integridad de la barrera cutánea. Este artículo resume la nueva información relacionada con las funciones de la IL-31 y presenta la evidencia y resultados disponibles hasta el momento de los ensayos clínicos de nemolizumab en dermatitis atópica y prurigo nodular (AU)

Interleukin 31 (IL-31) is a neurocytokine that stimulates sensory neurons involved in pruritus. It contributes to skin barrier inflammation, dysfunction, and remodeling. As the immune and nervous systems are interrelated, IL-31 has a key role in the treatment of atopic dermatitis and prurigo nodularis. Nemolizumab is a humanized monoclonal antibody that blocks the α subunit of the IL-31 receptor, modulates the neuroimmune response, and rapidly alleviates itching by directly blocking signaling. It reduces inflammation and lesion severity in atopic dermatitis and prurigo nodularis by restoring epithelial function and promoting skin barrier integrity. This review synthesizes the latest information on the functions of IL-31 and presents the current evidence, including clinical trial results, on the use of nemolizumab in the treatment of atopic dermatitis and prurigo nodularis (AU)

[Translated article] Nemolizumab: An Innovative Biologic Treatment to Control Interleukin 31, a Key Mediator in Atopic Dermatitis and Prurigo Nodularis / Nemolizumab: un innovador tratamiento biológico para el control de la interleuquina 31 (IL-31) clave en la dermatitis atópica y el prurigo nodular

Interleukin 31 (IL-31) is a neurocytokine that stimulates sensory neurons involved in pruritus. It contributes to skin barrier inflammation, dysfunction, and remodeling. As the immune and nervous systems are interrelated, IL-31 has a key role in the treatment of atopic dermatitis and prurigo nodularis. Nemolizumab is a humanized monoclonal antibody that blocks the α subunit of the IL-31 receptor, modulates the neuroimmune response, and rapidly alleviates itching by directly blocking signaling. It reduces inflammation and lesion severity in atopic dermatitis and prurigo nodularis by restoring epithelial function and promoting skin barrier integrity. This review synthesizes the latest information on the functions of IL-31 and presents the current evidence, including clinical trial results, on the use of nemolizumab in the treatment of atopic dermatitis and prurigo nodularis (AU)

La citoquina IL-31 es una neurocitoquina que estimula las neuronas sensoriales relacionadas con el picor, contribuye a la inflamación, la disfunción y remodelación de la barrera epidérmica. Al interrelacionar los sistemas inmunológico y nervioso constituye un factor clave en el tratamiento de dermatitis atópica y del prurigo nodular. Nemolizumab es un anticuerpo monoclonal humanizado que bloquea la subunidad α del receptor de la IL-31 y modula la respuesta neuroinmunitaria, bloquea directamente la señalización del prurito y alivia rápidamente el prurito, controlando la inflamación y reduciendo la gravedad del eccema en dermatitis atópica y las lesiones pruriginosas del prurigo nodular al restaurar la función epitelial y promover la integridad de la barrera cutánea. Este artículo resume la nueva información relacionada con las funciones de la IL-31 y presenta la evidencia y resultados disponibles hasta el momento de los ensayos clínicos de nemolizumab en dermatitis atópica y prurigo nodular (AU)

miR-155 activates the NLRP3 inflammasome by regulating the MEK/ERK/NF-κB pathway in carotid atherosclerotic plaques in ApoE−/− mice

Atherosclerosis is an inflammatory disease. The NLRP3 inflammasome and miR-155 are significant components of inflammation and atherosclerosis. The aim of this research was to explore the possible mechanism by which miR-155 mediates the formation of carotid atherosclerotic plaques via the NLRP3 inflammasome. Fifty 6-week-old male ApoE−/− mice were randomly divided into 5 groups. They are the blank group, the negative control (NC) group, the miR-155 mimic group, the miR-155 inhibitor group, and the miR-155 mimic and ERK inhibitor group. The blood lipid levels were measured by the enzyme method Oil red O, HE, and immunohistochemical staining were used to observe the degree of carotid plaque formation. PCR was used to measure the expression of miR-155. The blood lipid levels were measured by the enzyme method. Western blotting was used to measure the expression of NLRP3 inflammasome-related proteins, interleukin-1β, interleukin-18, and MEK/ERK/NF-κB signaling pathway-related proteins. Compared with those of the NC group, the expression of miR-155 in the miR-155 mimic group increased significantly (P < 0.05), the degree of carotid plaque formation increased, the plasma levels of TC and LDL also increased significantly (P < 0.05); the expression levels of NLRP3 inflammasome-related proteins, interleukin-1β, interleukin-18, and MEK/ERK/NF-κB signaling pathway-related proteins were also significantly increased. Injection of ERK inhibitors into miR-155 mimic mice reduced the expression levels of p-NF-κB, NLRP3 inflammasome-related proteins, and inflammatory cytokines. In conclusion, miR-155 can promote the formation of atherosclerotic plaque in ApoE−/− mice, which may be achieved by regulating the MEK/ERK/NF-κB pathway to activate the NLRP3 inflammasome. (AU)

