Influência da Delfinidina como potencial modulador da capacidade imunorregulatória das Células-Tronco Mesenquimais / Influence of Delphinidin as a potential modulator of the immunoregulatory capacity of Mesenchymal Stem Cells

As Células-Tronco Mesenquimais (CTMs), são células multipotentes, presentes em diversos tecidos, sendo bastante estudada devido sua capacidade imunorregulatória por meio da liberação de fatores solúveis. Fatores estes que atuam sobre as funções de células do sistema imunitário. Simultaneamente, estudos indicam que os compostos flavonoides, em destaque a Delfinidina, presente em alguns frutos e flores, possuem atuação anti-inflamatória e inibitória sobre células do sistema imunitário. Todavia, são escassos os estudos em relação entre a capacidade imunorregulatória da CTM e a influência da Delfinidina, sendo este o objetivo deste estudo. Inicialmente, a Delfinidina 3-O-ß-D-glicosídeo foi escolhido, devido a sua maior estabilidade e a dose de 50 µM foi selecionada após análise por citometria de fluxo que mostrou aumento da fase proliferativa do ciclo celular. Posteriormente ao realizar análise da produção de fatores solúveis pelas CTM, os resultados mostraram aumento da produção de IL-10, TGF-ß e Oxido nítrico pelas CTM tratadas com Delfinidina. Bem como, diminuição da expressão de p-NF-κB/NF-κB pelas CTMs tratadas com Delfinidina, quando avaliadas por Wersten Blot. Adicionalmente, para analisar a Delfinidina sobre os efeitos imunorregulatórios da CTM sob macrófagos (RAW 264.7), célula esta, importante no sistema imune inato. Foram realizadas culturas condicionadas, com posterior análise da produção de fatores solúveis, os resultados mostraram aumento da produção de IL-10, e diminuição da produção de TNF-α, IL-1α e IL-12 pelos macrófagos, nas culturas condicionadas. Assim como, diminuição da expressão do fator p-NF-κB/NF-κB pelos macrófagos nas culturas condicionadas, quando avaliadas por Wersten Blot. Ademais, ao analisar a atividade metabólica dos macrófagos por ensaio de MTT, os resultados mostraram que as culturas condicionadas e a Delfinidina per si foi capaz de diminuir a atividade metabólica, sem alterar os efeitos anti-inflamatórios sobre a célula. Em síntese, a Delfinidina mostrou acentuar a atuação imunorregulatória da CTM sobre a linhagem macrofágica, célula esta, de grande importância para o sistema imune inato

Mesenchymal Stem Cells (MSCs) are multipotent cells present in various tissues, being widely studied due to their immunoregulatory capacity through the release of soluble factors. These factors act on the functions of cells of the immune system. Simultaneously, studies indicate that flavonoid compounds, especially Delphinidin, present in some fruits and flowers, have anti inflammatory and inhibitory effects on immune system cells. However, there are few studies on the relationship between the immunoregulatory capacity of MSC and the influence of Delphinidin, which is the objective of this study. Initially, Delphinidin 3-O-ß-D-glycoside was chosen due to its greater stability and the 50 µM dose was selected after analysis by flow cytometry which showed an increase in the proliferative phase of the cell cycle. Subsequently, when analyzing the production of soluble factors by MSCs, the results showed an increase in the production of IL-10, TGF-ß and nitric oxide by MSCs treated with Delphinidin. As well as decreased expression of p-NF-κB/NF-κB by MSCs treated with Delphinidin, when evaluated by Wersten Blot. Additionally, to analyze Delphinidin on the immunoregulatory effects of MSC on macrophages (RAW 264.7), this cell is important in the innate immune system. Conditioned cultures were performed, with subsequent analysis of the production of soluble factors, the results showed an increase in the production of IL-10, and a decrease in the production of TNF-α, IL-1α and IL-12 by macrophages, in the conditioned cultures. As well as decreased expression of p-NF-κB/NF-κB factor by macrophages in conditioned cultures, when evaluated by Wersten Blot. Furthermore, when analyzing the metabolic activity of macrophages by MTT assay, the results showed that conditioned cultures and Delphinidin itself was able to decrease the metabolic activity, without altering the anti-inflammatory effects on the cell. In summary, Delphinidin has shown to enhance the immunoregulatory action of MSC on the macrophage lineage, a cell that is of great importance for the innate immune system

Therapeutic effects of benzoylaconitine and paeoniflorin in rats with collagen-induced arthritis

Abstract To explore the effects and mechanisms of benzoylaconitine and paeoniflorin on collagen-induced arthritis (CIA) rats. Weight, paw swelling, arthritis index and joint pathologic changes were examined in each group after CIA induction. PGE2, IL-1ß, IL-6, IL-10, TNF-α, VEGF, MMP-3, IgG and anti-CII Ab were assessed by ELISA; STAT1 and STAT3 expressions were analyzed immunohistochemically, and the ultrastructure of synovial cells was observed by transmission electron microscopy. Therapeutic effects were determined in CIA rats via injecting benzoylaconitine and paeoniflorin, which could alleviate the degree of swelling and arthritis index (AI) and pathological lesions of the sacroiliac gland; decrease the levels of PGE2, IL-1ß, TNF-α, VEGF and IgG in serum; reduce STAT1 and STAT3 expression in the membrane tissue; and inhibit the secretion and proliferation of synovial cells. These results showed that benzoylaconitine and paeoniflorin could significantly palliate the arthritic symptoms of CIA rats, and better therapeutic effects could be achieved if the two components were used in combination

O estado da arte das síndromes autoinflamatórias associadas à criopirina / The state of the art of cryopyrin-associated periodic syndromes

As síndromes autoinflamatórias associadas à criopirina (CAPS) compreendem um grupo espectral de doenças raras autoinflamatórias. Todas estas doenças estão relacionadas ao inflamassoma NLRP3, sendo que de 50-60% dos pacientes apresentam mutações ao longo do gene NLRP3. Clinicamente, febre recorrente associada à urticária neutrofílica e outros sintomas sistêmicos são o grande marco clínico, comum a todo o espectro. O bloqueio da interleucina-1 trouxe grande alívio ao tratamento destas desordens, mas variações na resposta clínica podem ser observadas, principalmente nos espectros mais graves. Neste trabalho os autores trazem uma revisão do estado da arte das doenças autoinflamatórias CAPS. Foi realizado levantamento de literatura e, ao final, 49 artigos restaram como base para construção do texto final. O trabalho traz de forma narrativa os principais pontos relacionados a imunofisiopatologia, manifestação clínica, diagnóstico, tratamento, complicações e novas armas diagnósticas, e terapia gênica.

