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OBJECTIVE: Studies suggest rheumatoid arthritis (RA) patients could benefit from periodontal treatment. However, published data are inconsistent, and there is a need for better-controlled research. Our study aims to address these limitations. METHODS: In this exploratory randomised delayed-start study, 22 RA patients with moderate/severe periodontitis were subjected to full-mouth debridement. Periodontal and rheumatological assessments, including measuring anti-cyclic citrullinated peptide 2 (CCP2) IgG levels, were performed at baseline (V1), 2 months (V2) and 6 months (V3) after step 1 and 2 of periodontal therapy. Primary outcome was changes in disease activity score for 28 joints (DAS28) between V2 and V1. Secondary outcomes were changes in other rheumatological or periodontal clinical parameters (V2 or V3-V1). RESULTS: RA disease activity was significantly higher in RA patients with severe periodontitis compared to moderate periodontitis at baseline, with significant positive correlations between several rheumatological and periodontal parameters. After periodontal treatment, RA patients with severe, but not moderate, periodontitis demonstrated significant improvements in DAS28 (ΔV2-V1, p = 0.042; ΔV3-V1, p = 0.001) and significant reduction in anti-CCP2 IgG levels at V3 (p = 0.032). CONCLUSION: Periodontal treatment is locally effective in patients with RA and impacts RA disease activity and anti-CCP2 antibody levels in patients with severe periodontitis. Hence, our data suggest that periodontal assessment and treatment should be integrated in the management of RA patients within a treat-to-target strategy. CLINICAL TRIAL REGISTRATION: www.isrctn.com, ISRCTN 17950307.
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In this work, we propose a comprehensive experimental study of the diffusion of nickel ions in combination with different cyclodextrins as carrier molecules for enhanced solubility and facilitated transport. For this, ternary mutual diffusion coefficients measured by Taylor dispersion method are reported for aqueous solutions containing nickel salts and different cyclodextrins (that is, α-CD, ß-CD, and γ-CD) at 298.15 K. A combination of Taylor dispersion and other methods, such as UV-vis spectroscopy, will be used to obtain complementary information on these systems. The determination of the physicochemical properties of these salts with CDs in aqueous solution provides information that allows us to understand solute-solvent interactions, and gives a significant contribution to understanding the mechanisms underlying diffusional transport in aqueous solutions, and, consequently, to mitigating the potential toxicity associated with these metal ions. For example, using mutual diffusion data, it is possible to estimate the number of moles of each ion transported per mole of the cyclodextrin driven by its own concentration gradient.
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Ciclodextrinas , Níquel , Níquel/química , Ciclodextrinas/química , Difusão , Solubilidade , Íons/químicaRESUMO
OBJECTIVE: To gauge the evidence of periodontal therapy's impact on measures of disease activity and systemic inflammatory burden in individuals with rheumatoid arthritis (RA). METHODS: A search for randomized trials and controlled cohort studies of RA patients with periodontitis was conducted on April 7, 2019, with an update on December 17, 2020 in PubMed, Cochrane Library (CENTRAL), Embase, ClinicalTrials.gov, and the World Health Organization International Clinical Trial Registry Platform portal. Two reviewers screened titles and abstracts and selected papers for full-text review. We used Outcome Measures in Rheumatology (OMERACT)-endorsed outcome domains for RA trials and summarized continuous outcomes using standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). We evaluated inconsistency using the I2 statistic and combined SMDs using random-effects models for the meta-analyses; fixed-effect meta-analyses were used for sensitivity analysis. To explore heterogeneity, we added stratified/meta-regression analyses, expressed in T2 . RESULTS: Of the 1,909 studies identified, 9 (including 10 comparisons) were eligible for quantitative synthesis (n = 388). Evidence suggested a favorable effect of periodontal treatment on disease activity (SMD -0.88 [95% CI -1.38, -0.38]; n = 311). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to judge the estimates' certainty; evidence rated as having low or very low certainty indicated that any possible effect of periodontal treatment in RA is likely to change as more evidence is provided. Selection bias and RA medication stability were highlighted as sources of heterogeneity between studies. CONCLUSION: There is an urgent need for a well-designed prospective cohort study (preferably a randomized controlled trial) of patients with RA and periodontitis using rigorous protocols, standardized diagnostic criteria, data collection, and adequate duration of follow-up.