Relation of serum IL-32 levels and gene polymorphism rs45499297 with obesity in Mexican patients: a laboratory and in silico analysis / Relación de los niveles séricos de IL-32 y del polimorfismo rs45499297 con la obesidad en pacientes mexicanos: un análisis de laboratorio e in silico

Background: many genes have been involved in the development of obesity. Interleukin 32 (IL-32) is a proinflammatory cytokine; rs45499297 is a T/C promoter, single-nucleotide polymorphism of the IL-32 gene. Objectives: this study aimed to evaluate the rs45499297 polymorphism and its association with obesity. Another objective of this study was to carry out an in silico analysis. Methods: this study was cross-sectional, and included 333 subjects classified by body mass index and fat percentage. The plasma glucose and lipid profile were measured. We measured serum IL-32 protein by ELISA and the rs45499297 polymorphism by PCR-RFLP. We used several databases to build the IL-32 gene network and infer transcription factors that bind to this polymorphic site. Results: subjects underweight and with low fat percentages had lower levels of IL-32. CT genotype and allele C were less frequent in the overweight/obesity group than in the normal-weight group. Interestingly, this result remained only in the male gender. We found that the transcription factors Hepatocyte Nuclear Factor and Specificity Protein 1 bind to this polymorphic site. In addition, we infer that IL-32 is involved in metabolic pathways related to viral infections. Conclusion: the TC genotype is associated with overweight/obesity. The decrease in levels of IL-32 observed in underweight and low fat percentage groups could be due to an impaired inflammatory profile. The in silico analysis showed that several transcriptional factors bind at this polymorphic site, and that the enrichment of the metabolic pathways is diverse (AU)

Introducción: la interleucina 32 es una citocina proinflamatoria. El rs45499297 es un polimorfismo de nucleótido simple del gen de IL-32, situado en la región promotora y caracterizado por un cambio de T/C. Objetivo: evaluar el polimorfismo rs45499297 y su asociación con la obesidad, y realizar un análisis in silico. Métodos: el estudio fue transversal e incluyó 333 sujetos clasificados por índice de masa corporal y porcentaje de grasa. Se midieron la glucosa y el perfil lipídico, así como los niveles séricos de IL-32 mediante ELISA y el genotipo del polimorfismo rs45499297 mediante PCR-RFLP. Para el análisis in silico se utilizaron varias bases de datos para hacer la red de genes de IL-32 e inferir factores de transcripción unidos al sitio polimórfico. Resultados: los sujetos con bajo peso y bajo porcentaje de grasa tienen niveles más bajos de IL-32. El genotipo TC y el alelo C se encontraron con menos frecuencia en los sujetos con sobrepeso/obesidad que en los normopeso, resultado que permaneció solo en el género masculino. Se encontró que el factor nuclear de los hepatocitos y la proteína de especificidad 1 se unen a este sitio polimórfico. Se infiere que IL-32 está involucrado en vías metabólicas relacionadas con las infecciones virales. Conclusión: el genotipo TC está asociado al sobrepeso/la obesidad. La disminución de los niveles de IL-32 observada en los sujetos con bajo peso y bajo porcentaje de grasa podría ser por un perfil inflamatorio alterado. El análisis in silico mostró que varios factores de transcripción se unen al sitio polimórfico y que el enriquecimiento de las vías metabólicas es diverso (AU)

Group 2 innate lymphoid cells (ILC2s): The spotlight in asthma pathogenesis and lung tissue injury