Cryopyrin-associated periodic syndromes (CAPS) comprise a spectrum of rare autoinflammatory disorders. They are all related to the NLRP3 inflammasome, and 50-60% of the patients harbor mutations along the NLRP3 gene. Clinically, recurrent fever associated with neutrophilic urticaria and other systemic symptoms are a hallmark of all the disorders in the spectrum. Biologic drugs that can block interleukin-1 were a milestone for the treatment of such rare diseases, although variability in clinical response to this therapeutic intervention were observed, especially in those affected by severe phenotypes. In this paper, the authors provide a state-of-the-art review of CAPS. A literature search was performed and, finally, 49 articles remained for the construction of the final manuscript. The article presents a narrative review focused on the topics related to immune pathophysiology, clinical manifestations, diagnosis, treatment, complications and new therapeutic options, and gene therapy.

Mecanismos de acción de agentes propuestos para el tratamiento farmacológico específico de la infección por SARS-CoV-2 / Mechanisms of action of proposed agents for the specific pharmacological treatment of SARS-CoV-2 infection

Resumen Desde la notificación de la pandemia por SARS-CoV-2, agente patógeno responsable del COVID-19, muchos de los tratamientos dirigidos a su manejo han estado sometidos a estudios de manera constante, con el fin de comprobar su eficacia y seguridad. El conocimiento de su virología y etiopatogenia posibilitaría objetivar los pasos moleculares específicos que puedan ser blancos terapéuticos de variados fármacos actualmente disponibles. Esta experiencia proviene principalmente de las infecciones por SARS-CoV y MERS-CoV, con resultados variados 'in vitro' en el SARS-CoV-2, sin evidencia clínica que demuestre efectividad y seguridad de dichos tratamientos. A la fecha, no se ha podido concretar con claridad un esquema de tratamiento específico, debido a que la evidencia surgida ha puesto en jaque cada uno de los fármacos propuestos. Esto ha motivado a continuar en la búsqueda de una estrategia efectiva que permita manejar esta pandemia con la seguridad y eficacia necesaria para que el beneficio terapéutico esté por sobre los posibles efectos adversos que estos esquemas farmacológicos pudiesen presentar. La siguiente revisión pretende mostrar la evidencia disponible a la fecha, definiendo la actividad de cada fármaco en función de su mecanismo de acción.

Since the beginning of the pandemic by SARS-CoV-2, the pathogen responsible for COVID-19, many of the therapeutic options for its management have been under constant revision, in order to verify their safety and efficiency. Knowledge of the viral structure and pathogenesis make it possible to determine the molecular pathways that may be targeted with current available drugs. The experience with these drugs comes mainly from infections caused by SARS-CoV and MERS-CoV, in vitro studies with SARS-CoV-2 that yield variable results, and clinical experience that does not ensure effectiveness and safety of such drugs. To date, it has not been possible to elucidate a specific treatment scheme, because of the constant release of evidence that challenges the usefulness of the proposed drugs. This has motived us to continue seeking for an effective strategy that allows to manage this pandemic in a safe and efficient manner, so that therapeutic benefit surpasses the related adverse drug reactions that can occur. The following review aims to showcase the evidence available to date by defining the activity of each drug based on its mechanism of action.

External Apical Root Resorption and IL-1A, IL-1RN Gene Polymorphisms: A Systematic Review and Meta-Analysis of Prospective Studies

ABSTRACT Objective: To reconnoiter the IL-1A (-889) and IL-1RN (+2018) gene polymorphisms and their association with EARR. Material and Methods: The Science Direct, PubMed and Scopus databases were comprehensively searched by two independent reviewers. In addition, the bibliographies of all relevant publications and textbooks were searched manually. A meta-analysis was performed using data available up to May 9, 2020. Results: A total of 13 and 9 publications were selected for the systematic review and meta-analysis, respectively for both IL-1A and IL-1RN genes. Odds ratio (OR) was used to evaluate the association of the gene polymorphism and the risk of EARR. The risk of EARR was estimated using the overall OR from the published studies. No association was found for IL-1A gene for the risk of EARR. However, the dominant and co-dominant models of IL-1RN gene polymorphism were associated with the risk of EARR. Conclusion: More studies are warranted to determine the relationship between IL-1A and IL-1RN gene polymorphisms and EARR for a clearer understanding of their interactions.

Perfil de citocinas Th1, Th2, Th17 y otras citocinas pro inflamatorias (IL-1ß, IL-6 y TNFα) en el plasma de pacientes con cáncer gástrico / Th1, Th2, Th17 cytokine profile and other pro-inflammatory cytokines (IL-1ß, IL-6 and TNFα) in the plasma of patients with gastric cancer

El cáncer gástrico (CG) es la neoplasia del tubo digestivo más prevalente en el mundo, asociada a factores genéticos del hospedero y externos, como infección por Helicobacter pylori. La patogénesis incluye inflamación crónica mediada por citocinas del microambiente tumoral, detectables sistémicamente. Estudios previos reportan niveles séricos de citocinas y su contribución al diagnóstico de CG. El presente estudio analiza el perfil de citocinas del tipo de Th1(IFNγ), Th2(IL-4 e IL-10), Th17(Th-17A) y otras pro inflamatorias: IL-1ß, IL-6 y TNF-α, en plasma de 70 casos de pacientes con CG comparándolos con 132 sujetos sanos equiparables en edad y sexo. Los casos provinieron del Hospital Roosevelt e Instituto Nacional de Cancerología de Guatemala (Incan) y formaron parte de un estudio previo. Se analizó la base de datos clínicos, patológicos y epidemiológicos. Se midieron los niveles de citocinas utilizando el sistema "MSD MULTI-SPOT Assay System". La edad promedio de los casos fue 59.5 años, (DE 13.0), 51%, eran positivos para IgG anti H. pylori. Un 71% presentó adenocarcinoma grado III (Borrman), según clasificación de Lauren 55% tenían tipo intestinal. Las siete citocinas cuantificadas se encontraron significativamente elevadas (p < .05) en el plasma de los casos respecto a sus controles. Los casos de CG tipo difuso presentaron niveles de IFNγ significativa-mente elevados. Por regresión logística, las citocinas IL-6 e IL-10, están asociadas significativamente a CG (p < .05) independientemente del estatus de infección por H. pylori. Se destacan la IL-6 e IL-10 como las principales citocinas asociadas a la presencia de CG.

