RESUMO
ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Fator de Crescimento Derivado de Plaquetas , Defeitos da Furca/patologia , Periodontite Crônica/patologia , Aloenxertos , Estatísticas não Paramétricas , Ensaios Clínicos Controlados não Aleatórios como AssuntoRESUMO
RESUMEN El envejecimiento es un proceso complejo que trae consigo cambios celulares, histológicos y cutáneos. Estos últimos son una de sus manifestaciones más evidentes. El plasma rico en plaquetas es una fuente fiable de obtención de células para regenerar tejidos; por su fácil disponibilidad es un material inocuo. La bioestimulación con el mismo, por su parte, es un conjunto de procedimientos para activar las funciones anabólicas de los fibroblastos, producción de colágeno, elastina y ácido hialurónico. La tendencia al empleo de este en tratamientos antiedad es cada vez mayor. El objetivo de este trabajo fue realizar una actualización del tema, para exponer aspectos importantes sobre formas de aplicación, indicaciones, complicaciones y contraindicaciones. Existen varios métodos para la bioestimulación facial, tales como la realización de pápulas, napagge y retroinyección. Se han empleado en alopecia androgénica, areata, envejecimiento cutáneo, etc. Las complicaciones más observadas son dolor, eritema, ardor y sangrado local. Entre las contraindicaciones más comunes se observan el herpes simple recidivante, coagulopatías, tratamiento con anticoagulantes, colagenopatías y neoplasias (AU).
ABSTRACT Aging is a complex process that brings with it cellular, histological and cutaneous changes, the latter being one of its most obvious manifestations. Platelet-rich plasma is a reliable source of cells to regenerate tissues; due to its easy availability, it is a harmless material. Bio-stimulation with it is a set of procedures to activate the fibroblasts anabolic functions and the production of collagen, elastin and hyaluronic acid. The tendency to use it in anti-aging treatments increases faster and faster. The objective of this work was updating the topic to expose important aspects about application methods, indications, complications and contraindications. There are several methods of applying facial bio-stimulation such as performing papules, napagge, and retroinjection. It has been used in androgenic alopecia, alopecia areata, cutaneous ageing, etc. The most commonly found complications are pain, erythema, burning and local bleeding. The most common contraindications include recidivist herpes simplex, coagulopaties, anticoagulant treatment, collagen-related diseases and neoplasms (AU).
Assuntos
Humanos , Masculino , Feminino , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Dermatologia/métodos , Fator de Crescimento Derivado de Plaquetas/biossíntese , Envelhecimento da Pele/efeitos dos fármacos , Medicamentos HemoderivadosRESUMO
The objective in this study was to evaluate the clinic effect of applying allogenic platelet-rich plasma (PRP) heated or not, for treating cornea ulcers, including the dosage of PDGF-BB in the cornea. The ulcers were induced, standardizing the left eye from 81 rats (Ratus norvegicus, albinus variety), assigned randomly into three groups (N=27): control group (CG) which did not receive any topic treatment; heated PRP group (GA) and PRP group (GP), which received topical treatment every eight hours for five days. Each group underwent evaluation at 24 hours (M1), three days (M3) and five days (M5). The clinical exam evaluated the opacity, vascularization and corneal repair. The corneal PDGF-BB was dosed through the ELISA method. The corneal opacity was decreased in PRP-treated animals (GA and GP) and corneal repair time reduced when compared to CG at M1 and M5. Furthermore, GP showed greater vascularization at M3 compared to M1. Applied allogenic PRP eye drops, heated or not, speed up corneal healing, and reduce corneal repair time. However, the corneal PDGF concentration was not altered in any of the treatments.(AU)
Objetivou-se avaliar o efeito clínico da aplicação de plasma rico em plaquetas alogênico (PRP) aquecido ou não, no tratamento de úlceras de córnea, como a dosagem de PDGF-BB na córnea. As úlceras foram induzidas, padronizando-se o olho esquerdo de 81 ratos (Rattus norvegicus, variedade albinus), aleatoriamente, nos três grupos (N = 27): grupo controle (CG), que não recebeu nenhum tratamento tópico; grupo PRP aquecido (GA) e grupo PRP (GP), que receberam tratamento tópico a cada oito horas, durante cinco dias. Cada grupo foi subdividido em 24 horas (M1), três dias (M3) e cinco dias (M5). O exame clínico avaliou a opacidade, a vascularização e o reparo corneano. O PDGF-BB corneano foi dosado pelo método Elisa. Houve diminuição da opacidade da córnea nos animais tratados com PRP (GA e GP) e diminuição do tempo de reparo da córnea em comparação com CG, M1 e M5. Além disso, foi observada maior vascularização no GP no momento M3 em relação ao M1. A aplicação de colírios de PRP alogênico, aquecidos ou não, acelera a cicatrização da córnea, além de reduzir o tempo de reparo da córnea. No entanto, a concentração de PDGF na córnea não se alterou em nenhum dos tratamentos.(AU)
Assuntos
Animais , Ratos , Soluções Oftálmicas/uso terapêutico , Fator de Crescimento Derivado de Plaquetas/análise , Úlcera da Córnea/induzido quimicamente , Plasma Rico em Plaquetas , Ensaio de Imunoadsorção Enzimática/veterinária , Animais de LaboratórioRESUMO
Objectives: Reviewing information available about platelet-rich plasma (PRP) applied to dental treatments, introducing the general concept of PRP, as well as analyzing actual data about, and challenges faced by, the dental field. Data & sources: The current study analyzed the most informative publications about PRP application available in this field and gathered the maximum information about it as possible. Conclusions: PRP use, either alone or in association with other biomaterials, can significantly favor different fields such as tissue engineering, since it is an innovative technique that attracts the interest of clinicians and basic scientists. However, it is necessary conducting better designed and controlled experiments to enable successful tissue healing based on PRP use. Clinical significance: The current review can be used by clinicians as source of information about the actual rules and protocols adopted in the herein addressed field, besides providing specific examples of such applications. (AU)