Asthma is a heterogeneous disease with ranging etiology and severity. Asthma is a disease of chronic inflammation of the airways, with clinical symptoms of wheezing, breathlessness, cough, and chest tightness manifested as chronic fixed or variable airflow obstruction and airway hyperresponsiveness that predispose the airway epithelium to repeated injury, repair, and regeneration. In recent years, innate lymphoid cells (ILC1, ILC2, and ILC3) have been discovered. The predominant ILC type found in the lung tissue is group 2 innate lymphoid cells (ILC2s). Upon damage to the airway epithelium mediating the release of epithelial cytokines (TSLP, IL-33, and IL-25) ensued the activation of ILC2 in an antigen-independent manner. Activated ILC2 produces a significant amount of type 2 cytokines (IL-4, IL-5, IL-9, and IL-13), altogether contributing to type 2 inflammation in the airways. ILC2s are mediators of type 2 immunity for many type 2 inflammatory diseases such as asthma, since ILC2s were reported to play an important role in asthma pathogenesis. Here we discuss the role of ILC2 in the development of asthma and ILC2 effector cytokines (IL-4, IL-5, and IL-13) contributing to airway epithelial structural changes (AU)

A prospective study in women: açaí (Euterpe oleracea Martius) dietary intake affects serum p-selectin, leptin, and visfatin levels / Un estudio prospectivo en mujeres: la ingesta dietética de açaí (Euterpe oleracea Martius) afecta a los niveles séricos de p-selectina, leptina y visfatina

BACKGROUND: açaí is the fruit of the palm tree Euterpe oleracea Martius, which is native to the Amazon region. This fruit has been extensively studied due to its potential effects on human health. Studies have also evaluated the potential effect of açaí on the inflammatory response, but there are still few studies that have assessed this property in humans. OBJECTIVE: in this study we aimed to evaluate the effects of 200 g of açaí pulp consumption per day during four weeks on a rich panel of inflammatory biomarkers. METHODS: a prospective nutritional intervention study was conducted on forty apparently healthy women who consumed 200 g of açaí pulp per day for four weeks. A panel of serum inflammatory markers were evaluated before and after the nutritional intervention, namely, cell adhesion molecules (ICAM-1, IVAM-1, P-selectin, MCP-1, and fractalkine), interleukins (IL-1β, IL-6, IL-8, IL-10, and IL-17) and adipokines (adiponectin, leptin, visfatin, and adipsin). The data were analyzed using paired Student's t-test to evaluate the effect of the intervention using PASW Statistics, version 18.0, and a p-value of < 0.05 was considered significant. RESULTS: four weeks of açaí pulp consumption decreased p-selectin, leptin, and visfatin concentrations in the serum of the participating women. CONCLUSION: these results show that consumption of açaí pulp was able to modulate important biomarkers of the inflammatory process in apparently healthy women

INTRODUCCIÓN: el açaí es el fruto de la palmera Euterpe oleracea Martius, originaria de la región amazónica. Esta fruta ha sido ampliamente estudiada debido a sus posibles efectos sobre la salud humana. Los estudios también han evaluado el efecto potencial del açaí sobre la respuesta inflamatoria, pero todavía hay pocos estudios que hayan evaluado esta propiedad en seres humanos. OBJETIVO: en este estudio, nuestro objetivo ha sido evaluar los efectos del consumo de 200 g de pulpa de açaí por día durante cuatro semanas sobre un rico panel de biomarcadores inflamatorios. MÉTODOS: se ha realizado un estudio prospectivo de intervención nutricional en el que cuarenta mujeres aparentemente sanas han consumido 200 g de pulpa de açaí al día durante cuatro semanas. Se ha evaluado un panel de marcadores inflamatorios séricos antes y después de la intervención nutricional, a saber, moléculas de adhesión celular (ICAM-1, IVAM-1, P-selectina, MCP-1 y fractalquina), interleucinas (IL-1β, IL-6, IL-8, IL-10 e IL-17) y adipocinas (adiponectina, leptina, visfatina y adipsina). Los datos han sido analizados mediante la prueba de la t de Student pareada para evaluar el efecto de la intervención mediante el PASW Statistics, versión 18.0, y todo valor de p < 0,05 se consideró significativo. RESULTADOS: después de cuatro semanas de consumo de pulpa de açaí disminuyeron las concentraciones de p-selectina, leptina y visfatina en el suero de las mujeres participantes. CONCLUSIÓN: estos resultados muestran que el consumo de pulpa de açaí ha sido capaz de modular importantes biomarcadores del proceso inflamatorio en mujeres aparentemente sanas