Gastric cancer (GC) is the most prevalent gastrointestinal neoplasm in the world, associated with host and external genetic factors, such as Helicobacter pylori infection. The pathogenesis includes chronic inflammation mediated by cytokines of the tumor microenvironment, systemically detectable. Previous studies report serum levels of cyto-kines and their contribution to the diagnosis of GC. The present study analyzes the profile of cytokines of the type Th1 (IFNγ), Th2 (IL-4 and IL-10), Th17 (Th-17A) and other pro-inflammatory: IL-1ß, IL-6 and TNF-α, in plasma of 70 cases of patients with GC compared with 132 healthy subjects comparable in age and sex. The cases came from the Roosevelt Hospital and the National Cancer Institute of Guatemala -Incan- and were part of a previous study. The clinical, pathological and epidemiological databases were analyzed. Cytokine levels were measured using the "MSD MULTI-SPOT Assay System". The average age of the cases was 59.5 years, (SD 13.0), 51% were positive for IgG anti H. pylori, 71% had grade III adenocarcinoma (Borrman), according to Laurenís classification, 55% had intestinal type. The seven cytokines quantified were found to be significantly elevated (p < .05) in the plasma of the cases compared to their controls. The diffuse GC cases presented significantly elevated IFNγ levels. By logistic regression, the cytokines IL-6 and IL-10 are significantly associated with GC (p < .05) regardless of the H. pylori infection status. IL-6 and IL-10 stand out as the main cytokines associated with the presence of GC.

Síndrome de Hiper IgD: espectros clínicos, achados genéticos e condutas terapêuticas / Hyper-IgD syndrome: clinical spectrum, genetic findings, and therapeutic approaches

A deficiência de mevalonato quinase (MVK; MIM #142680; ORPHA #343) é uma doença genética, espectral, rara, associadas a mutações ao longo do gene MVK causando distúrbios na síntese do colesterol, que culminam em: inflamação sistêmica com febre, adenopatia, sintomas abdominais e outros achados clínicos. Enquanto no polo leve da doença os achados mais comuns são febres recorrentes com linfadenopatia, no polo mais grave adiciona-se o acometimento do sistema nervoso central (meningites assépticas, vasculites e atraso do desenvolvimento neuropsicomotor) e do sistema hematopoiético (síndrome de ativação macrofágica). Apesar de inúmeras terapêuticas, os bloqueadores da interleucina-1 ainda são os únicos medicamentos capazes de controlar a doença e de impedir a evolução para amiloidose. Os estudos atuais visam tentar novos tratamentos, como o transplante de células-tronco hematopoiéticas, ou mesmo a terapia gênica.

Mevalonate kinase deficiency (MVK; MIM #142680; ORPHA #343) is a rare spectral genetic disorder linked to mutations along the MVK gene leading to impaired cholesterol synthesis, clinically observed as systemic inflammation with fever, adenopathy, abdominal manifestations, and other clinical findings. While on mild forms recurrent fever with lymphadenopathy is commonly observed, severe forms add to that neurological (aseptic meningitis, vasculitis, and neuropsychomotor developmental delay) and hematopoietic involvement (macrophage activation syndrome). Despite of several therapeutic approaches, blocking interleukin-1 is the only effective method to control the disease and prevent the development of systemic amyloidosis. Ongoing studies aim to test new treatments, such as hematopoietic stem cell transplantation and gene therapy.

Informe diário de evidências COVID-19: busca realizada em 27 de abril de 2020 / COVID-19 daily evidence report: search conducted on April 27, 2020

Essa é uma produção do Departamento de Ciência e Tecnologia (Decit) da Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos em Saúde (SCTIE) do Ministério da Saúde (Decit/SCTIE/MS), que tem como missão promover a ciência e tecnologia e o uso de evidências científicas para a tomada de decisão do SUS, tendo como principal atribuição o incentivo ao desenvolvimento de pesquisas em saúde no Brasil, de modo a direcionar os investimentos realizados em pesquisa pelo Governo Federal às necessidades de saúde pública. Informar sobre as principais evidências científicas descritas na literatura internacional sobre tratamento farmacológico para a COVID-19. Além de resumir cada estudo identificado, o informe apresenta também uma avaliação da qualidade metodológica e a quantidade de artigos publicados, de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, entre outros). Foram encontrados 9 artigos.

Concentrations of matrix metalloproteinase-2 and interleukin-1 beta in the aqueous humor of dogs with normal and cataractous eyes / Concentração de metaloprotease-2 e de interleucina-1 beta no humor aquoso de cães com olhos normais e cataratosos