Objetivos: Revisar as informações disponíveis sobre o plasma-rico em plaquetas (PRP) aplicado a tratamentos odontológicos, introduzir o conceito geral de PRP e analisar dados reais sobre os desafios enfrentados pelo campo odontológico. Dados e fontes: O presente estudo analisou as publicações mais informativas sobre a aplicação do PRP disponíveis neste campo e reuniu o máximo de informações possível. Conclusões: O uso do PRP, isoladamente ou em associação com outros biomateriais, pode favorecer significativamente diferentes campos, como a engenharia de tecidos, uma vez que é uma técnica inovadora que atrai o interesse de clínicos e cientistas básicos. No entanto, é necessário realizar experimentos mais bem projetados e controlados para permitir a cura bem-sucedida dos tecidos com base no uso do PRP. Significado clínico: A revisão atual pode ser usada pelos médicos como fonte de informações sobre as regras e protocolos atuais adotados no campo aqui tratado, além de fornecer exemplos específicos de tais aplicações.(AU)
Assuntos
Cirurgia Bucal , Fator de Crescimento Derivado de Plaquetas , Regeneração Tecidual Guiada Periodontal , Nanotecnologia , Plasma Rico em Plaquetas , Tratamento Dentário Restaurador sem TraumaRESUMO
Abstract Objective: This study evaluated the angiogenesis-enhancing potential of a tricalcium silicate-based mineral trioxide aggregate (ProRoot MTA), Biodentine, and a novel bioceramic root canal sealer (Well-Root ST) in human dental pulp stem cells (hDPSCs), human periodontal ligament stem cells (hPLSCs), and human tooth germ stem cells (hTGSCs). Methodology: Dulbecco's modified Eagle's medium was conditioned for 24 h by exposure to ProRoot MTA, Biodentine, or Well-Root ST specimens (prepared according to the manufacturers' instructions). The cells were cultured in these conditioned media and their viability was assessed with 3-(4,5-dimethyl-thiazol-2-yl)-5-(3-carboxy-methoxy-phenyl)-2-(4-sulfo-phenyl)-2H tetrazolium (MTS) on days 1, 3, 7, 10, and 14. Angiogenic growth factors [platelet-derived growth factor (PDGF), basic fibroblast growth factor (FGF-2), and vascular endothelial growth factor (VEGF)] were assayed by sandwich enzyme-linked immunosorbent assay (ELISA) on days 1, 7, and 14. Human umbilical vein endothelial cell (HUVEC) migration assays were used to evaluate the vascular effects of the tested materials at 6-8 h. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, and Friedman and Wilcoxon signed rank tests. Results: None of tricalcium silicate-based materials were cytotoxic and all induced a similar release of angiogenic growth factors (PDGF, FGF-2, and VEGF) (p>0.05). The best cell viability was observed for hDPSCs (p<0.05) with all tricalcium silicate-based materials at day 14. Tube formation by HUVECs showed a significant increase with all tested materials (p<0.05). Conclusion: The tricalcium silicate-based materials showed potential for angiogenic stimulation of all stem cell types and significantly enhanced tube formation by HUVECs.
Assuntos
Humanos , Materiais Restauradores do Canal Radicular/farmacologia , Células-Tronco/efeitos dos fármacos , Cerâmica/farmacologia , Silicatos/farmacologia , Compostos de Cálcio/farmacologia , Indutores da Angiogênese/farmacologia , Ligamento Periodontal/citologia , Ligamento Periodontal/efeitos dos fármacos , Germe de Dente/citologia , Germe de Dente/efeitos dos fármacos , Materiais Biocompatíveis/farmacologia , Teste de Materiais , Fator de Crescimento Derivado de Plaquetas/análise , Fator de Crescimento Derivado de Plaquetas/efeitos dos fármacos , Ensaio de Imunoadsorção Enzimática , Sobrevivência Celular/efeitos dos fármacos , Reprodutibilidade dos Testes , Fator 2 de Crescimento de Fibroblastos/análise , Fator 2 de Crescimento de Fibroblastos/efeitos dos fármacos , Estatísticas não Paramétricas , Neovascularização Fisiológica/efeitos dos fármacos , Polpa Dentária/citologia , Polpa Dentária/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/análise , Fator A de Crescimento do Endotélio Vascular/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Citometria de FluxoRESUMO
ABSTRACT Purpose: To compare the intravitreal concentrations of cellular mediators involved in neurodegeneration, inflammation, and angiogenesis in patients with proliferative diabetic retinopathy and other vitreoretinal diseases. Methods: A multiplex bead immunoassay was used to measure vitreous levels of pigment epithelium-derived factor, serum amyloid P, C-reactive protein, complement C4, alpha-1 antitrypsin, vascular endothelial growth factor, platelet-derived growth factor-AA, platelet-derived growth factor-BB, interleukin-6, interleukin-8, interleukin-10, tumor necrosis factor alpha and beta in patients undergoing 23-gauge vitrectomy for proliferative diabetic retinopathy and other diagnoses (control group). Results: We evaluated 55 patients, of whom 24 had proliferative diabetic retinopathy and 31 had other diagnoses including vitreous hemorrhage, retinal detachment, macular hole, and epiretinal membrane. Patients with proliferative diabetic retinopathy demonstrated increased levels of serum amyloid P (85.49 vs. 31.38 ng/mL); C-reactive protein (59.89 vs. 41.75 ng/mL), vascular endothelial growth factor (2,330.11 vs. 554.25 pg/mL; p<0.001), platelet-derived growth factor A (127.32 vs. 39.11 pg/mL), platelet-derived growth factor B (29.37 vs. 7.12 pg/mL), interleukin-6 (69.37 vs. 33.58 pg/mL), interleukin-8 (175.25 vs. 59.71 pg/mL), and interleukin-10 (3.70 vs. 1.88 pg/mL); all p<0.004 when compared with the control group. Levels of pigment epithelium-derived factor (30.06 vs. 27.48 ng/mL; p=0.295), complement C4 (570.78 vs. 366.24 ng/mL; p=0.069), and alpha-1-antitrypsin (359.27 vs. 522.44 ng/mL; p=0.264) were not significantly different between the groups. Intravitreal levels of tumor necrosis factor-alpha and tumor necrosis factor-beta were undetectable. Serum Amyloid P, C-reactive protein, platelet-derived growth factor A, platelet-derived growth factor B, interleukin-6, and interleukin-8 were correlated positively with vascular endothelial growth factor. Conclusions: Cellular mediators involved in neurodegeneration and inflammation demonstrated increased levels in the vitreous humor of patients with proliferative diabetic retinopathy and may be part of the pathogenesis of diabetic retinopathy.
