RESUMEN
Developmental risk factors, such as the exposure to stress or high levels of glucocorticoids (GCs), may contribute to the pathogenesis of anxiety disorders. The immunomodulatory role of GCs and the immunological fingerprint found in animals prenatally exposed to GCs point towards an interplay between the immune and the nervous systems in the etiology of these disorders. Microglia are immune cells of the brain, responsive to GCs and morphologically altered in stress-related disorders. These cells are regulated by adenosine A2A receptors, which are also involved in the pathophysiology of anxiety. We now compare animal behavior and microglia morphology in males and females prenatally exposed to the GC dexamethasone. We report that prenatal exposure to dexamethasone is associated with a gender-specific remodeling of microglial cell processes in the prefrontal cortex: males show a hyper-ramification and increased length whereas females exhibit a decrease in the number and in the length of microglia processes. Microglial cells re-organization responded in a gender-specific manner to the chronic treatment with a selective adenosine A2A receptor antagonist, which was able to ameliorate microglial processes alterations and anxiety behavior in males, but not in females.
Asunto(s)
Ansiedad/metabolismo , Receptor de Adenosina A2A/fisiología , Animales , Trastornos de Ansiedad/patología , Células Cultivadas , Dexametasona/farmacología , Femenino , Glucocorticoides/metabolismo , Glucocorticoides/farmacología , Lipopolisacáridos/farmacología , Masculino , Microglía/efectos de los fármacos , Microglía/fisiología , Embarazo , Efectos Tardíos de la Exposición Prenatal , Ratas , Ratas Wistar , SexismoRESUMEN
BACKGROUND: Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality worldwide. Chronic hepatitis B infection is associated with an increased risk of cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Our aim is to analyze, through a mathematical model, the potential impact of anti-HBV vaccine in the long-term (that is, decades after vaccination) number of LT. METHODS: The model simulated that the prevalence of HBV infection was 0.5% and that approximately 20% of all the liver transplantation carried out in the state of São Paulo are due to HBV infection. RESULTS: The theoretical model suggests that a vaccination program that would cover 80% of the target population would reach a maximum of about 14% reduction in the LT program. CONCLUSION: Increasing the vaccination coverage against HBV in the state of São Paulo would have a relatively low impact on the number of liver transplantation. In addition, this impact would take several decades to materialize due to the long incubation period of liver failure due to HBV.
Asunto(s)
Carcinoma Hepatocelular/epidemiología , Vacunas contra Hepatitis B/administración & dosificación , Cirrosis Hepática/epidemiología , Neoplasias Hepáticas/epidemiología , Trasplante de Hígado/estadística & datos numéricos , Modelos Teóricos , Adolescente , Adulto , Anciano , Carcinoma Hepatocelular/prevención & control , Carcinoma Hepatocelular/virología , Niño , Preescolar , Hepatitis B/complicaciones , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Virus de la Hepatitis B/patogenicidad , Humanos , Lactante , Recién Nacido , Cirrosis Hepática/prevención & control , Cirrosis Hepática/virología , Fallo Hepático/cirugía , Neoplasias Hepáticas/prevención & control , Neoplasias Hepáticas/virología , Persona de Mediana Edad , Prevalencia , Vacunación , Adulto JovenRESUMEN
Exposure to elevated levels of glucocorticoids (GCs) during neurodevelopment has been identified as a triggering factor for the development of reward-associated disorders in adulthood. Disturbances in the neural networks responsible for the complex processes that assign value to rewards and associated stimuli are critical for disorders such as depression, obsessivecompulsive disorders, obesity and addiction. Essential in the understanding on how cues influence behavior is the Pavlovianinstrumental transfer (PIT), a phenomenon that refers to the capacity of a Pavlovian stimulus that predicts a reward to elicit instrumental responses for that same reward. Here, we demonstrate that in utero exposure to GCs (iuGC) impairs both general and selective versions of the PIT paradigm, suggestive of deficits in motivational drive. The iuGC animals presented impaired neuronal activation pattern upon PIT performance in cortical and limbic regions, as well as morphometric changes and reduced levels of dopamine in prefrontal and orbitofrontal cortices, key regions involved in the integration of Pavlovian and instrumental stimuli. Normalization of dopamine levels rescued this behavior, a process that relied on D2/D3, but not D1, dopamine receptor activation. In summary, iuGC exposure programs the mesocorticolimbic dopaminergic circuitry, leading to a reduction in the attribution of the incentive salience to cues, in a dopamine-D2/D3-dependent manner. Ultimately, these results are important to understand how GCs bias incentive processes, a fact that is particularly relevant for disorders where differential attribution of incentive salience is critical.