We aimed to determine the concentration of MMP-2 and IL-1ß in the aqueous humor of dogs with healthy eyes (n=8) and in those with mature (n=8) and hyper mature cataracts (n=8). Correlations between cytokines, cytokines, and intraocular pressure (IOP), as well as cytokines with ages of patients of each group, were also assessed. In patients with cataract, aqueous humor was collected at the end of the electroretinographic procedure. In healthy dogs, aqueous humor was collected before elective surgeries. Cytokine levels were determined using ELISA. IOP was assessed by applanation tonometry. IOP of patients with mature and hyper mature cataracts were lower than the ones measured in normal eyes (P=0.158). MMP-2 aqueous humor concentration was higher in patients with hyper mature cataracts, in comparisons with healthy patients (P=0.04). Average IL-1 ß aqueous concentration was higher in patients with cataracts (P<0.0001). Significant higher values of IL-1 ß were observed in patients with hyper mature, than in the ones with mature cataracts (P=0.0085). Correlations between MMP-2 and IL-1 ß (r=-0.38, P=0.06), MMP-2 and IOP (r=-0.149, P=0.484), and IL-1 ß and the ages of patients were not observed (P>0.05). IL-1 ß and IOP correlated negatively (r=-0.42, P=0.04). MMP-2 and the ages of patients correlated only in dogs with mature cataracts (r=0.772, P=0.02). It can be concluded that the increment in the aqueous humor concentration of IL-1 ß found in dogs with mature and hyper mature cataracts, in addition to the negative relationship of this cytokine with IOP, suggests that IL-1 ß is involved in the pathogenesis of LIU. Despite dogs with hypermature cataracts presented significant higher concentrations of MMP-2 in the aqueous humor, such cytokine did not correlate with IL-1 ß and IOP. In our study, a relationship between aqueous humor cytokines and the ages of patients was only confirmed between MMP-2 and the ages of dogs with mature cataracts.(AU)

Objetivou-se determinar as concentrações da metalloprotease-2 (MMP-2) e de interleucina-1 ß (IL-1 ß) em cães com olhos saudáveis (n=8) e naqueles com catarata madura (n=8) e hipermatura (n=8). Correlações entre ambas as citocinas, entre as citocinas e a pressão intraocular (PIO), assim como entre as citocinas e a idade dos pacientes dentro de cada grupo foram averiguadas. Nos pacientes com catarata, o humor aquoso foi colhido ao final da eletrorretinografia. Nos cães saudáveis, o humor aquoso foi colhido antes do início de cirurgias eletivas. Os níveis das citocinas foram determinados por ELISA e a PIO por tonometria de aplanação. A PIO dos pacientes com catarata madura e hipermadura foram mais baixas que aquelas dos pacientes controle (P=0.158). A concentração de MMP-2 no humor aquoso foi maior nos pacientes com catarata hipermtura, comparativamente aos pacientes saudáveis (P=0.04). A concentração de IL-1 ß no humor aquoso foi mais elevada nos cães com catarata (P<0.0001). Nos pacientes com catarata hipermatura, os valores de IL-1 ß foram significativamente mais altos que aqueles dosados nos pacientes com catarata madura (P=0.0085). Correlações entre MMP-2 e IL-1 ß (r=-0.38, P=0.06), MMP-2 e PIO (r=-0.149, P=0.484) e IL-1 ß e as idades dos pacientes não foram observadas (P>0.05). A IL-1 ß se correlacionou negativamente com a PIO (r=-0.42, P=0.04). Correlação entre MMP-2 e a idades dos pacientes foi observada apenas nos cães com catarata madura (r=0.772, P=0.02). Conclui-se que o aumento na concentração de IL-1 ß no humor aquoso de cães com catarata madura e hipermatura, associado à correlação negativa entre essa citocina e a PIO, sugerem que a mesma está envolvida na patogênese da uveíte induzida pela lente. Apesar dos cães com catarata hipermadura apresentarem concentrações significativamente maiores de MMP-2 no humor aquoso, essa citocina não se correlacionou com a IL-1 ß e a PIO. Em nosso estudo, correlação entre as citocinas dosadas no humor aquoso e a idade dos pacientes foi confirmada apenas entre MMP-2 e a idade dos cães com catarata madura.(AU)

Suppression of hepatic apoptosis induced by acetaminophen using a combination of resveratrol and quercetin: an association of oxidative stress and interleukin-11 / Suspensión de la apoptosis hepática inducida por acetaminofén mediante una combinación de resveratrol y quercetina: una asociación de estrés oxidativo e interleucina-1

We sought to determine whether the combined polyphenolic compounds, resveratrol and quercetin can substantially protect against modulation of hepatic biomarkers of apoptosis and survival, p53-Bax axis and B-cell lymphoma 2 (Bcl-2) in an animal model of acetaminophen-induced acute liver injury via the association of oxidative stress and interleukin-11 (IL-11). The model group of rats received a single dose of acetaminophen (2 g/kg), whereas the protective group of rats was pre-treated for 7 days with combined doses of resveratrol (30 mg/kg) and quercetin (50 mg/kg) before being given a single dose of acetaminophen. All rats were then sacrificed 24 hours post acetaminophen ingestion. Acetaminophen overdose induced acute liver injury as demonstrated by profound liver parenchymal damage and increased levels of the liver injury enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Acetaminophen significantly (p<0.05) modulated malondialdehyde (MDA), p53, apoptosis regulator Bax, Bcl-2, IL-11, interleukin-6 (IL-6), ALT, AST, superoxide dismutase (SOD), and glutathione peroxidase (GPx), which were significantly protected by resveratrol plus quercetin. We further demonstrated a significant (p<0.01) correlation between IL-11 scoring and the levels of p53, Bax, Bcl-2, and MDA. Thus, resveratrol plus quercetin effectively protect against acetaminophen-induced apoptosis, which is associated with the inhibition of oxidative stress and IL-11.

En el estudio se intentó determinar si los compuestos polifenólicos combinados, el resveratrol y la quercetina pueden proteger sustancialmente contra la modulación de los biomarcadores hepáticos de apoptosis y supervivencia, el eje p53-Bax y el linfoma de células B 2 (Bcl-2) en un modelo animal de lesión hepática aguda inducida por acetaminofén, a través de la asociación del estrés oxidativo y la interleucina-11 (IL-11). El grupo modelo de ratas recibió una dosis única de acetaminofén (2 g / kg), mientras que el grupo protector de ratas fue tratado durante 7 días con dosis combinadas de resveratrol (30 mg / kg) y quercetina (50 mg / kg) antes de recibir una dosis única de acetaminofén. Todas los animales fueron sacrificados 24 horas después de la ingestión de acetaminofén. La sobredosis de acetaminofén indujo una lesión hepática aguda, como se observó en el daño profundo del parénquima hepático y el aumento de los niveles de las enzimas en la lesión hepática, alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST). Acetaminofén moduló significativamente (p <0.05) malondialdehído (MDA), p53, regulador de apoptosis Bax, Bcl2, IL-11, interleucina-6 (IL-6), ALT, AST, superóxido dismutasa (SOD) y glutatión peroxidasa ( GPx), los que se encontraron significativamente protegidos por el resveratrol y quercetina. Además se determinó una correlación significativa (p <0.01) entre la puntuación de IL-11 y los niveles de p53, Bax, Bcl-2 y MDA. En conclusión, el resveratrol más la quercetina protegen de manera efectiva contra la apoptosis inducida por acetaminofén, asociada con la inhibición del estrés oxidativo y la IL-11.