RESUMO Objetivo: Comparar as concentrações intravítreas de mediadores celulares envolvidos na neurodegeneração, inflamação e angiogênese em pacientes com retinopatia diabética proliferativa e outras doenças vítreo-retinianas. Métodos: Um ensaio imunomagnético foi utilizado para medir os níveis vítreos do fator derivado do epitélio pigmentar, amilóide P sérico, proteína-C-reativa, complemento C4, e alfa-1-antitripsina, fator de crescimento do endotélio vascular, fator de crescimento derivado das plaquetas AA, fator de crescimento derivado das plaquetas BB, interleucina-6, interleucina-8, interleucina-10, fator de necrose tumoral alfa e beta em pacientes submetidos à vitrectomia 23-gauge para retinopatia diabética proliferativa ou outros diagnósticos (grupo controle). Resultados: Foram avaliados 55 pacientes, dos quais 24 tinham retinopatia diabética proliferativa e 31 tinham outros diagnósticos, incluindo hemorragia vítrea, descolamento de retina, buraco macular e membrana epirretiniana. Pacientes com retinopatia diabética proliferativa demonstraram níveis aumentados de amilóide P sérico (85,49 vs 31,38 ng/mL), proteína-C-reativa (59,89 vs 41,75 ng/mL), fator de crescimento do endotélio vascular (2.330,11 vs 554,25 pg/mL, p<0.001), fator de crescimento derivado das plaquetas-A: (127,32 vs 39,11 pg/mL), fator de crescimento derivado das plaquetas-B (29,37 vs 7,12 pg/mL), interleucina-6 (69,37 vs 33,58 pg/mL), interleucina-8 (175,25 vs 59,71 pg/mL) e interleucina-10 (3,70 vs 1,88 pg/mL), todos com p<0,004 quando comparados ao grupo controle. Níveis de fator derivado do epitélio pigmentar (30,06 vs 27,48 ng/mL; p=0,295), complemento C4 (570,78 vs 366,24 ng/mL; p=0,069), alfa-1 antitripsina (359,27 vs 522,44 ng/mL; p=0,264) não foram significativamente diferente entre os grupos. Níveis intravítreos de fator de necrose tumoral alfa e fator de necrose tumoral beta foram indetectáveis. O amilóide P sérico, a proteína C-reativa, o fator de crescimento derivado das plaquetas A e B, a interleucina-6 e a interleucina-8 correlacionaram-se positivamente com o fator de crescimento do endotélio vascular. Conclusões: Os medidores celulares envolvidos na neurodegeneração e inflamação demonstraram níveis aumentados no humor vítreo de pacientes com retinopatia diabética proliferativa e podem ser parte da patogênese da retinopatia diabética.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Degeneração Retiniana/patologia , Corpo Vítreo/patologia , Mediadores da Inflamação/análise , Retinopatia Diabética/patologia , Valores de Referência , Vitrectomia , Proteína C-Reativa/análise , Fator de Crescimento Derivado de Plaquetas/análise , Componente Amiloide P Sérico/análise , Serpinas/análise , Estudos Transversais , Interleucinas/análise , Estatísticas não Paramétricas , Fator A de Crescimento do Endotélio Vascular/análise , Retinopatia Diabética/cirurgia , Proteínas do Olho/análise , Fatores de Crescimento Neural/análiseRESUMO
Una comunicación oroantral es el espacio creado entre el seno maxilar y la cavidad oral, si ésta no es tratada a tiempo puede desencadenar una fístula e inclusive la presencia de sinusitis crónica. La comunicación oroantral es una de las complicaciones con mayor prevalencia que puede presentarse durante los procedimientos quirúrgicos cercanos a la zona donde se vea involucrado el seno maxilar. Con mayor incidencia encontramos los primeros molares, seguidos de los segundos molares y por último los terceros molares. El manejo convencional de una comunicación oroantral va desde su cierre espontáneo hasta el manejo quirúrgico; esto dependerá del tamaño de la lesión y el tiempo transcurrido de ésta. El caso clínico se trata de un paciente de 42 años de edad con antecedente de extracción del O.D. 16 por facultativo particular, desarrollando posteriormente un cuadro de sinusitis, por lo que acude al Servicio de Urgencias del Hospital Regional 1o de Octubre, I.S.S.S.T.E. en la CDMX, siendo valorado por nuestro servicio, donde se observa una comunicación franca entre la cavidad bucal y el seno maxilar, realizándose cierre de la misma con una membrana de plasma rico en factores de crecimiento plaquetario (AU)
Oroantral communication is the space created between the maxillary sinus and the oral cavity, if the communication is not treated on time, it would progress to oroantral fi stula or chronic sinus disease. An oroantral communication is the most common complication during surgical procedures closer to the maxillary sinus. With greater incidence we found sites of upper fi rst molar, followed by the second molar and fi nally third molars. The conventional handling of an oroantral communication goes between spontaneously closure or surgical closure management, it will depend in the size of the lesion and the time elapsed. The present article shows a clinical case, is a male patient of 42 years old with a previous extraction of tooth 16, by a private doctor, later developing a picture of sinusitis. Then he goes to the emergency department of the Hospital 1o of October, ISSSTE in the CDMX, being evaluated by our service, where there is a frank communication between the oral cavity and the maxillary sinus, closing it with a plasma membrane rich in growth factors (AU)
Assuntos
Humanos , Masculino , Adulto , Seio Maxilar , Membranas Artificiais , Fístula Bucoantral , Fator de Crescimento Derivado de Plaquetas , Plasma Rico em Plaquetas , Unidade Hospitalar de Odontologia , México , Procedimentos Cirúrgicos Bucais , Cuidados Pós-Operatórios , Retalhos Cirúrgicos , Extração DentáriaRESUMO
Abstract The aim was to investigate the angiogenic effects of concentrated growth factors on human dental pulp cells and human umbilical vein endothelial cells. Cells were treated with concentrated growth factor extracts. The CCK-8 assay and cell cycle assay were conducted to evaluate cell growth. Cell migration was evaluated by the Transwell migration assay. Angiogenesis-associated mRNA and protein expression levels were determined using quantitative real-time PCR and Western blotting, respectively. A tube formation assay was conducted to evaluate the angiogenic capacity in vitro. The data showed that compared with the control, concentrated growth factor extracts significantly promoted dental pulp cell proliferation and differentiation and endothelial cell proliferation and migration in a dose-dependent manner (p < 0.05). Concentrated growth factor extracts also promoted the tube-like structure formation of endothelial cells in vitro. The RT-PCR and Western blot results showed that concentrated growth factor extracts upregulated the expression of angiogenesis-related genes - chemokine receptor-4, platelet-derived growth factor, and vascular endothelial growth factor - in dental pulp cells. In conclusion, concentrated growth factors showed proangiogenic effects on dental pulp cells and endothelial cells and have good application potential for dental pulp revascularization.
