Assuntos
Hipersensibilidade , Humanos , Hipersensibilidade/etiologia , Níquel , Aparelhos Ortodônticos , TitânioRESUMO
OBJECTIVE: ANCA (p-ANCA and x-ANCA) have been documented to occur in many inflammatory disorders. The specific ANCA antigens and the clinical correlation of a positive ANCA test in these disorders are still for the most part obscure. The aim of the present study was to investigate the prevalence of and the target antigens for ANCA in patients with IBD. METHODS: 104 patients (67 age between 3-18 years, mean age 8+/-3 and 37 age between 25-70 years, mean age 48+/-15) clinically and hystopathologically diagnosed as: 67 ulcerative colitis, 16 Crohn' disease, 21 other colitis (7 indeterminate colitis) were enrolled in our study. ANCA were determined by ELISA and IIF methods. RESULTS: We observed a good performance in terms of sensibility and specificity of ANCA, and a good correlation between the two methods used; as regard ELISA determination the antigen frequently found in our cases was lactoferrin (60%). CONCLUSIONS: Is still unclear the role of these "minor antigens" in the diagnosis and pathogenesis of IBD, but is clear that only morphologic evaluation is no more sufficient.
Assuntos
Anticorpos Anticitoplasma de Neutrófilos/sangue , Doenças Inflamatórias Intestinais/sangue , Isoantígenos/sangue , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Epitopos , Granulócitos , Humanos , Doenças Inflamatórias Intestinais/imunologia , Pessoa de Meia-IdadeRESUMO
AIM: Nowadays the diagnosis of inflammatory bowel disease (IBD) and the differentiation between Crohn disease (CD) and ulcerative colitis (UC) is still based on morphological changes identified at endoscopy, radiology, and histopathology. In 5-15% of cases this differentiation is not possible (diagnosed with indeterminate colitis). METHODS: We evaluated if recently developed commercial kits for the determination of anti-Saccharomyces Cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) are useful in differentiating cases of UC from CD diseases with a consequent reduced number of undefined colitis and improved clinical management. Sera from 56 consecutive patients with a clinical diagnoses of IBD were evaluated in a blinded fashion for the presence of ASCA IgA and IgG and ANCA IgG with 2 different diagnostic methods: indirect immunofluorescence (IIF) and enzyme-linked immunosorbent assay (ELISA). RESULTS: In our cases we observed good agreement between histopathological examination and laboratory results and the combined use of ASCA and ANCA yielded a correct diagnosis in 93% of patients with CD and in 97% of the UC patients. CONCLUSIONS: We confirm the value of the test for the diagnosis of CD and UC and the differentiation from other forms of colitis.
Assuntos
Anticorpos Anticitoplasma de Neutrófilos/sangue , Anticorpos Antifúngicos/sangue , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/imunologia , Saccharomyces cerevisiae/imunologia , Adulto , Idoso , Diagnóstico Diferencial , Ensaio de Imunoadsorção Enzimática , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Doenças Inflamatórias Intestinais/patologia , Masculino , Pessoa de Meia-IdadeAssuntos
Antraquinonas/administração & dosagem , Anticorpos Antifúngicos/análise , Catárticos/administração & dosagem , Doenças Inflamatórias Intestinais/imunologia , Saccharomyces cerevisiae/imunologia , Antraquinonas/imunologia , Formação de Anticorpos , Biomarcadores/análise , Reações Falso-Positivas , HumanosRESUMO
Glomerulonephritis occurring in association with alpha(1)-antitrypsin deficiency has been sporadically reported in the literature but it is assumed to be a rare and poorly investigated disease. The complete pathologic pattern of glomerular lesions has not yet been established. The aim of our work was to investigate the correlation between the extent of antiprotease deficiency and the expression of nephropathy evaluated in two groups of patients (47 heterozygotic subjects with the PiMZ phenotype and 12 homozygotic subjects with the PiZZ phenotype) by a noninvasive approach with urinalyses and proteinuria measurement. No statistical differences between proteinuria in the two groups were observed suggesting that nephropathy is not a direct and single expression of the protein deficiency.
