[Evaluation of plasmatic A protein as only marker during first trimester of pregnancy]. / Evaluación de la proteína A plasmática asociada al embarazo como marcador único durante el primer trimestre.

BACKGROUND: One of main targets of prenatal diagnosis is Down's syndrome. Biochemical and sonographic markers together are efficient. The use of a single marker has not shown the same efficiency, although it has not been sufficient evaluated. OBJECTIVE: To shown results of PAPP-A as a single marker in first pregnancy trimester. MATERIALS AND METHODS: Prospective, cross-sectional and random study, which evaluated 400 women with biochemical marker PAPP-A in the first pregnancy trimester. RESULTS: PAPP-A detected a true positive case (0.3%), 28 false positive cases (7.0%) and 371 true negative cases (92.8%), there were no false negative cases. Between 9 to 11 weeks, rate of false positives fluctuated between 5.5 and 6.7%, in 12th week it was 1.2% and in 13th week 18.2%. PAPP-A has 95.1% of specificity (weeks 9 to 12) and 82.2% of maternal age. DISCUSSION: A 5% of false positive rate is acceptable for prenatal diagnosis markers. It has been reported that PAPP-A is less discriminatory at 10 weeks of gestation. In this study the rate fluctuated between 6 and 7% (weeks 9 to 11), which increased at 13th week. Markers with low false positive rate stimulate the use of prenatal screening. CONCLUSIONS: The use of combined markers: biochemical (free fraction of beta-hGC, PAPP-A) and sonographic, are most recommendable in the first trimester of the pregnancy because of them low rate of false positives. PAPP-A can be used as a single marker between 9 to 11 weeks; false positive cases must be studied with combined markers.

Sodium arsenite retards proliferation of PHA-activated T cells by delaying the production and secretion of IL-2.

Arsenic is a metalloid that commonly contaminates drinking water, and is a known human carcinogen. It has been shown that peripheral blood mononuclear cells (PBMCs) from healthy donors treated in vitro with NaAsO(2) and stimulated with phytohemagglutinin (PHA) show a lower proliferation than nontreated cells. We reported previously a reduction in the secretion of IL-2 in NaAsO(2)-treated PBMCs stimulated with PHA, an observation that might explain, in part, the reduction in proliferation. Since arsenic induces cytoskeleton alterations, which in turn may affect protein transport of the cell, we assumed that NaAsO(2) induced an accumulation of IL-2 inside the cells, and thus a reduction in the secretion of IL-2. In order to demonstrate this hypothesis, we assessed the intracellular IL-2 at the single cell level by flow cytometry, and unexpectedly found a reduction in the percentage of IL-2 producing T cells in the presence of NaAsO(2). We tracked the proliferation of T cells by using the 5,6-carboxyfluorescein diacetate succinimidyl ester (CFSE) dye and found that NaAsO(2) slows down the entrance to cell division and delays the proliferation of cells that have already entered the cell cycle. Nevertheless, the expression of the activation molecules, CD25 and CD69, was unaltered. Assessment of the intracellular and secreted IL-2 in kinetic experiments showed that in fact, NaAsO(2) delays the production of IL-2, given that a recovery of both intracellular and secreted IL-2 was detected at 72 h. Evaluation of the cell cycle showed a higher proportion of cells in G(0)/G(1) and a lower proportion in G(2)/M in the presence of NaAsO(2). We thus conclude that NaAsO(2) reduces proliferation of T cells by delaying the production and secretion of IL-2, thus blocking T cells in G(1); as a consequence, the entry to cell cycle and the rounds of cell division are retarded, and a lower proliferation of T cells is hence observed.