Assuntos
Humanos , Masculino , Adulto , Neovascularização Fisiológica/fisiologia , Peptídeos e Proteínas de Sinalização Intercelular/fisiologia , Polpa Dentária/citologia , Células Endoteliais da Veia Umbilical Humana/fisiologia , Valores de Referência , Fatores de Tempo , Fator de Crescimento Derivado de Plaquetas/análise , Fator de Crescimento Derivado de Plaquetas/fisiologia , Ciclo Celular/fisiologia , Células Cultivadas , Western Blotting , Reprodutibilidade dos Testes , Análise de Variância , Receptores CXCR4/análise , Receptores CXCR4/fisiologia , Peptídeos e Proteínas de Sinalização Intercelular/análise , Fator A de Crescimento do Endotélio Vascular/análise , Fator A de Crescimento do Endotélio Vascular/fisiologia , Proliferação de Células/fisiologia , Ensaios de Migração Celular , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Resumo Esta revisão tem por objetivo elencar as condições oftalmológicas em que tem sido utilizado o concentrado de plaquetas (CP), assim como as suas propriedades bioquímicas e fisiológicas. O CP possui tanto o potencial anticatabólico, presente no soro autólogo, quanto substâncias com propriedades anabólicas, que em conjunto são responsáveis pelos seus benefícios no tratamento de doenças da superfície ocular. Atualmente há um lapso de ensaios clínicos neste tema, tanto na oftalmologia como em outras áreas médicas, existindo mais estudos e relatos sobre o uso de soro autólogo. Em oftalmologia, o CP tem sido usado no tratamento do olho seco sintomático, úlceras corneanas, queimaduras oculares dentre outras aplicações, sendo uma alternativa eficaz em diversas patologias oculares; portanto, é evidente a importância de mais estudos nesse tema, para comprovar a efetividade do produto.
Abstract The aim of this review is to list the ophthalmological conditions in which platelet concentrate (CP) has been used, as well as its biochemical and physiological properties. The CP has both anticatabolic potential, present in autologous serum, and substances with anabolic properties, which together are responsible for its benefits in the treatment of ocular surface diseases. There is currently a shortage of clinical trials in this area, both in ophthalmology and other medical areas, with more studies and reports on the use of autologous serum. In ophthalmology, CP has been used in the treatment of symptomatic dry eye, corneal ulcers and ocular burns, among other applications, being an effective alternative in several ocular pathologies; therefore, it's evident the importance of more studies in this topic to prove the efficiency of this product.
Assuntos
Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Síndromes do Olho Seco/tratamento farmacológico , Úlcera da Córnea/tratamento farmacológico , Plasma Rico em Plaquetas , Oftalmopatias/tratamento farmacológico , Lubrificantes Oftálmicos/uso terapêuticoRESUMO
Abstract: INTRODUCTION: Transforming growth factor beta 1 (TGFB1) and platelet-derived growth factor (PDGF) are the main cytokines related to hepatic fibrogenesis. METHODS: RNA isolated from the platelets and hepatic tissue of 43 HCV carriers was used for quantitative polymerase chain reaction to determine TGFB1, PDGFA, and PDGFB RNA expression. RESULTS: The mRNA expression of PDGFA in platelets was significantly lower in the group with advanced fibrosis than in the group with early-stage fibrosis. TGFB1 was more frequently expressed in platelets than in hepatic tissue, which was different from PDGFB. CONCLUSIONS: A pathway mediated by overexpression of TGFB1 via PDGFA in megakaryocytes could be involved in the development of fibrosis.
Assuntos
Humanos , Masculino , Feminino , Adulto , Fator de Crescimento Derivado de Plaquetas/análise , Hepatite C Crônica/sangue , Proteínas Proto-Oncogênicas c-sis/sangue , Fator de Crescimento Transformador beta1/sangue , Cirrose Hepática/sangue , Índice de Gravidade de Doença , Plaquetas/química , RNA Mensageiro/análise , Reação em Cadeia da Polimerase , Hepatite C Crônica/complicações , Cirrose Hepática/virologia , Pessoa de Meia-IdadeRESUMO
Objective: to compare the platelet concentration obtained after application of the protocol of plasma rich in growth factors - universal 1 (PRGF-U1) and the protocol of Anitua and Andia (PRP-A) for obtaining platelet rich plasma. Material and Method: A descriptive, cross-sectional and comparative study was carried out with a simple random probabilistic sample consisting of 16 patients who attended the Periodontics service of the Unit of Second Specialization in Stomatology of the National University of Trujillo. Five blood samples were obtained from each patient, after applying a health questionnaire to rule out any disease or drug consumption, in order to obtain the baseline platelet concentration and that obtained after PRGF-U1 and PRP-A. To compare the platelet concentrations of the two protocols, Students t-test was used considering a significance level of p<0.05. RESULTS: The baseline platelet concentration was 371,250 +/- 68,203 platelets/ μL, for PRGF-U1 it was 747,875 +/- 121,645 platelets/μL and for PRP-A it was 595,000 +/- 129,202 platelets/ML. A statistically significant difference (p<0.001) was found between both protocols. Conclusion: The PRGF-U1 protocol yielded a higher platelet concentration compared to the Anitua and Andia protocol.