Persistencia de secukinumab en pacientes con psoriasis, artritis psoriásica y espondilitis anquilosante / Persistence of secukinumab in patients with psoriasis, psoriatic arthritis, and ankylosing spondylitis

OBJETIVO: Determinar la persistencia del tratamiento con secukinumab en sus diferentes indicaciones. MÉTODO: Estudio descriptivo, observacional, retrospectivo donde se incluyeron los pacientes adultos tratados con secukinumab en sus diferentes indicaciones desde su comercialización en noviembre de 2015 hasta octubre de 2019. Las variables recogidas fueron sexo, edad, diagnóstico, fecha de inicio, línea de tratamiento, número de pacientes que habían suspendido el tratamiento y motivo de suspensión, persistencia global a los 12 meses, distribución de pacientes y persistencia según indicación, línea de tratamiento y motivo de suspensión. RESULTADOS: Han sido tratados con secukinumab 143 pacientes, de los que 104 llevaban en tratamiento 12 o más meses. La media de edad fue 49,8 ± 12,6 años; 52,9% fueron hombres. Suspendieron el tratamiento 56 pacientes (53,8%) con una media de duración del mismo de 12,7 ± 10,2 meses. El resto (n = 48) continuaban con una media de duración de 25,7 ± 9,9 meses en el momento del corte del estudio. La persistencia global a los 12 meses fue de 10,0 ± 3,3 meses con una tasa de discontinuación a los 12 meses del 31,7%. La persistencia por patología a los 12 meses fue 10,7 ± 2,9 para los pacientes con psoriasis, 9,7 ± 3,4 meses para los pacientes con artritis psoriásica y 8,8 ± 3,8 para los pacientes con espondilitis anquilosante. De los 48 pacientes que continuaban en tratamiento, 22 (45,8%) están recibiendo el fármaco en primera línea. De los 56 pacientes que discontinuaron, 15 (26,8%) lo hicieron por fallo primario (persistencia 3,8 ± 1,1 meses) y 27 (48,2%) por fallo secundario (persistencia 18,6 ± 9,6 meses). La persistenciaen los pacientes que continuaban en tratamiento fue superior en psoriasis (28,8 ± 10,3 meses) y en los que suspendieron por fallo secundario fue superior en espondilitis anquilosante (28,0 ± 4,2 meses). En los pacientes de primera línea, la persistencia fue inferior al resto, siendo 21,2 ± 7,2 meses, 3,5 ± 0,5 meses y 8,3 ± 2,5 meses, si continuaban en tratamiento, presentaron fallo primario o fallo secundario, respectivamente. CONCLUSIONES: Nuestros datos muestran una persistencia ligeramente superior en pacientes con psoriasis y una menor tasa de discontinuación en aquellos pacientes sin exposición previa a un tratamiento biológico. Se necesitan estudios a largo plazo que lo confirmen y conocer los factores que pueden influir en la persistencia del secukinumab