Comparison of TNF-α and IL-1ß Concentrations in Gingival Crevicular Fluid During Early Alignment Stage of Orthodontic Treatment in Adults and Adolescents

Abstract Objective: To compare the levels of TNF-α and IL-1β in the gingival crevicular fluid (GCF) during early leveling stage of orthodontic treatment. Material and Methods: This study was carried out on 20 orthodontic patients, including 10 teenagers and 10 adults. Before bonding, GCF was collected with a paper strip in gingival sulcus of maxillary right central incisor on the disto labial aspect for 60 seconds, followed by bonding and insertion of initial 14 NiTi archwire. GCF collection was repeated 24 hours, 7 days, and 28 days after bonding. Measurement of TNF-α and IL-1β levels was done utilizing Enzyme-Linked Immunosorbent Assay (ELISA). Data were analyzed in SPSS using repeated measurement test. Results: Concentration of TNF-α and IL-1β increased after treatment. There was no significant relationship between TNF-α and IL-1β concentrations subsequent to bonding in comparison to the baseline. There was no significant relationship in TNF-α and IL-1β level changes in the two age groups and between males and females. Conclusion: Concentration of TNF-α and IL-1β increased after treatment. Age and sex had no statically significant effect on the concentration of TNF-α and IL-1β.

Evaluating the effects of vanadyl sulfate on biomarkers of oxidative stress and inflammation in renal tissue of rats with diabetes type 2

Vanadyl sulfate (VS) is an ingredient in some food supplements and experimental drugs. This study was designed to assay the effects of VS on biomarkers of oxidative stress and inflammation in renal tissue of rats with diabetes type 2. 30 male Wistar rats were divided into three equal groups as follow: non-diabetics, non-treated diabetics and VS-treated diabetics. Diabetes type 2 has been induced through high fat diet and fructose in the animals. Diabetic rats were treated with 25 mg/kgBW of VS in water for 12 weeks. At the end of study, glucose and insulin were measured using commercially available kits in serum and biomarkers of oxidative stress and inflammation in renal homogenates of animals were measured by related methods. Compared to controls, glucose and insulin were increased significantly in non-treated diabetic rats (p-value <0.05) that showed the induction of diabetes type 2 in rats. The results showed that in VS-treated diabetic rats compared to the non-treated diabetic group, vanadyl sulfate significantly reduced the glucose and insulin secretion and changed renal inflammatory and oxidative markers, except protein carbonyl so that we couldn't find any significant changes. Our study showed that vanadyl supplementation had positive effects on oxidative stress and inflammation biomarkers in kidney of diabetic rats

IL-10 Cytokine as Potential Biomarkers in Women with Fibromyalgia Who Underwent to a Short Balneotherapy Treatment

Abstract Fibromyalgia (FM) is a nonarticular rheumatic syndrome that leads to diffuse myalgia, sleep disturbances and morning stiffness. Balneotherapy has been shown an effective strategy to improve the health conditions of patients; however, the treatment follow-up is based on patient report due to the lack of biomarkers. Thus, this study evaluated the application of cytokines and phosphoglycerate mutase I (PGAM-I) to monitoring FM patient underwent to balneotherapy treatment. Eleven healthy and eleven women with FM were submitted to daily sessions of balneotherapy during 10 days. Clinical and quality of life parameters were assessed through a FIQ questionnaire. Blood levels of TNF-(, interleukins (IL-1, IL-2 and IL-10) and PGAM-I expression in patients' saliva were also evaluated. Patients with FM showed significant improvements in their clinical status after treatment. Also, FM patients has IL-10 levels lower than healthy women and the balneotherapy increased the expression of this cytokine in both groups, concomitantly to pain relief. Although inflammatory cytokines (IL-1, IL-2 and TNF-() were more expressed in FM patients than healthy patients their levels did not reduce after treatment. A slight increase of PGAM-I expression was observed. In conclusion, IL-10 levels could be a useful biomarker to balneotherapy follow-up of FM patients. However, these findings must be analyzed in a larger number of patients in order to validate IL-10 as an effective biomarker.

Biomarcadores suPAR y citocinas en la detección temprana de cáncer gástrico / suPAR and cytokines as biomarkers in early detection of gastric cancer

El cáncer gástrico (CG) es un problema prevalente a nivel mundial, presentándose aproximadamente 18 millones de casos nuevos en el año 2018, representa el 5.7% del total de cánceres, siendo la quinta neoplasia maligna más común en el mundo. En Guatemala se sitúa entre los primeros cinco cánceres respecto a morbilidad y mor-talidad. El CG se ha asociado de manera contundente a infección por Helicobacter pylori el cual desencadena un proceso inflamatorio crónico; adicionalmente algunas cepas de H. pylori producen toxinas bacterianas capaces de inducir cambios celulares que conllevan al desarrollo del proceso neoplásico. La alta mortalidad por CG en parte, se relaciona con la etapa tardía en la que se diagnostica ya que se requiere el uso de métodos invasivos, lo que dificulta su detección temprana. El objetivo de la presente revisión, fue realizar una narrativa de los estudios y las evidencias científicas, respecto de la identificación de biomarcadores séricos en la detección temprana del cáncer gástrico. Se revisaron dos tipos de biomarcadores, la proteína soluble uPAR (suPAR) que es el receptor del activador del plasminógeno (uroquinasa) y promotora de angiogénesis y por otro lado, la detección sérica de las citocinas IL-1ß, IL-6, TNFα, IL-10, IFNγ, IL-4 e IL-17 en el CG así como su potencial utilidad en su detección temprana. Estos biomarcadores fueron seleccionados por la ventaja que tendrían de ser métodos no invasivos que podrían mejorar la detección, tratamiento y pronóstico de esta enfermedad.