Assuntos
Masculino , Feminino , Humanos , Adulto , Contagem de Plaquetas , Fator de Crescimento Derivado de Plaquetas , Plasma Rico em Plaquetas , Medicina Regenerativa , Estudos Transversais , Guias como AssuntoRESUMO
O objetivo do presente estudo foi avaliar o impacto clínico e imunológico da matriz derivada de esmalte (EMD) na cicatrização periodontal, após a realização de cirurgias de recobrimento radicular. Dezesseis pacientes, com média de idade de 47,7 anos (DP=7,0), foram submetidos à cirurgia de recobrimento radicular com enxerto de tecido conjuntivo subepitelial associado ou não à matriz derivada de esmalte. O estudo seguiu o modelo de boca dividida e randomizado para os lados teste e controle. Os seguintes parâmetros clínicos foram analisados no dia da cirurgia e 6 meses após o procedimento cirúrgico: altura da recessão (AR), largura da faixa de gengiva queratinizada (LFG), largura da recessão (LR), profundidade de sondagem (PS), nível de inserção clínica (NIC) e espessura gengival (EG). Além da análise clínica, foram realizadas avaliações dos seguintes marcadores inflamatórios: IL-1ß, IL -1RA, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL12, IL-13, IL-15, IL-17, EOTAXIN, FGF, G-CSF, GM-CSF, IFN-ï§, IP-10, MCP-1, MIP 1α, PDGF-bb, MIP 1ß, RANTES, TNF-α e VEGF, no fluido gengival no dia da cirurgia e com 7 e 14 dias de pós-operatório. Análise da dor pós-operatória e a análise estética também foram realizadas. Os resultados demonstraram que o lado tratado com EMD resultou em percentual de cobertura radicular (p=0,03) significantemente maior quando comparado com o lado controle. Setenta e cinco por cento dos sítios apresentaram cobertura radicular completa no lado teste e 43,8% no controle, em 6 meses. O EMD não trouxe resultados significantes para aumento de espessura gengival e ganho de faixa de tecido queratinizado. As análises imunológicas mostraram um aumento de VEGF (p=0,03) e PDGF (p=0,03) aos 14 dias de pós-operatório com o EMD e altas expressões de mediadores inflamatórios como IL-1ß (p=0,04; p=0,03), IL-6 (p=0,05; p=0,05), TNF-α (p=0,02; p=0,02), MIP-1α (p=0,02; p=0,05) com 7 dias de pós-operatório, em ambos os grupos, teste e controle, respectivamente. Não houve diferença entre os grupos na avaliação da dor pós-operatória e foi demonstrada uma diferença significante entre a avaliação da estética final do paciente daquela realizada por um profissional calibrado e experiente. Assim sendo, concluímos que o EMD parece ter impacto clínico e imunológico, nas cirurgias de recobrimento de raízes, com percentuais significantemente maiores de cobertura radicular e completa cobertura radicular assim como aumento significantemente maior na liberação de VEGF e PDGF-bb com 14 dias de pós-operatório, sugerindo ser um importante elemento para uma melhor cicatrização.
The aim of the present study was to evaluate the clinical and immunological impact of the enamel-derived matrix (EMD) on periodontal healing, after root-covering surgeries. Sixteen patients, mean age 47.7 years (SD = 7.0), underwent root-graft surgery with graft of subepithelial connective tissue associated or not with enamel-derived matrix. The study followed the split-mouth model and randomized to the sides test and control. The following clinical parameters were analyzed on the day of surgery and 6 months after the surgical procedure: height of the recession (AR), width of keratinized tissue (LFG), width of the recession (LR), probing depth (PS), clinical attachment level (NIC) and gingival thickness (EG). In addition to the clinical analysis, the following inflammatory markers were evaluated: IL-1ß, IL-1RA, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL IL-13, IL-15, IL-17, EOTAXIN, FGF, GCSF, GMCSF, IFN-, IP-10, MCP-1, MIP-1α, PDGF-bb, MIP-1ß, RANTES, TNF-α and VEGF in the gingival crevicular fluid at baseline and at 7 and 14 postoperative days. Postoperative pain analysis and aesthetic analysis were performed. The results showed that the side treated with EMD resulted in a significantly higher percentage of root coverage (p = 0.03) when compared to the control side. Seventy-five percent of the sites had complete root coverage on the test side and 43.8% on the control side in 6 months. The EMD did not bring significant results to increase gingival thickness and gain of width keratinized tissue. Immunological analyzes showed an increase in VEGF (p = 0.03) and PDGF (p = 0.03) at 14 days postoperatively with EMD and high expression of inflammatory mediators such as IL-1ß (p = 0.04) (P = 0.05), MIP-1α (p = 0.05), TNF-α (p = 0.02, p = 0.02) 02, p = 0.05) with 7 postoperative days, in both groups, test and control, respectively. There was no difference between the groups in the evaluation of postoperative pain and a significant difference between the evaluation of the final aesthetic of the patient and the one performed by a calibrated and experienced professional was demonstrated. Thus, we concluded that EMD appears to have a clinical and immunological impact in root coverage surgeries, with significantly greater percentage of root coverage and complete root coverage, as well as a significantly higher increase in the release of VEGF and PDGF-bb with 14 days of postoperative, suggesting to be an important element for a better wound healing.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tecido Conjuntivo/transplante , Citocinas , Proteínas do Esmalte Dentário , Retração Gengival/cirurgia , Regeneração Tecidual Guiada Periodontal , Periodontia , Cicatrização , Estética Dentária , Mediadores da Inflamação , Fator de Crescimento Derivado de Plaquetas , Fator A de Crescimento do Endotélio VascularRESUMO
O objetivo deste estudo foi investigar o papel do fator de crescimento derivado de plaquetas-BB (PDGF-BB) na concentração de 300ng/ml na taxa de proliferação e adesão de células derivadas da granulação óssea humana a fragmentos radiculares periodontalmente comprometidos. Na primeira etapa do estudo, foi estabelecida cultura primária de células da granulação óssea de dois pacientes adultos, sistemicamente saudáveis, não fumantes. Após a expansão celular, as células foram caracterizadas para determinação do fenótipo por meio de ensaios de viabilidade celular, MTT, ensaio de atividade de fosfatase alcalina, ensaio de mineralização e caracterização imunohistoquímica por meio de citometria de fluxo (segunda etapa). Na terceira etapa do estudo, os efeitos da adição de PDGF-BB recombinante humano na concentração de 300ng/ml na taxa de proliferação e adesão de células derivadas da granulação óssea a superfícies radiculares periodontalmente comprometidas foram investigados. A taxa de proliferação celular estimulada pelo PDGF-BB (grupo teste) ou pelo meio de cultura (grupo controle) foi investigada por meio de contagem de células viáveis nos frascos de cultura após 1, 3, 5 e 7 dias do cultivo celular. Foram obtidos 30 fragmentos dentários a partir de dentes extraídos por razões periodontais. Os fragmentos foram raspados com curetas Gracey e