OBJECTIVE: To determine persistence of treatment with secukinumab across its different indications. METHOD: This is a retrospective descriptive observational study including adult patients treated with secukinumab in its different indications from the drug's introduction in November 2015 to October 2019. The variables included were sex; age; diagnosis; initiation date; line of treatment; number of patients who discontinued treatment and reason for discontinuation; overall persistence at 12 months; distribution of patients; and persistence according to indication, line of treatment and reason for suspension. RESULTS: One-hundred forty-three patients were started on secukinumab, but only patients who had been in treatment at least 12 months before the end of the study were included. Mean patient age was 49.8 years (±12.6); 52.9% were men. Fifty-six patients (53.8%) had discontinued treatment by the end of the study, with a mean duration of treatment of 12.7 months (±10.2). The other patients (n = 48) continued with their therapy. Mean duration of treatment in these patients was 25.7 months (±9.9). Overall persistence at 12 months was 10.0 months (±3.3) with a discontinuation rate at 12 months of 31.7%. Persistence at 12 months was 10.7 months (±2.9) for patients with psoriasis, 9.7 months (±3.4) for patients with psoriatic arthritis, and 8.8 months (±3.8) for those with ankylosing spondylitis. Of the 48 patients who continued with their treatment after completion of the study, 22 (45.8%) received the drug as first-line treatment. Of the 56 discontinuations, 15 (26.8%) were due to primary failure (persistence: 3.8 months [±1.1]) and 27 (48.2%) were due to secondary failure (persistence: 18.6 months [±9.6]). Persistence in patients who continued treatment was higher in psoriasis (28.8 months [±10.3]). In those who discontinued due to secondary failure it was higher in the group with ankylosing spondylitis (28.0 months [±4.2]). Persistence among patients on first-line secukinumab was higher than for other patients: 21.2 months (±7.2) if they stayed on treatment, 3.5 months (±0.5) if they presented with primary treatment failure, and 8.3 months (±2.5) in those with secondary treatment failure. CONCLUSIONS: Our data show slightly higher persistence levels in patients with psoriasis and lower discontinuation rates in those without previous exposure to biological therapy. Long-term studies are needed to confirm these findings and to gain a better understanding of the factors that can influence persistence of secukinumab

Periodontitis and alzheimer's disease

BACKGROUND: Alzheimer's disease (AD), the main cause of dementia in the adult population, is characterized by a progressive loss of cognitive function. It is considered that neuroinflammation plays a fundamental role in its onset and progression. The bacteria present in the disbiotic microbiome generated during the course of periodontitis (PE) are capable of inducing a systemic inflammatory response, exacerbating the production of proinflammatory mediators that have the potential to spread to the systemic circulation. MATERIAL AND METHODS: A literature review was made using the databases Scielo, PubMed, EBSCO and key words "Alzheimer disease", "Periodontitis", "Neurodegeneration", "Inflammation mediators", "Elderly". RESULTS: Several hypotheses point to similar pathophysiological pathways in the establishment of AD and PE, sharing cellular and molecular proinflammatory characteristics. In periodontitis, locally produced cytokines and pro-inflammatory products spread from the ulcerated periodontal pocket into the systemic circulation, or around the trigeminal nerve terminals, which allows the passage of bacteria or their products to the brain. This fact leads to the formation of plaques of amyloid peptide and intraneuronal neurofibrillar tangles (NFTs) that activate the glial cells producing a significant increase in proinflammatory cytokines in the affected regions that lead to a loss of neuronal synapses and neurodegeneration, contributing to the progression of AD. CONCLUSIONS: This review of the literature contributes to the understanding of the pathological pathways shared by both diseases such as oxidative damage and inflammation. There is not enough evidence to determine an association between this two pathologies, so it is considered necessary to conduct studies for determine if periodontitis is capable of inducing or exacerbating the neuroinflammation that will trigger AD

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Fungal co-infection in COVID-19 patients: should we be concerned? / Coinfección fúngica en pacientes con COVID-19: ¿debemos preocuparnos?

Critically ill COVID-19 patients have higher pro-inflammatory (IL-1, IL-2, IL-6, tumor necrosis alpha) and anti-inflammatory (IL-4, IL-10) cytokine levels, less CD4 interferon-gamma expression, and fewer CD4 and CD8 cells. This severe clinical situation increases the risk of serious fungal infections, such as invasive pulmonary aspergillosis, invasive candidiasis or Pneumocystis jirovecii pneumonia. However, few studies have investigated fungal coinfections in this population. We describe an update on published reports on fungal coinfections and our personal experience in three Spanish hospitals. We can conclude that despite the serious disease caused by SARS-CoV-2 in many patients, the scarcity of invasive mycoses is probably due to the few bronchoscopies and necropsies performed in these patients because of the high risk in aerosol generation. However, the presence of fungal markers in clinically relevant specimens, with the exception of bronchopulmonary colonization by Candida, should make it advisable to early implement antifungal therapy