Gastric cancer (GC) is a prevalent problem worldwide, presenting approximately 18 million new cases in 2018, representing 5.7% of all cancers, being the fifth most common malignancy in the world. In Guatemala it is among the first five cancers in terms of morbidity and mortality. CG has been strongly associated with Helicobacter pylori infection, which triggers a chronic inflammatory process; additionally, some strains of H. pylori produce bacterial toxins capable of inducing cellular changes that lead to the development of cancer. The high mortality due to GC in part is related to the late stage in which it is diagnosed since the use of invasive methods is required, making it difficult to detect it early. The objective of this review was to make a narrative of the studies carried out and the scientific evidence regarding the identification of serum biomarkers in the early detection of gastric cancer. Two types of biomarkers were reviewed, the soluble protein uPAR (suPAR) which is the receptor for plasminogen activator (urokinase) and promoter of angiogenesis and, on the other hand, serum detection of cytokines IL-1ß, IL-6, TNFα, IL-10, IFNγ, IL-4 and IL-17 in the CG as well as its potential usefulness in its early detection. These biomarkers were selected for the advantage they would have of being non-invasive methods that could improve the detection, treatment and prognosis of this disease.

Análise crítica dos estudos que mudaram a prática clínica recente: inflamação e doença coronariana / Critical analysis of the studies that changed recent clinical practice: inflammation and coronary disease

Os estudos com estatinas envolvendo desfechos clínicos mostraram que, mesmo atingindo as metas lipídicas, os pacientes que persistem com níveis aumentados de proteína C-reativa, têm maior risco de eventos cardiovasculares. A doença aterosclerótica das coronárias também apresentou maior regressão nos estudos com estatinas, quando ocorreu além de redução efetiva de LDL-colesterol, redução da proteína-C reativa. Nos últimos anos, dois importantes estudos com terapias anti-inflamatórias mostraram resultados divergentes. O estudo CANTOS, com o anticorpo monoclonal canaquinumabe, mostrou redução do eventocombinado de morte cardiovascular, infarto ou acidente vascular cerebral não fatais, e a magnitude do benefício foi associada ao grau de diminuição de marcadores inflamatórios, como proteína C-reativa ou interleucina 6. No estudo CIRT, os pacientes que receberam o anti-inflamatório metotrexato não tiveram redução de desfechos cardiovasculares, mas tampouco tiveram redução dos mencionados marcadores inflamatórios. Esses resultados, em conjunto, sugerem que o bloqueio específico de uma via inflamatória, como a citocina, pode ser mais relevante do que efeito anti-inflamatório per se e revela um caminho para diminuição do risco inflamatório residual

Studies with statins involving clinical endpoints have shown that, in spite of achieving lipid goals, patients with high levels of C-reactive protein are at higher risk for cardiovascular events. Atherosclerotic coronary artery disease has also presented greater regression in studies with statins when, in addition to an effective reduction in LDL cholesterol, a reduction in C-reactive protein was achieved. In recent years, two important studies involving anti-inflammatory therapies reported divergent results. The CANTOS study, with the human monoclonal antibody canakinumab, showed a decrease in combined cardiovascular death, non-fatal myocardial infarction or non-fatal stroke events and the magnitude of that benefit was associated with the degree of reduction in the inflammatory markers, such as C-reactive protein and interleukin-6. In the CIRT study, patients who received the anti-inflammatory methotrexate did not have a decrease in cardiovascular outcomes, but neither was there a reduction in the inflammatory markers mentioned. Taken together, these results suggest that the specific blockade of an inflammatory pathway, such as that of cytokine,may be more relevant than the antiinflammatory effect per se and reveal a promising way to reduce the residual inflammatory risk

Anti-interleukin-1 treatment among patients with familial Mediterranean fever resistant to colchicine treatment. Retrospective analysis

ABSTRACT BACKGROUND: Up to 5% of familial Mediterranean fever (FMF) cases are unresponsive to colchicine, through resistance, side effects and toxicity. Anakinra is an alternative treatment for FMF patients whose disease remains uncontrolled with colchicine. We aimed to evaluate anti-interleukin-1 treatment regarding clinical findings, laboratory parameters and quality of life (QoL) among FMF patients presenting resistance and toxicity towards colchicine. DESIGN AND SETTING: Descriptive observational study at the rheumatology clinic, Adnan Menderes University Medical School, Aydın, Turkey. METHODS: Among the patients included, age, sex, MEFV genotypes, acute-phase reactants, hepatic/renal function tests, average colchicine dose, disease duration, attack frequency, attack duration, disease severity, proteinuria, amyloidosis and QoL were evaluated. Colchicine resistance was defined as > 6 typical episodes/year or > 3 per 4-6 months. Kolmogorov-Smirnov, Friedman and two-way analysis of variance tests were used for statistical analyses. RESULTS: Between 2015 and 2017, 14 FMF patients receiving anakinra were enrolled. The mean colchicine dose was 1.7 ± 0.3 mg/day before use of anakinra. Ten patients were attack-free after treatment, while three showed reductions of at least 50% in attack frequency, attack duration and disease severity. Proteinuria levels in all patients with renal amyloidosis decreased after treatment. QoL among patients with renal amyloidosis differed significantly from QoL among non-amyloidosis patients. Mean visual analogue scale scores significantly improved in both groups after use of anakinra. CONCLUSIONS: Use of anakinra reduced attack frequency and proteinuria and acute-phase reactant levels, and improved QoL, with only a few uncomplicated side effects among colchicine-resistant or intolerant FMF patients. Injection-site reactions of severity insufficient to require discontinuation of treatment were seen.