condicionados com solução em gel de EDTA a 24% durante 3 minutos, lavados com solução de soro fisiológico, secos e posicionados em placas de 24 poços. Foram incubadas sobre os fragmentos tratados 1x104 células GO por 24 horas, seguido por fixação e preparo para análise por microscopia eletrônica de varredura (MEV). O número de células aderidas sobre os fragmentos foi analisado nas fotomicrografias. O padrão de crescimento das células GO foi compatível com células ósseas, com modificação do padrão do crescimento com o aumento do número de passagens. Houve atividade de fosfatase alcalina em meio osteogênico e convencional, com pico máximo aos 7 dias e atividade de mineralização estimulada ou não por meio osteogênico, com pico máximo aos 21 dias. A análise por meio de citometria de fluxo demonstrou que as células GO não expressaram CD105 e CD166 na 14a passagem, indicando sua diferenciação celular avançada nesse período. A adição de rhPDGF-BB resultou em mudança na taxa de proliferação celular, observando-se pico máximo de crescimento aos 7 dias, com diferenças estatisticamente significantes (p < 0.005; ANOVA post hoc Tukey) em relação aos períodos de 1, 3 e 5 dias. O ensaio de MTT demonstrou maior viabilidade celular no período de 48 hs, comparativamente aos períodos de 24 e 72 horas, quando a densidade óptica celular diminuiu de forma significativa (p< 0.05; Friedmann pósteste Dunn). No ensaio de adesão celular, pode-se observar que a adição de rhPDGFBB aumentou significativamente o número de células aderidas aos fragmentos dentários (p< 0.05; teste t não pareado com correção Welch), com alteração da morfologia celular. Esses resultados sugerem que as células GO tem características compatíveis com linhagem de células osteoblásticas, de fenótipo mais diferenciado após a 12a passagem. A adição de rhPDGF-BB (300ng/ml) resulta em aumento da taxa de proliferação das células GO e do número de células aderidas a fragmentos radiculares, indicando que, nesta concentração, o fator de crescimento é citocompatível, favorecendo a proliferação e adesão celular.(AU)
The goal of this study was to investigate the effects of recombinant human platelet derived growth factor (rhPDGF-BB) at the concentration of 300ng/ml in the proliferation and adhesion of human bone granulation cells to periodontally diseased root fragments. At the first stage of the study, the granulation tissue existent in healing sockets (21 days after its creation) was collected from two systemically healthy nonsmoking adults to the establishment of primary culture. The in vitro properties of bone granulation (BG) cell lineage were characterized by cell viability, MTT, alkaline phosphatase activity and mineralization assays. The effects of culture medium (control) and rhPGDF-BB 300ng/ml (test) in the proliferation and adhesion of BG cells were investigated. The rate of BG cells proliferation was investigated by the number of viable cells present at 1, 3, 5 and 7 days after platting. Thirty root fragments were obtained from teeth extracted for periodontal reasons. Root fragments were scaled and root planed, conditioned with EDTA 24% for 3 minutes, rinsed in saline solution, air-dryed and positioned in 24-well plates. Each fragment was seeded with 104 BG cells, fixated after 24 hours and prepared for analysis in SEM. The number of cells adhered to the fragments was analysed in photomicrographies. BG cells growth pattern was compatible with osteogenic cell lineage, showing modification with the increasing number of cell passage. GO cells expressed alkaline phosphatase activity in conventional and osteogenic culture medium, with maximum peak at 7 days, as well as mineralization activity stimulated or not by osteogenic or non-osteogenic culture medium, with maximum peak at 21 days. The analysis by flow cytometer showed that BG cells have not expressed CD105 and CD106 at the 14th passage, indicating its advanced cell differentiation. The addition of rhPDGF-BB resulted in modification of proliferation rate, with maximum peak observed at 7 days, significantly different from 1-, 3- and 5-day periods (p< 0.005; ANOVA post hoc Tukey). MTT assay showed greater cell viability after 48 hours than after 24 and 72 hours, when optical density has significantly diminished (p< 0.05; Friedmann post hoc Dunn). At cell adhesion assay, it could be observed that the adhesion of rhPDGF-BB has significantly increased the number of cells adhered to root fragments (p< 0.05; unpaired t test with Welchs correction), and alterations in cell morphology. These results suggest that BG cells present in vitro characteristics compatible with osteoblastic cell lineages, with a more differentiated phenotype after the 12th passage. The addition of rhPDGF-BB (300 ng/ml) results in increase of the rate of BG cell proliferation and in the number of cells adhered to root fragments, indicating that, at this concentration, the growth factor is compatible with BG cells and favors cells proliferation and adhesion.(AU)
Assuntos
Humanos , Masculino , Feminino , Adesão Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Tecido de Granulação/citologia , Fator de Crescimento Derivado de Plaquetas/farmacologia , Raiz Dentária/citologia , Alvéolo Dental/citologia , Análise de Variância , Regeneração Óssea/efeitos dos fármacos , Contagem de Células , Células Cultivadas , Citometria de Fluxo , Imuno-Histoquímica , Microscopia Eletrônica de Varredura , Reprodutibilidade dos Testes , Estatísticas não ParamétricasRESUMO
BACKGROUND: Airway remodeling is a key feature of asthma, characterized by increased proliferation of airway smooth muscle cells (ASMCs). S100A8 is a calcium-binding protein with a potential to regulate cell proliferation. Here, the effect of exogenous S100A8 protein on the proliferation of ASMCs induced by platelet-derived growth factor (PDGF) and the underlying molecular mechanism was investigated. METHODS: Rat ASMCs were cultured with or without a neutralizing antibody to the receptor for advanced glycation end-products (RAGE), a potential receptor for S100A8 protein. Purified recombinant rat S100A8 protein was then added into the cultured cells, and the proliferation of ASMCs induced by PDGF was detected by colorimetric-based WST-8 assay and ampedance-based xCELLigence proliferation assay. The expression levels of RAGE in ASMCs were analyzed using western blotting assay. RESULTS: Results showed that exogenous S100A8 inhibited the PDGF-induced proliferation of rat ASMCs in a dose- dependent manner with the maximal effect at 1 µg/ml in vitro. Furthermore, when ASMCs was pre-treated with anti-RAGE neutralizing antibody, the inhibitory effect of S100A8 on PDGF-induced proliferation was significantly suppressed. In addition, neither the treatment with S100A8 or PDGF alone nor the pre-treatment with rS100A8 followed by PDGF stimulation affected the expression levels of RAGE. CONCLUSIONS: Our study demonstrated that S100A8 inhibits PDGF-induced ASMCs proliferation in a manner dependent on membrane receptor RAGE.