Los pacientes gravemente enfermos con COVID-19 presentan concentraciones más elevadas de citoquinas pro-inflamatorias (IL-1, IL-2, IL-6 y factor de necrosis tumoral alfa) y anti-inflamatorias (IL-4 e IL-10), menor expresión de interferón-gama y un número más bajo de células CD4 y CD8. Esta grave situación clínica aumenta el riesgo de padecer coinfecciones fúngicas, como la aspergilosis pulmonar invasora, la candidiasis invasora o la neumonía por Pneumocystis jirovecii. Sin embargo, pocos estudios han investigado las coinfecciones fúngicas en esta población. En esta revisión describimos una actualización de las publicaciones sobre coinfecciones fúngicas en esta población de pacientes y nuestra experiencia personal en tres hospitales españoles. Podemos concluir que a pesar de la grave enfermedad causada por el SARS-CoV-2 en muchos pacientes, la baja frecuencia de micosis invasoras se debe probablemente a las pocas broncoscopias y necropsias realizadas en estos pacientes debido al alto riesgo de producción de aerosoles. Sin embargo, la presencia de marcadores fúngicos en muestras clínicas relevantes, con la excepción de la colonización broncopulmonar por Candida, debería aconsejar la instauración precoz de una terapia antifúngica

Elevated serum levels of interleukin-37 correlate with poor prognosis in gastric cancer

Background: interleukin-37 (IL-37) is as a natural suppressor of the innate inflammatory and immune responses. It has also been reported to be involved in carcinogenesis and metastasis. The present case-control study was designed to investigate the role of serum levels of IL-37 in patients with gastric cancer. Methods: serum IL-37 levels were determined using the enzyme-linked immunosorbent assay in 180 patients diagnosed with gastric cancer and 100 healthy controls. The association between IL-37 levels and clinical factors was assessed. Univariate and multivariate analyses were performed to investigate the prognostic significance of these parameters in gastric cancer. Results: serum IL-37 levels in gastric cancer patients (5.606 +/- 0.837 pg/ml) were significantly higher than those in healthy controls (2.364 +/- 0.210 pg/ml, p < 0.001). High serum IL-37 levels were related to a poorly differentiated histologic type (p = 0.046) and advanced T stage (p = 0.003). The Kaplan-Meier survival analysis indicated that the high-IL-37 group had a poorer overall survival and progression-free survival (overall survival [OS]: 39.0 months vs 13.0 months, p < 0.001, progression-free survival [PFS]: 25.0 months vs 10.0 months, p < 0.001). Multivariate analyses showed serum IL-37 to be an independent prognostic factor for gastric cancer patients (OS: hazard ratios [HR] = 1.842, 95% CI: 1.190-2.854, p = 0.006; PFS: HR = 1.547, 95% CI: 1.014-2.359, p = 0.043). Conclusions: in conclusion, serum IL-37 levels were associated with poor overall survival and progression-free survival in gastric cancer patients. IL-37 may be a potential predictor of prognosis in gastric cancer

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Fármacos en investigación / Investigational drugs

La piedra angular del tratamiento de la enfermedad pulmonar obstructiva crónica (EPOC) es la broncodilatación, y en los últimos años se ha desarrollado un importante número de moléculas que han ido cambiando paulatinamente la práctica clínica habitual en estos pacientes. Los fármacos multivalentes con más de un mecanismo de acción broncodilatador representan el próximo paso en materia de relajación del músculo liso bronquial, pero dada la creciente evidencia sobre el estrés oxidativo y estado inflamatorio generalizado de la EPOC, existe una clara tendencia a demostrar el beneficio de formulaciones antiinflamatorias respecto a un potencial control sintomático, y secundariamente la reducción de la importante carga económica que supone el consumo de recursos sanitarios. En este capítulo se pretende dar un resumen esquemático y actualizado sobre los fármacos en investigación en EPOC en las fases previas de su desarrollo clínico

Bronchodilators are the cornerstone of Chronic obstructive pulmonary disease (COPD) treatment, and in the last years an important number of new molecules have changed gradually the clinical practice in these patients. Multivalent drugs with more than one mechanism of action represent the next step in terms of bronchial smooth muscle relaxation, although, giving the growing evidence of oxidative stress and generalized inflammation in COPD, there is a clear tendency to test the potential benefit of new anti-inflammatory drugs for symptoms control in the first place and consequently the reduction of the high economic burden of this disease. This chapter aims to give a schematical and updated review of new drugs for COPD in the preclinical phases of their clinical development

Assessment of IL-31 levels and disease severity in children with atopic dermatitis