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Artrite Reumatoide , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/terapia , Humanos , Estudos ProspectivosRESUMO
AIM: We determined the role played by O-linked N-acetylglucosamine (O-GlcNAc) of proteins in systemic arteries during late pregnancy in normotensive and hypertensive rats. MAIN METHODS: O-GlcNAc levels and O-GlcNAc modification of endothelial nitric oxide synthase (eNOS) were determined in aorta (conductance vessel) and mesenteric arteries (resistance vessels) of non-pregnant (NP) and pregnant (P) Wistar rats and spontaneously hypertensive rats (SHR). Vascular O-GlcNAc-modified proteins, O-GlcNAcase (OGA) and O-GlcNAc transferase (OGT) expression, and OGA activity were analyzed. Concentration-response to phenylephrine (PE) curves were constructed for arteries with and without endothelium. Arteries were treated with vehicle or PugNAc (OGA inhibitor, 100 µmol/L) in the presence of L-NAME (NOS inhibitor, 100 µmol/L). KEY FINDINGS: The content of vascular O-GlcNAc-modified proteins was lower, OGT and OGA expression did not change, and OGA activity was higher in arteries of P-Wistar rats and P-SHR compared to arteries of NP-groups. Reactivity to PE increased in arteries of P-Wistar rats treated with PugNAc compared to vehicle. O-GlcNAcylation of eNOS decreased in P-SHR compared to NP-SHR. PugNAc partially inhibited the effects of endothelium removal and L-NAME on reactivity to PE in arteries of P-Wistar rats. However, PugNAc did not alter reactivity to PE in arteries of P-SHR. Our data showed that pregnancy decreased the content of vascular O-GlcNAc-modified proteins. SIGNIFICANCE: Increased OGA activity and decreased O-GlcNAc modification of eNOS boosts eNOS activity in arteries of P-Wistar rats. In P-SHR, altered OGA activity may lower the content of O-GlcNAc-modified proteins, but decreased OGT activity seems a potential mechanism to reduce glycosylation.
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Acetilglucosamina/química , Aorta Torácica/fisiopatologia , Hipertensão/fisiopatologia , Artérias Mesentéricas/fisiopatologia , Processamento de Proteína Pós-Traducional , beta-N-Acetil-Hexosaminidases/metabolismo , Animais , Aorta Torácica/enzimologia , Feminino , Glicosilação , Hipertensão/enzimologia , Artérias Mesentéricas/enzimologia , N-Acetilglucosaminiltransferases , Gravidez , Ratos , Ratos Endogâmicos SHR , Ratos Wistar , beta-N-Acetil-Hexosaminidases/químicaRESUMO
OBJECTIVES: To compare reproductive outcomes using two different soft catheters i.e. Set TDT® and Cook® Sydney IVF. The primary outcome was defined as a positive ß-human chorionic gonadotropin (ß-hCG) test. METHODS: Our prospective study recruited 68 patients undergoing in vitro fertilization cycles in a private fertility clinic in Porto Alegre, Brazil, between January 2014 and April 2016. They were divided into two groups according to the catheter that would be used for the embryo transfer, and the groups were matched by age. The total number of patients in each group was: 34 for the TDT and 34 for the Cook Sydney. All the patients were submitted to a ß-hCG test 12 days after the embryo transfer for pregnancy outcome evaluation. RESULTS: Ten out of 34 patients from the TDT group had a positive outcome for pregnancy, corresponding to 29.4%. The Cook Sydney group had 9 patients out of 34 with positive outcomes, corresponding to 26.5%. Comparing the efficacy of both catheters for the primary outcome, there was no significant difference (p>0.05) between the TDT and the Cook Sydney catheters. CONCLUSION: The TDT and the Cook Sydney catheters efficacies were similar for embryo transfer during assisted reproductive technology cycles.