Efeitos do queijo probiótico com adição de Lactobacillus casei-01 na periodontite experimental em ratos / Effects of probiotic cheese supplemented with Lactobacillus casei-01 on experimental periodontitis in rats

Objetivo: Este estudo avaliou os efeitos da ingestão de alimento funcional, queijo Prato contendo Lactobacillus casei-01, no desenvolvimento da periodontite experimental (PE) em ratos. Materiais e Métodos: 44 ratos machos Wistar foram divididos em 4 grupos (n = 11): C (controle) - animais sem indução de PE e alimentados com ração convencional (RC) + queijo convencional (CONV); PROB - animais sem indução de PE e alimentados com RC + queijo probiótico (PROB); PE - animais com indução de PE e alimentados com RC + queijo CONV e PE-PROB - animais com indução de PE e alimentados com RC + queijo PROB. O queijo Prato foi fabricado por método tradicional com bactérias lácticas, suplementado ou não com a cepa probiótica Lactobacillus casei-01. No dia 0 do experimento, queijo CONV ou PROB, de acordo com o grupo experimental, foi administrado oralmente para todos os animais 1 x / dia até o final do experimento. No dia 28, a PE foi induzida nos primeiros molares inferiores direito e esquerdo dos animais dos grupos PE e PE-PROB. No dia 42, todos os animais foram submetidos à eutanásia. Foram realizadas análises microtomográfica na região da bifurcação e nos sítios vestibular, lingual e interproximais [volume ósseo (BV), número de trabéculas (Tb.N), espessura das trabéculas (Tb.Th), perda óssea alveolar (ABL)] e análises histológica (parâmetros dos tecidos moles e duros), histométrica [porcentagem de osso na furca (PBF)] e imunoistoquímica [fator de necrose tumoral-α (TNFα), interleucina (IL)-1ß, IL-10, fator de crescimento transformador-ß1 (TGFß1) e fosfatase ácida resistente ao tartarato (TRAP)] na região da furca. Foram realizadas análises histológica (parâmetros de inflamação, celularidade e estruturação tecidual) e histométrica [altura de vilosidades (VH) e profundidade de cripta (CD)] nos tecidos intestinais. Os dados foram submetidos à análise estatística. Resultados: Os valores de BV foram similares em todos os grupos experimentais. No entanto, os grupos PE e PE-PROB apresentaram Tb.N significativamente maior e Tb.Th significativamente menor que os grupos C e PROB. O grupo PE apresentou PBF significativamente menor que os grupos C e PROB, e similar ao grupo PE-PROB. Os grupos PE e PE-PROB apresentaram maior expressão de citocinas pró-inflamatórias (TNFα e IL-1ß) e TRAP que os grupos C e PROB. O grupo PE-PROB apresentou maior expressão de citocinas anti-inflamatórias (TGFß1 e IL-10) que o grupo PE. Não houve diferenças significativas para os valores de VH e CD entre os gru pos experimentais. Conclusão: O consumo de queijo Prato, tanto CONV como PROB, teve efeito protetor nos tecidos periodontais durante o desenvolvimento da PE em ratos. Contudo, o queijo PROB parece ter estimulado principalmente a expressão de citocinas antiinflamatórias, quando comparado ao queijo CONV, favorecendo o processo de reparo tecidual(AU)

Objective: This study evaluated the effects of a functional food (Prato cheese) intake supplemented with Lactobacillus casei-01 in experimental periodontitis (EP) in rats. Materials and Methods: 44 Wistar male rats were divided into 4 groups (n = 11): C (control) - animals without EP induction and fed with conventional feed (CF) + conventional cheese (CONV); PROB - animals without EP induction and fed with CF + probiotic cheese (PROB); EP - animals with EP induction and fed with CF + CONV cheese; and EP-PROB - animals with EP induction and fed with CF + PROB cheese. Prato cheese was produced by traditional lactic bacteria manufacturing method, supplemented or not with the probiotic strain Lactobacillus casei-01. On day 0, either CONV or PROB cheese, according to the experimental group, was orally administered to all animals once a day until the end of the experiment. On day 28, EP was induced on the right and left mandibular first molars of the animals of groups EP and EP-PROB. On day 42, all animals were euthanized. Microtomographic analysis was performed in the furcation region and at the buccal, lingual and interproximal sites [bone volume (BV), trabeculae number (Tb.N), trabeculae thickness (Tb.Th), alveolar bone loss (ABL)]. Histologic (hard and soft tissue parameters), histometric [bone percentage in the furcation area (PBF)] and immunohistochemical [transforming growth factor-α (TNF-α), interleukin (IL)-1ß, IL-10, transforming growth factor-ß1 (TGF- ß1) and tartrate resistant acid phosphatase (TRAP)] analyses were performed in the furcation region. Histologic (inflammatory, cellularity and tissue structure parameters) and histometric [villi height (VH) and crypt depth (CD)] analyses were performed in the intestinal tissues. Data were statistically analyzed. Results: BV values were similar in all experimental groups. However, groups EP and EP-PROB presented significantly greater Tb.N and significantly lower Tb.Th than groups C and PROB. Group EP presented significantly lower PBF than groups C and PROB, and similar to group EP-PROB. Groups EP and EP-PROB presented higher expression of pro-inflammatory cytokines (TNF-α and IL-1ß) and TRAP than groups C and PROB. Group EP-PROB presented higher expression of anti-inflammatory cytokines (TGFß1 e IL-10) than group EP. No significant differences were observed among groups for VH and CD values. Conclusion: CONV as well as PROB Prato cheese intake promoted a protective effect on periodontal tissues during EP induction in rats. However, PROB cheese seems to mainly stimulate the e xpression of antiinflammatory cytokines when compared with CONV cheese, favoring tissue repair process(AU)

Clinical Observation of the Efficacy of Endoscopic Retrograde Cholangiopancreatography on Elder Choledocholithiasis and Its Effects on the Levels of TNF-α, IL-1, and IL-6

SUMMARY OBJECTIVE: We conducted this study to investigate the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on elder choledocholithiasis and its effects on the levels of TNF-α, IL-1, and IL-6. METHODS: Elder patients with choledocholithiasis were enrolled in this study, and according to the surgical methods, they were divided into the ERCP group and the surgical group. After treatment, we compared the efficacy of these two methods on patients, inflammatory responses indicated by the levels of TNF-α, IL-1, and IL-6, and the complications. RESULTS: No statistical significance was identified in the difference of the success rate in removal between the two groups (98% vs. 94%), but indicators of the ERCP group, including the surgical duration (28.5±12.8) min, remission duration of abdominal pain (1.2±0.2) d, recession time of jaundice (2.0±0.3) d, postoperative bedridden time (1.4±0.2) d, treatment time of the anti-infection (1.5±0.2) d, length of stay in hospital (6.5±0.3) d, levels of TNF-α (2.1±0.2) μg/L, IL-1 (6.3±0.8) μg/L, IL-6 (2.8±0.3) μg/L, and the incidence rate of complications (1.8%), were all significantly lower than those in the surgical group (p<0.05). CONCLUSION: In the treatment of choledocholithiasis, ERCP is excellent in controlling the trauma, accelerating the recovery duration, reducing the occurrence of complications and ameliorating the inflammatory responses. Thus, it is an ideal choice for choledocholithiasis.