INTRODUCTION AND OBJECTIVES: Atopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10-20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective. The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively. MATERIAL AND METHODS: One hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit. RESULTS: The statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27). CONCLUSION: IL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity

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Sobrepeso y obesidad en enfermedad celiaca: expresión del perfil de interleuquinas th17 / Overweight and obesity in celiac disease: expression of the interleukin profi le Th17

Introducción: la alteración histológica en el intestino delgado de los enfermos celiacos produce una pobre absorción que deteriora o dificulta una ganancia óptima de peso. Esto puede ser el resultado de un aumento de la expresión de las interleuquinas Th17 gluten-específicas. Objetivo: el objetivo de este estudio fue comparar la expresión de las interleuquinas Th17 en pacientes celiacos con peso normal y sobrepeso/ obesidad. Métodos: se estudiaron 22 pacientes con reciente diagnóstico de enfermedad celiaca: 15 con peso normal y siete con sobrepeso/obesidad. Se tomaron biopsias de intestino delgado para la evaluación de la expresión de las interleuquinas a través de PCR a tiempo-real. Resultados: los niveles de expresión de las interleuquinas Th17 mostraron una tendencia a ser más altos en las biopsias de intestino de pacientes con sobrepeso/obesidad en comparación a los celiacos con peso normal, sin embargo, esta diferencia no fue significativa. Conclusión: el exceso de peso en pacientes celiacos no es influenciado por los niveles de expresión de interleuquinas Th17

Introduction: the histological alteration in the small intestine of the celiac patients produces a poor absorption that deteriorates or hinder an optimal weight gain. This can be the result of an increase expression of the Th17 gluten-specific interleukins. Objective: the aim of this study was to compare the expression of Th17 interleukins in celiac patients with normal and overweight/obese nutritional status. Methods: a total of 22 patients with newly diagnosed celiac disease were eligible: 15 patients with normal weight and seven overweight/obese. Small intestine biopsies were taken for the evaluation of the expression of interleukins through real-time PCR. Results: expression levels of Th17 interleukins showed a tendency to be higher in intestinal biopsies of overweight/obese patients compared to normal weight celiac subjects; however, this difference was not statistical significant. Conclusion: body weight excess in celiac patients is not influenced by the expression levels of Th17 interleukins

Rol del receptor de adenosina A2A, óxido nítrico y factor de crecimiento de endotelio vascular en la sepsis: una revisión no sistemática / Role of adenosine A2A receptor, nitric oxide, and vascular endothelial growth factor in sepsis. A non-systematic review

La sepsis es una enfermedad de origen infeccioso con una prevalencia de 2.911 por 100.000 pacientes en Estados Unidos, y se caracteriza por el desbalance de la respuesta pro y antiinflamatoria por parte del sistema inmune. Sin embargo, la falta de comprensión de la respuesta del huésped frente a la infección justifica la importancia de su debate. En esta revisión no sistemática se plantea la relación funcional que existiría entre el receptor de adenosina A2A (A2A), óxido nítrico (NO) y factor de crecimiento vascular (VEGF), los cuales regulan la vasodilatación y la permeabilidad microvascular, y que en la sepsis se encuentran alterados. La evidencia revisada muestra que en el medio extracelular expuesto a infección se genera un estado de hipoxia celular, la que aumenta la producción de adenosina, nucleósido derivado del metabolismo del ATP. Esta molécula, al activar el receptor A2A presente en células del sistema inmune y endoteliales es capaz de reducir la respuesta inmunológica y aumentar la permeabilidad vascular, lo que a su vez ha sido asociado con una mayor progresión bacteriana y fallo multisistémico. Molecularmente, A2A activa la síntesis y producción de NO y VEGF. Por su parte, VEGF, al activar su receptor tipo 2 aumenta también la producción de NO, generando un circulo potenciador del efecto inmunológico y vascular. Pese a estas evidencias no hemos encontrado estudios que relacionen directamente estos 3 actores, A2A-NO y VEGF en la sepsis. Por ello, a la luz de la evidencia revisada, proponemos que la vía A2A-NO-VEGF sería un blanco de estudio en la fisiopatología y tratamiento de la sepsis (AU)