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Catéteres , Transferência Embrionária/métodos , Transferência Embrionária/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Adulto , Brasil , Transferência Embrionária/instrumentação , Feminino , Humanos , Gravidez , Estudos ProspectivosRESUMO
AIP56 (apoptosis-inducing protein of 56 kDa) is a metalloprotease AB toxin secreted by Photobacterium damselae subsp. piscicida that acts by cleaving NF-κB. During infection, AIP56 spreads systemically and depletes phagocytes by postapoptotic secondary necrosis, impairing the host phagocytic defense and contributing to the genesis of infection-associated necrotic lesions. Here we show that mouse bone marrow-derived macrophages (mBMDM) intoxicated by AIP56 undergo NF-κB p65 depletion and apoptosis. Similarly to what was reported for sea bass phagocytes, intoxication of mBMDM involves interaction of AIP56 C-terminal region with cell surface components, suggesting the existence of a conserved receptor. Biochemical approaches and confocal microscopy revealed that AIP56 undergoes clathrin-dependent endocytosis, reaches early endosomes, and follows the recycling pathway. Translocation of AIP56 into the cytosol requires endosome acidification, and an acidic pulse triggers translocation of cell surface-bound AIP56 into the cytosol. Accordingly, at acidic pH, AIP56 becomes more hydrophobic, interacting with artificial lipid bilayer membranes. Altogether, these data indicate that AIP56 is a short-trip toxin that reaches the cytosol using an acidic-pH-dependent mechanism, probably from early endosomes. Usually, for short-trip AB toxins, a minor pool reaches the cytosol by translocating from endosomes, whereas the rest is routed to lysosomes for degradation. Here we demonstrate that part of endocytosed AIP56 is recycled back and released extracellularly through a mechanism requiring phosphoinositide 3-kinase (PI3K) activity but independent of endosome acidification. So far, we have been unable to detect biological activity of recycled AIP56, thereby bringing into question its biological relevance as well as the importance of the recycling pathway.
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Proteínas Reguladoras de Apoptose/metabolismo , Apoptose , Toxinas Bacterianas/metabolismo , NF-kappa B/metabolismo , Photobacterium/metabolismo , Animais , Sobrevivência Celular , Células Cultivadas , Citosol/química , Endocitose , Endossomos/química , Concentração de Íons de Hidrogênio , Macrófagos/microbiologia , Macrófagos/fisiologia , Masculino , Camundongos Endogâmicos C57BL , Microscopia Confocal , Peptídeo Hidrolases/metabolismo , Transporte Proteico , ProteóliseRESUMO
AIP56 (apoptosis-inducing protein of 56 kDa) is a major virulence factor of Photobacterium damselae piscicida (Phdp), a Gram-negative pathogen that causes septicemic infections, which are among the most threatening diseases in mariculture. The toxin triggers apoptosis of host macrophages and neutrophils through a process that, in vivo, culminates with secondary necrosis of the apoptotic cells contributing to the necrotic lesions observed in the diseased animals. Here, we show that AIP56 is a NF-κB p65-cleaving zinc-metalloprotease whose catalytic activity is required for the apoptogenic effect. Most of the bacterial effectors known to target NF-κB are type III secreted effectors. In contrast, we demonstrate that AIP56 is an A-B toxin capable of acting at distance, without requiring contact of the bacteria with the target cell. We also show that the N-terminal domain cleaves NF-κB at the Cys(39)-Glu(40) peptide bond and that the C-terminal domain is involved in binding and internalization into the cytosol.