RESUMO OBJETIVO: Realizamos este estudo para investigar a eficácia clínica da colangiopancreatografia retrógrada endoscópica (ERCP) na coledocolitíase idosa e seus efeitos nos níveis de TNF-α, IL-1 e IL-6. MÉTODOS: Pacientes idosos com coledocolitíase foram matriculados neste estudo. De acordo com os métodos cirúrgicos, eles foram divididos em grupo ERCP e grupo cirúrgico. Após o tratamento, comparamos a eficácia desses dois métodos em pacientes, respostas inflamatórias indicadas pelos níveis de TNF-α, IL-1 e IL-6 e as complicações. RESULTADOS: Não houve significância estatística na diferença da taxa de sucesso na remoção entre os dois grupos (98% versus 94%), mas indicadores do grupo ERCP, incluindo a duração cirúrgica (28,5 ± 12,8) min, duração da remissão da dor abdominal (1,2 ± 0,2) d, tempo de recessão de icterícia (2,0 ± 0,3) d, tempo pós-operatório (1,4 ± 0,2) d, tempo de tratamento da infecção (1,5 ± 0,2) d, duração da internação (6,5 ± 0,3) d, níveis de TNF-α (2,1 ± 0,2) μg / L, IL-1 (6,3 ± 0,8) μg / L, IL-6 (2,8 ± 0,3) μg / L e a taxa de incidência de complicações (1,8 %) foram todos significativamente inferiores aos do grupo cirúrgico (p<0,05). CONCLUSÃO: No tratamento da coledocolitíase, a ERCP é excelente no controle do trauma, acelerando a duração da recuperação, reduzindo a ocorrência de complicações e melhorando as respostas inflamatórias. Assim, é uma escolha ideal para a coledocolitíase.

Pro-inflammatory Cytokines, Biomarkers, Genetics and the Immune System: A Mechanistic Approach of Depression and Psoriasis / Citocinas proinflamatorias, biomarcadores, genética y sistema inmunológico: un enfoque mecanicista de la depresión y la psoriasis

ABSTRACT Objective: To highlight the inflammatory and immunological mechanisms involved in depression and psoriasis. Methods: A comprehensive literature search was performed in various databases, in total 145 studies were selected. Results: Depression and psoriasis have an association. Immune mechanisms -the actions of tumor necrosis factor-a, interleukin 1 (IL-1), IL-2, IL-10, IL-22, IL-17, interferon-7, IL-1ß, prostaglandin E2, C-reactive protein, IL-6, and IL-8 etc.-, and some genetic changes are involved. Conclusions: A possible bidirectional relationship of psoriasis and major depression exists; i.e. the depression leads to psoriasis, and psoriasis leads to depression. We recommend more studies in the future to get a deeper and better understanding about this relationship.

RESUMEN Objetivo: Poner de relieve los mecanismos inflamatorios e inmunológicos involucrados en la depresión y la psoriasis. Métodos: Se realizó en varias bases de datos una búsqueda bibliográfica completa; en total se incluyeron 145 estudios. Resultados: Hay asociación entre depresión y psoriasis y están involucrados mecanismos inmunitarios -las acciones del factor de necrosis tumoral alfa, las interleucinas (IL) 1, 2, 10, 22 y 17, el interferón gamma, la IL-1ß, la prostaglandina E2, la proteína C reactiva, la IL-6 y la IL-8, etc. - y algunos cambios genéticos. Conclusiones: Hay una posible relación bidireccional entre psoriasis y depresión, es decir, la depresión lleva a psoriasis y la psoriasis lleva a depresión. Se recomiendan más estudios en el futuro para obtener una comprensión más profunda y mejor sobre esta relación.

Pro - inflammatory cytokines and metalloproteinase activation in polypropylene mesh implant in rat subcutaneous tissue

ABSTRACT Aims and Objectives: Polypropylene meshes have been increasingly adopted for correction of pelvic organ prolapse due to its lower recurrence rate when compared to surgeries without meshes. The study of the interaction of these materials with the host tissue may contribute to the development of materials with best biocompatibility and, consequently, less complication rates. Materials and Methods: The present study compares the inflammatory reaction of standard-weight (SW) and lightweight (LW) meshes (72 g/m216g/m2 respectively), implanted in the abdomen of 20 adult rats, which were euthanized in four or 30 days. Quantification of pro-inflammatory markers, IL-1 and TNF-α, and of metalloproteinases, MMP2 and MMP3, were carried out through immunohistochemistry with AxioVision® software. Results: There were no significant differences in the quantification of IL-1 and TNF-α in LW versus SW meshes. However, IL-1 quantification increased along time (30 days >4 days, p=0.0269). Also, MMP-2 quantification was similar to SW and LW and both presented a significant increase along time (30 days >4 days, p <0.0001). MMP-3 quantification also showed no difference between the SW and LW groups, but increased along time (30 days >4 days, p=0.02). Conclusions: Mesh's density did not influence the quantification of pro-inflammatory cytokines IL-1 and TNF-α and metalloproteinases 2 and 3. The increased expression of IL-1, MMP-2 and MMP-3 over time could represent a longstanding inflammatory response after PP mesh implantation. Possibly, the occurrence of adverse events following PP prosthetic implants can be influenced by other factors, not solely related to the amount of implanted material.