Assuntos
Animais , Ratos , Fator de Crescimento Derivado de Plaquetas/agonistas , Miócitos de Músculo Liso/efeitos dos fármacos , Calgranulina A/administração & dosagem , Proliferação de Células/efeitos dos fármacos , Receptor para Produtos Finais de Glicação Avançada/efeitos dos fármacos , Células CultivadasRESUMO
Stem cells from human exfoliated deciduous teeth (SHEDs) have great potential to treat various dental-related diseases in regenerative medicine. They are usually maintained with 10% fetal bovine serum (FBS) in vitro. Modified platelet-rich plasma (mPRP) would be a safe alternative to 10% FBS during SHEDs culture. Therefore, our study aimed to compare the proliferation and differentiation of SHEDs cultured in mPRP and FBS medium to explore an optimal concentration of mPRP for SHEDs maintenance. Platelets were harvested by automatic blood cell analyzer and activated by repeated liquid nitrogen freezing and thawing. The platelet-related cytokines were examined and analyzed by ELISA. SHEDs were extracted and cultured with different concentrations of mPRP or 10% FBS medium. Alkaline phosphatase (ALP) activity was measured. Mineralization factors, RUNX2 and OCN, were measured by real-time PCR. SHEDs were characterized with mesenchymal stem cells (MSCs) markers including vimentin, CD44, and CD105. mPRP at different concentrations (2, 5, 10, and 20%) enhanced the growth of SHEDs. Moreover, mPRP significantly stimulated ALP activity and promoted expression of RUNX2 and OCN compared with 10% FBS. mPRP could efficiently facilitate proliferation and differentiation of SHEDs, and 2% mPRP would be an optimal substitute for 10% FBS during SHEDs expansion and differentiation in clinical scale manufacturing.
Assuntos
Humanos , Animais , Bovinos , Proliferação de Células/fisiologia , Polpa Dentária/citologia , Células-Tronco Mesenquimais/citologia , Plasma Rico em Plaquetas , Dente Decíduo/citologia , Fosfatase Alcalina/antagonistas & inibidores , Análise de Variância , Técnicas de Cultura de Células/métodos , Diferenciação Celular/fisiologia , Células Cultivadas , Subunidade alfa 1 de Fator de Ligação ao Core/análise , Meios de Cultura , Ensaio de Imunoadsorção Enzimática , Fator de Crescimento Derivado de Plaquetas/análise , Reação em Cadeia da Polimerase em Tempo Real , Reprodutibilidade dos Testes , Fatores de Tempo , Fator de Crescimento Transformador beta1/análiseRESUMO
La utilización de las plaquetas con fines terapéuticos ha cobrado gran interés en los últimos años por las grandes propiedades que presentan como reparadoras de tejidos. Además de su papel en la coagulación y la hemostasia, las plaquetas contienen gránulos alfa con varias moléculas (factores de crecimiento) que son secretadas tras su activación. Se realizó una revisión bibliográfica, donde se exponen las principales propiedades y funciones de las plaquetas que le confieren propiedades terapéuticas en diferentes lesiones del sistema osteomioarticular. Se presentan además sus componentes y funciones. Se llega a conclusiones destacando la utilidad de las plaquetas con fines terapéuticos en pacientes con afecciones ortopédicas.
The use of platelets for therapeutic purposes has gained great interest in recent years by their large properties as tissue repair. Besides its role in clotting and hemostasis, platelet alpha granules contain several molecules (growth factors) that are secreted upon activation. A literature review was performed to present the main features and functions of platelets that give them therapeutic properties in different injuries of the osteomioarticular system. Its components and functions are also presented here. Platelets usefulness for therapeutic purposes in patients with orthopedic conditions is highlighted.
Assuntos
Humanos , Coagulação Sanguínea , Doenças Ósseas/terapia , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Bases de Dados Bibliográficas/estatística & dados numéricos , Doenças Musculares/terapiaRESUMO
Abnormal high mobility group protein B1 (HMGB1) activation is involved in the pathogenesis of pulmonary fibrosis. Pulmonary rehabilitation mixture (PRM), which combines extracts from eight traditional Chinese medicines, has very good lung protection in clinical use. However, it is not known if PRM has anti-fibrotic activity. In this study, we investigated the effects of PRM on transforming growth factor-β1 (TGF-β1)-mediated and bleomycin (BLM)-induced pulmonary fibrosis in vitro and in vivo. The effects of PRM on TGF-β1-mediated epithelial-mesenchymal transition (EMT) in A549 cells, on the proliferation of human lung fibroblasts (HLF-1) in vitro, and on BLM-induced pulmonary fibrosis in vivo were investigated. PRM treatment resulted in a reduction of EMT in A549 cells that was associated with attenuating an increase of vimentin and a decrease of E-cadherin. PRM inhibited the proliferation of HLF-1 at an IC50 of 0.51 µg/mL. PRM ameliorated BLM-induced pulmonary fibrosis in rats, with reduction of histopathological scores and collagen deposition, and a decrease in α-smooth muscle actin (α-SMA) and HMGB1 expression. An increase in receptor for advanced glycation end-product (RAGE) expression was found in BLM-instilled lungs. PRM significantly decreased EMT and prevented pulmonary fibrosis through decreasing HMGB1 and regulating RAGE in vitro and in vivo. PRM inhibited TGF-β1-induced EMT via decreased HMGB1 and vimentin and increased RAGE and E-cadherin levels. In summary, PRM prevented experimental pulmonary fibrosis by modulating the HMGB1/RAGE pathway.