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Proteínas Reguladoras de Apoptose/fisiologia , Apoptose/fisiologia , Toxinas Bacterianas/metabolismo , Metaloproteases/metabolismo , Photobacterium/metabolismo , Fator de Transcrição RelA/metabolismo , Fatores de Virulência/metabolismo , Animais , Bass , Doenças dos Peixes/metabolismo , Interações Hospedeiro-Patógeno , Leucócitos/metabolismo , Leucócitos/patologia , Proteínas RecombinantesRESUMO
The present manuscript reports for the first time the sequencing and characterisation of sea bass (sb) MHCII alpha and beta chains and Ii chain cDNAs as well as their expression analysis under resting state. 3D homology modelling, using crystal structures from mammalian orthologues, has been used to illustrate and support putative structural homologies of the sea bass counterparts. The sbIi cDNA consists of 96 bp of 5'-UTR, a 843 bp open reading frame (ORF) and 899 bp of 3'-UTR including a canonical polyadenylation signal 16 nucleotides before the polyadenylation tail. The ORF was translated into a 280 amino acid sequence, in which all characteristic domains found in the Ii p41 human form could be identified, including the cytoplasmic N-terminus domain, the transmembrane (TM) region, the CLIP domain, the trimerization domain and the thyroglobulin (Tg) type I domain. The trimerization and Tg domains of sbIi were successfully modelled using the human counterparts as templates. Four different sequences of each class II alpha and beta MHCII were obtained from a single fish, apparently not derived from a single locus. All the characteristic features of the MHCII chain structure could be identified in the predicted ORF of sea bass alpha and beta sequences, consisting of leader peptide (LP), alpha1/beta1 and alpha2/beta2 domains, connecting peptide and TM and cytoplasmic regions. Furthermore, independently of the HLA-DR crystal structure used as template in homology modelling, a similar predicted 3D structure and trimeric quaternary architecture was obtained for sbMHC, with major deviations occurring only within the sea bass MHCII alpha1 domain.
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Antígenos de Diferenciação de Linfócitos B/química , Bass/genética , Bass/imunologia , Antígenos de Histocompatibilidade Classe II/química , Análise de Sequência de DNA , Homologia Estrutural de Proteína , Regiões 5' não Traduzidas/genética , Sequência de Aminoácidos , Animais , Antígenos de Diferenciação de Linfócitos B/genética , Antígenos de Diferenciação de Linfócitos B/metabolismo , Sequência de Bases , DNA Complementar/genética , Regulação da Expressão Gênica , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe II/metabolismo , Interações Hidrofóbicas e Hidrofílicas , Modelos Moleculares , Dados de Sequência Molecular , Filogenia , Alinhamento de SequênciaRESUMO
Bacterial modulation of phagocyte cell death is an emerging theme in pathogenesis. Here we describe the systemic destruction of macrophages and neutrophils by the Gram-negative Photobacterium damselae ssp. piscicida (Phdp) in fish pasteurellosis, a deadly systemic infection. Following experimental inoculation, Phdp spreads by bacteraemia and colonizes the organs, producing a septicaemic infection, and secretes the apoptogenic exotoxin AIP56 which is systemically disseminated. In experimental and natural pasteurellosis, destruction of macrophages and neutrophils by secondary necrosis following caspase-3-associated apoptosis was seen predominantly in the spleen, head kidney and gut lamina propria. Identical phagocyte destruction occurred after injection of rAIP56, but not of heat-inactivated rAIP56, or AIP56-negative Phdp strains, indicating that AIP56 is responsible for phagocyte destruction occurring in pasteurellosis. Active caspase-3 and active neutrophil elastase are present in the blood in advanced infection, indicating that phagocyte lysis by secondary necrosis is accompanied by release of tissue-damaging molecules. The AIP56-induced lysis of phagocytes represents a very efficient, self-amplifying etiopathogenic mechanism, because it results in two effects that operate in concert against the host, namely, evasion of the pathogen from a crucial defence mechanism through the destruction of both professional phagocytes, and release of tissue-damaging molecules. The induction by a bacterial exotoxin of in vivo systemic lysis of both professional phagocytes by secondary necrosis, now described for the first time, may represent an overlooked etiopathogenic mechanism operating in other infections of vertebrates.