Sepsis is an infectious disease with a prevalence of 2.9 per 100 individuals in the United States. It is characterised by an unbalanced pro- and anti-inflammatory response driven by the immune system. However, further discussion is needed due to the lack of understanding on the details of the host response to the infection. This non-systemic review addresses the functional relationship between the Adenosine 2A receptor (A2A), Nitric Oxide (NO), and Vascular Epithelial Growth Factor (VEGF), which regulate vasodilation and micro-vascular permeability, which in turn are affected in sepsis. The evidence reviewed shows that an state of cellular hypoxia is generated due to infection, which increases the production of adenosine (ADO), a nucleoside derived from the metabolism of ATP. This molecule, by activating A2A receptor present in cells of the immune and endothelial systems reduces the immune response and increasing vascular permeability, which in turn has been associated with greater bacterial progression and multisystem failure. Molecularly, A2A activates the synthesis and production of NO and VEGF. In this regard, VEGF, by activating its type 2 receptor (VEGFR2) also increases NO production. This generates a cycle that enhances the immunological and vascular effect. Despite this, no studies were found that directly links these three actors, A2A-NO and VEGF, in sepsis. Therefore, taking into account the reviewed evidence, it is proposed that the A2A-NO-VEGF pathway could be a target of study in the pathophysiology and treatment of sepsis (AU)

Effect of a 2000-m running test on antioxidant and cytokine response in plasma and circulating cells

Exercise intensity usually correlates with increased oxidative stress and enhanced cytokine production. However, it is unknown if all types of exercise that induce muscle damage can cause a parallel response in the oxidation balance and cytokine production. To this end, the effect of a 2000-m running test in a group of volunteers that regularly train in aerobic routines was studied. Different circulating parameters were measured, oxidative stress markers (protein carbonyls and malondialdehyde), antioxidant enzyme activity, and cytokine levels in plasma as well as in the main circulating cells of blood samples obtained in basal conditions and after test execution. As a result, the test caused muscle damage evidenced by an increase in circulating creatine kinase and myoglobin. This was accompanied by an increase in protein carbonyls in plasma and peripheral blood mononuclear cells. Activities of antioxidant enzymes (catalase, glutathione peroxidase and reductase, superoxide dismutase) were elevated in peripheral blood mononuclear cells, neutrophils, and erythrocytes after the test. Regarding cytokine production, interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α exhibited no significant changes after the test. Results suggest that this short but intense running exercise (2000 m) can induce muscle damage and elicit a good balance between oxidant/antioxidant responses with no changes in the circulating concentration of pro-inflammatory cytokines

Rol de los receptores de adenosina en la interacción adipocito-macrófago durante la obesidad / Role of adenosine receptors in the adipocyte-macrophage interaction during obesity

La inflamación generada en el tejido adiposo o lipoinflamación, puede contribuir al desarrollo de la resistencia a la insulina. Los mecanismos asociados a la lipoinflamación están relacionados con la función de los adipocitos y los macrófagos presentes en el tejido adiposo. En este contexto, el nivel del nucleósido adenosina está aumentado en individuos con obesidad. Las causas o consecuencias de este aumento no se conocen. Aunque, adenosina al activar a sus receptores (A1, A2A, A2B y A3) es capaz de modular diferencialmente la función de adipocitos y macrófagos, con el fin de evitar la reducción de la sensibilidad a la insulina y generar un estado antiinflamatorio en el individuo con obesidad. En esta revisión proponemos que adenosina podría ser un elemento clave en el desarrollo de nuevas estrategias para el control de la lipoinflamación y homeostasis metabólica a través de la regulación del diálogo adipocito-macrófago (AU)

Lipoinflamation is the inflammation generated in the adipose tissue. It can contribute to the development of insulin resistance. The lipoinflammation-associated mechanisms are related to the function of adipocytes and macrophages present in the adipose tissue. In this regard, the level of nucleoside adenosine is increased in individuals with obesity. Causes or consequences of this increase are unknown. Although, adenosine activating its receptors (A1, A2A, A2B and A3) is able to differentially modulate the function of adipocytes and macrophages, in order to avoid the reduction of insulin sensitivity and generate an anti-inflammatory state in subject with obesity. In this review we propose that adenosine could be a key element in the development of new strategies for limit lipoinflammation and regulate metabolic homeostasis through modulation of adipocyte-macrophage dialogue (AU)

POEMS syndrome and idiopathic portal hypertension: a possible association

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