Assuntos
Animais , Humanos , Masculino , Medicamentos de Ervas Chinesas/farmacologia , Fibrose Pulmonar/tratamento farmacológico , Fibrose Pulmonar/prevenção & controle , Antibióticos Antineoplásicos , Receptor para Produtos Finais de Glicação Avançada/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Bleomicina , Western Blotting , Células Cultivadas , Colágeno/efeitos dos fármacos , Misturas Complexas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Transição Epitelial-Mesenquimal/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Proteína HMGB1/efeitos dos fármacos , Hidroxiprolina/análise , Imuno-Histoquímica , Pulmão/efeitos dos fármacos , Pulmão/patologia , Fator de Crescimento Derivado de Plaquetas/efeitos dos fármacos , Fibrose Pulmonar/patologia , Distribuição Aleatória , Ratos Sprague-Dawley , Reprodutibilidade dos Testes , Fator de Crescimento Transformador beta1/efeitos dos fármacosRESUMO
Objetivos Defeitos ósseos extensos em região maxilo-facial podem ser corrigidos com enxerto autógeno, no entanto as desvantagens desta modalidade terapêutica levam à pesquisa por novos substitutos ósseos. Com isso, avaliamos o comportamento biológico e osteoindutivo do PDGF-BB associado a diferentes carreadores, por meio de análise histológica, histométrica e imunoistoquímica em defeitos críticos realizados em calotas cranianas de ratos. Materiais e método 96 defeitos críticos de 5 mm de diâmetro foram criados em calotas cranianas de ratos. Cada defeito foi aleatoriamente dividido em 8 grupos experimentais (AUT, COA, TCP, TCP+PDGF, END, END+PDGF, BIO, BIO+PDGF), avaliados aos 15 e 30 dias pós-operatórios com relação a histomorfometria e imunoistoquímica. Resultados Os resultados mostraram que houve neoformação óssea em todos os grupos analisados, independentemente do tempo pós-operatório. Aos 30 dias, o grupo TCP só não diferiu do grupo BIO na neoformação óssea (p = 0,1403). Em nenhum dos grupos de biomateriais analisados, o fator de crescimento estimulou o aumento da neoformação óssea (p > 0,05). Conclusão Com a metodologia utilizada, o fator de crescimento associado com os biomateriais testados não induziu neoformação óssea. Relevância clínica Baseado nestes resultados, é necessário desvendar os mecanismos osteoblásticos nas fases iniciais da cicatrização óssea e o seu desfecho em longo prazo, para que a concentração adequada do PDGF-BB possa ser bem empregada com o arcabouço ósseo que mais o favorece para as reconstruções maxilofaciais.
Objectives Extensive bone defects in maxillofacial region can be corrected with autograft, however the disadvantages of this type of therapy lead to the search for new bone substitutes. Thus, we evaluated the biological behavior and osteoinductive PDGF-BB associated with different carriers, by histological analysis and immunohistochemical histometric critical defects performed in rats calvaria. Materials and method 96 critical defects were created with 5 mm diameter calvaria of rats. Each defect was randomly divided into eight experimental groups (AUT, COA, TCP, TCP + PDGF, END, END + PDGF, BIO, BIO + PDGF), evaluated at 15 and 30 postoperative days for histomorphometry and immunohistochemistry. Results The results showed new bone formation in all groups, independent of postoperative time. At 30 days, the TCP group just did not differ from BIO group in the new bone formation (p = 0.1403). In none of the groups analyzed biomaterials, growth factor stimulated increase in bone formation (p > 0.05). Conclusion With the methodology used, the growth factor associated with the tested biomaterials did not induce new bone formation. Clinical relevance Based on these results, it is necessary to unravel the osteoblastic mechanisms in the early stages of bone healing and their outcome in the long term, so that the appropriate concentration of PDGF-BB may be well employed with the bone structure that most favors for maxillofacial reconstructions.
Assuntos
Animais , Ratos , Materiais Biocompatíveis , Regeneração Óssea , Implantes Dentários , Fator de Crescimento Derivado de Plaquetas , Ratos WistarRESUMO
Se analiza el significado del concepto de “obsesión” en el alienismo del siglo XIX. Desde el punto de vista clínico, la descripción de Esquirol fue completada por otros autores (Jules Falret, Legrand du Saulle). En el ámbito de la reflexión psicopatológica, el alienismo francés, con el delirio emotivo de Morel o la psicastenia de Janet, defendió la teoría emocional, frente al trastorno intelectual propuesto por los médicos alemanes. Finalmente, se insiste en la importancia del marco cultural en la aparición de los síntomas obsesivos y de su interpretación. En este sentido, se estudian las relaciones de los escrúpulos religiosos con la melancolía o la aparición de categorías diagnósticas sometidas a los códigos y mentalidades fin-de-siècle.
The article analyses the significance of the concept of “obsession” in nineteenth-century alienism. From a clinical point of view, Esquirol’s description was completed by other authors (Jules Falret, Legrand du Saulle). In the area of psychopathological studies, French alienism, with Morel’s emotional delirium or Janet’s psychasthenia, defended the emotional theory, as opposed to the intellectual disorder proposed by German doctors. Lastly, the importance of the cultural framework is stressed in the appearance of obsessive symptoms and their interpretation. Along these lines, the article discusses the relationship of religious scruples to melancholy or the appearance of diagnostic categories subject to fin de siècle codes and mentalities.