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Exotoxinas/fisiologia , Doenças dos Peixes/patologia , Infecções por Bactérias Gram-Negativas/patologia , Macrófagos/patologia , Neutrófilos/patologia , Animais , Apoptose , Western Blotting , Caspase 3/sangue , Caspase 3/metabolismo , Eletroforese em Gel de Poliacrilamida , Exotoxinas/genética , Exotoxinas/metabolismo , Doenças dos Peixes/sangue , Doenças dos Peixes/microbiologia , Peixes , Infecções por Bactérias Gram-Negativas/microbiologia , Imuno-Histoquímica , Rim/enzimologia , Rim/microbiologia , Rim/patologia , Elastase de Leucócito/sangue , Elastase de Leucócito/metabolismo , Macrófagos/microbiologia , Necrose , Neutrófilos/microbiologia , Photobacterium/genética , Photobacterium/patogenicidade , Baço/enzimologia , Baço/microbiologia , Baço/patologia , Virulência/genéticaRESUMO
Detachment-induced apoptosis of enterocytes (anoikis) has not been investigated in vivo. Here we describe anoikis of fish enterocytes following detachment in a septicemia by Photobacterium damselae subsp. piscicida, or following injection of its exotoxin. The in vivo study was complemented with an ex vivo time-lapse analysis using conditions duplicating the in vivo situation. Linings of enterocytes detached from intestine mucosa dissociate into isolated enterocytes which undergo caspase 3-mediated anoikis with cell rounding, loss of polarization, condensation of chromatin and fragmentation of the nuclear envelope, early swelling of mitochondria with rupture of the outer membrane, and brush border disappearance. One mechanism for brush border loss was shedding of apoptotic bodies incorporating the apical part of the enterocyte. Brush border disappearance was also associated with disassembly of the F-actin microvillar core and involved re-absorption into the cell, or expansion and vesiculation followed by shedding of microvillar fragments. The enterocyte anoikis terminates by secondary necrosis and lysis due to lack of elimination by phagocytosis of apoptosing enterocytes. The conditions prevailing in vivo in the gut lumen accelerate enterocyte secondary necrosis. Our results underscore the importance of analyzing anoikis under conditions similar to those occurring in vivo.
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Anoikis , Enterócitos/patologia , Enterócitos/ultraestrutura , Necrose/patologia , Actinas/metabolismo , Animais , Adesão Celular , Separação Celular , Enterócitos/citologia , Epitélio/ultraestrutura , Peixes , Trato Gastrointestinal/citologia , Trato Gastrointestinal/ultraestrutura , Microvilosidades/ultraestrutura , Mitocôndrias/ultraestrutura , Infecções por Pasteurella/patologiaRESUMO
Caspase-9 is an initiator caspase in the apoptotic process whose function is to activate effector caspases that are downstream in the mitochondrial pathway of apoptosis. This work reports for the first time the complete sequencing and characterisation of caspase-9 in fish. A 1924bp cDNA of sea bass caspase-9 was obtained, consisting of 1308bp open reading frame coding for 435 amino acids, 199bp of the 5'-UTR and 417bp of the 3'-UTR including a canonical polyadenilation signal 10 nucleotides upstream the polyadenilation tail. The sequence retains the pentapeptide active-site motif (QACGG) and the putative cleavage sites at Asp(121), Asp(325) and Asp(343). The sequence of sea bass caspase-9 exhibits a very close homology to the sequences of caspase-9 from other vertebrates, particularly with the putative caspases-9 of Danio rerio and Tetraodon nigroviridis (77.5 and 75.4% similarity, respectively), justifying the fact that the phylogenetic analysis groups these species together with sea bass. The sea bass caspase-9 gene exists as a single copy gene and is organised in 9 introns and 10 exons. The sea bass caspase-9 showed a basal expression in all the organs analysed, although weaker in spleen. The expression of sea bass caspase-9 in the head kidney of sea bass infected with the Photobacterium damselae ssp. piscicida (Phdp) strain PP3, showed increased expression from 0 to 12h returning to control levels at 24h. Caspase-9 activity was detected in Phdp infected sea bass head kidney from 18 to 48h post-infection, when the fish were with advanced septicaemia.