Assuntos
Glomerulonefrite/etiologia , Deficiência de alfa 1-Antitripsina , Glomerulonefrite/genética , Glomerulonefrite/metabolismo , Hematúria , Humanos , Fenótipo , Proteinúria , Deficiência de alfa 1-Antitripsina/genéticaRESUMO
Despite relevant progress, the impact of chemotherapy on advanced gastric cancer patients' survival is still unsatisfactory. Thus, the key objective of our efforts should be palliation of the symptoms and the maintenance of an adequate quality of life. In this phase-II study, we evaluated toxicity and efficacy of the combination of cisplatin, fluorofolates and mitomycin C. Thirty-one advanced gastric cancer patients received cisplatin (15 mg/m2) and 5-fluorouracil (350 mg/m2), both for 5 consecutive days every 4 weeks; 5-fluorouracil infusion was preceded by a rapid i.v. injection of 100 mg/m2 leucovorin, while mitomycin-C (10 mg/m2) was administered on day 1 of odd cycles. Cycles were repeated every 4 weeks until disease progression. We recorded 16 objective responses (51.6%, 95% confidence interval: 42.63-60.57); furthermore, such a response rate was coupled with a moderate degree of toxicity and an extremely good tolerance. In particular, alopecia, a frequent and distressing side-effect in patients, especially women, in our series occurred only in two patients. This treatment appears to be an active and tolerable therapeutic option for patients with advanced gastric carcinoma.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/tratamento farmacológico , Terapia de Salvação , Neoplasias Gástricas/tratamento farmacológico , Adulto , Idoso , Alopecia/induzido quimicamente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma/mortalidade , Carcinoma/patologia , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Esquema de Medicação , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Doenças Hematológicas/induzido quimicamente , Humanos , Nefropatias/induzido quimicamente , Leucovorina/administração & dosagem , Leucovorina/efeitos adversos , Tábuas de Vida , Masculino , Pessoa de Meia-Idade , Mitomicina/administração & dosagem , Mitomicina/efeitos adversos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Análise de Sobrevida , Resultado do TratamentoRESUMO
BACKGROUND: Airways inflammation is a feature of chronic obstructive pulmonary disease (COPD), but the role of corticosteroids in the management of clinically stable patients has yet to be established. A randomised controlled study was carried out to investigate the effect of high dose inhaled beclomethasone dipropionate (BDP) administered for two months to patients with stable, smoking related COPD. Sputum induction was used to evaluate bronchial inflammation response. METHODS: 34 patients (20 men and 14 women) were examined on three separate occasions. At the initial clinical assessment (visit 0), spirometry and blood gas analysis were performed. On visit 1 (within one week of visit 0) sputum induction was performed and each patient was randomised to receive either BDP 500 micrograms three times daily (treated group) or nothing (control group). After two months (visit 2), all patients underwent repeat clinical assessment, spirometry, and sputum induction. RESULTS: There were no differences in sputum cell counts between the groups at baseline. After two months of treatment, induced sputum samples from patients in the treated group showed a reduction in both neutrophils (-27%) and total cells (-42%) with respect to baseline, while the control group did not (neutrophils +9%, total cells +7%). Macrophages increased in the treated group but not in the control group. The mean final value of sputum neutrophils was 52% in the treated group and 73.3% in the control group (95% confidence interval (CI) -27.2 to -15.4). The mean final value of sputum macrophages was 35.8% in treated group and 19.3% in control group (95% CI 10.3 to 22.8). The differences between the treated and control groups for neutrophils (-21.3%), macrophages (+16.5%), and total cells (-65%) were significant. Spirometry and blood gas data did not change from baseline in either patient group. CONCLUSIONS: A two month course of treatment with high dose inhaled BDP reduces significantly neutrophil cell counts in patients with clinically stable, smoking related COPD. Further studies on the effectiveness of inhaled steroids in COPD are needed to confirm the clinical importance of this observation.
Assuntos
Beclometasona/administração & dosagem , Glucocorticoides/administração & dosagem , Contagem de Leucócitos/efeitos dos fármacos , Pneumopatias Obstrutivas/tratamento farmacológico , Escarro/imunologia , Administração por Inalação , Idoso , Beclometasona/uso terapêutico , Contagem de Células , Método Duplo-Cego , Esquema de Medicação , Feminino , Glucocorticoides/uso terapêutico , Humanos , Pneumopatias Obstrutivas/imunologia , Pneumopatias Obstrutivas/patologia , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Espirometria , Escarro/citologia , Estatísticas não ParamétricasRESUMO
BACKGROUND: Up to date, the etiology and the pathogenesis of HES are still unknown and particularly it is unclear why eosinophils in HES are more aggressive towards tissues than in other eosinophilic conditions. METHODS: We assessed the cationic proteins ECP and EPX serum concentrations, their in vitro release from polymorphonuclear cell culture, and the monoclonal antibodies EG1 and EG2 in 3 patients with HES, 6 patients with other hypereosinophilic conditions and 20 healthy control subjects. RESULTS: Serum ECP and EPX concentrations were higher in eosinophilic patients than in healthy subjects. Hypereosinophilic patients had more EG2+ cells than healthy subjects, but EG2+ rate failed to differentiate HES from other hypereosinophilic conditions (p = 0.074). Moreover, the release in vitro of ECP and EPX was significantly higher in HES patients (p < 0.05). CONCLUSIONS: Our preliminary results seem to suggest the importance of functional data, such as ECP and EPX release, in differentiating HES from other hypereosinophilic diseases. Particularly, ECP and EPX release in vitro is higher in cell cultures from HES patients than from patients with other hypereosinophilic conditions.