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Bacteriemia/veterinária , Bass/genética , Caspase 9/genética , Doenças dos Peixes/microbiologia , Expressão Gênica , Infecções por Bactérias Gram-Negativas/veterinária , Sequência de Aminoácidos , Animais , Bacteriemia/genética , Sequência de Bases , Bass/microbiologia , Caspase 9/química , Caspase 9/classificação , Clonagem Molecular , DNA Complementar/genética , Doenças dos Peixes/enzimologia , Doenças dos Peixes/genética , Infecções por Bactérias Gram-Negativas/enzimologia , Infecções por Bactérias Gram-Negativas/genética , Dados de Sequência Molecular , Photobacterium , Filogenia , Homologia de Sequência de AminoácidosRESUMO
Justificativa e objetivos - A laparoscopia ginecológica é procedimento que determina alta incidência de náusea e vômito no pósðoperatório. Este estudo teve por finalidade comparar a eficácia do propofol isoladamente ou em associaçäo com a dexametasona na prevençäo de náusea e vômito em pacientes submetidas à laparoscopia ginecológica. Método - Participaram do estudo 40 pacientes, estado físico ASA I e II com idades entre 18 e 46 anos, sem queixas gástricas prévias, submetidas à laparoscopia para diagnóstico ou cirurgia. As pacientes foram divididas em 2 grupos; o grupo 1 recebeu (soluçäo fisiológica 2 ml) e o grupo 2 dexametasona (8 mg), por via venosa antes da induçäo da anestesia. Todas as pacientes receberam midazolam (7,5 mg) por via oral como medicaçäo préðanestésica, sufentanil (0,5 µg.kgðû), propofol em infusäo contínua para induçäo e manutençäo da anestesia (BIS - 60) e N2O/O2 em fraçäo inspirada de O2 a 40 por cento e atracúrio (0,5 mg.kgðû) como bloqueador neuromuscular. A analgesia pós-operatória foi realizada com cetoprofeno (100 mg) e buscopam composto. As pacientes fora avaliadas na sala de recuperaçäo pós-anestésica (SRPA) e na enfermaria 1, 2, 3 e 12 horas após a alta da SRPA. Resultados - Ambos os grupos foram idênticos quanto aos dados antropométricos e à duraçäo da cirurgia e da anestesia. No grupo 1 (n = 20) uma paciente apresentou náusea na SRPA e na enfermaria e três pacientes vomitaram na enfermaria. No grupo 2 (n = 20) nenhuma paciente apresentou náusea ou vômito durante o período de observaçäo clínica, resultados estatisticamente näo significativos. Conclusões - O propofol isoladamente ou associado à dexametasona foi eficaz na prevençäo de náusea e vômito no pós-operatório de pacientes submetidas à laparoscopia ginecológica
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Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Anestésicos Intravenosos/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Dexametasona , Genitália Feminina/cirurgia , Procedimentos Cirúrgicos em Ginecologia , /prevenção & controle , PropofolRESUMO
BACKGROUND AND OBJECTIVES: Gynecological laparoscopy is a procedure associated to a high incidence of postoperative nausea and vomiting (PONV). This study aimed at comparing the efficacy of propofol or propofol plus dexamethasone in preventing PONV in patients submitted to gynecological laparoscopy. METHODS: Forty female patients, physical status ASA I and II, aged 18 to 46 years, with no previous gastric complaint, undergoing diagnostic or surgical laparoscopy were randomly distri- buted in 2 groups: Group 1 - patients were given 2 ml IV saline solution, while Group 2 was given intravenous dexamethasone (8 mg), before anesthetic induction. All patients were premedicated with oral midazolam (7.5 mg) and induced with sufentanil (0.5 microg.kg-1) and propofol targed controlled infusion (BIS 60), with N2O/O2 (F I O2=0.4) for maintenance. Neuromuscular block was obtained with atracurium (0.5 mg.kg-1). Postoperative analgesia consisted of ketoprofen (100 mg) and butyl-eschopolamine plus dipirone. Patients were evaluated in the PACU and in the ward after 1, 2, 3 and 12 hours after PACU discharge. RESULTS: Both groups were identical regarding demographics data as well as surgery and anesthesia duration. One Group 1 patient referred nausea in postanesthetic care unit and in the ward, and 3 patients referred vomiting in the ward. In Group 2, no patient referred nausea and vomiting, but the difference was not statistically significant. CONCLUSIONS: Propofol or propofol plus dexamethasone were efficient in preventing PONV in patients submitted to gynecological laparoscopy.