ABSTRACT
There are no evidence-based guidelines about prophylaxis against Pneumocystis jiroveci pneumonia in inflammatory bowel disease. We report a case of P. jiroveci pneumonia in patient with Crohn's disease receiving infliximab and methotrexate. This case emphasizes the importance of considering the possibility of this infection in inflammatory bowel disease patients treated on biological therapy.
Subject(s)
Humans , Female , Middle Aged , Pneumonia, Pneumocystis/chemically induced , Gastrointestinal Agents/adverse effects , Crohn Disease/drug therapy , Infliximab/adverse effects , Pneumonia, Pneumocystis/diagnostic imaging , Radiography , Tomography, X-Ray Computed , Risk Factors , Immunosuppressive Agents/adverse effectsABSTRACT
En los últimos años, la participación del sistema inmune innato en el desarrollo de la pre-eclampsia ha sido el objetivo de numerosos estudios. Sin embargo, el rol de las células agresoras naturales (NK) en esta patología no ha sido totalmente aclarado. Las células NK, componentes del sistema inmune innato, poseen actividad citotóxica espontánea, y secretan citoquinas tales como interferón gamma (INF-y ) y Factor de Necrosis Tumoral alfa (TNF-alfa). En el presente estudio hemos analizado la actividad funcional y el inmunofenotipo de células NK obtenidas desde sangre periférica de pacientes con pre-eclampsia, mujeres sanas embarazadas y mujeres sanas no embarazadas. Se cuantificó la actividad cititóxica usando el ensayo de liberación de51cromo. La producción de citoquinas en respuesta a activadores policlonales y el inmunofenotipo (CD3-CD16+CD56+) fueron determinados por citometría de flujo. Estos parámetros no evidenciaron diferencias significativas entre los grupos estudiados; sin embargo, en las pacientes con pre-eclampsia se observa una tendencia hacia una menor citotoxicidad y menor producción de TNF-alfa en células NK estimulada sin vitro, y una proporción aumentada del subtipo celular NK CD56-CD16+ en sangre periférica en relación con los otros dos grupos estudiados.
NK cells functionality during pregnancy. During the last few years, the role of innate immune system in development of pre-eclampsia has been the focus of a number of studies. However, the role of natural killer (NK) cells in pregnancy and pre-eclampsia has not been totally clarified. NK cells, an important component of innate immune system, normally exhibit spontaneus cytolytic activity and secrete cytokines such as interferon gamma (IFN-y) and tumor necrosis factor alpha (TNF-alpha). In current paper, we studied functional activity and immunophenotype of peripheral blood NKcells obtained from patients with pre-eclampsia, healthy pregnant women and non-pregnant healthy women. For this purpose, we quantified cytolytic activity using 51chromium release assay. We determined cytokine production in response to polyclonal activators and cells immunophenotype (CD3-CD16+CD56+) by flow cytometry. We found no significant differences in these parameters among the three groups studied, however, in patients with pre-eclampsia, there is a tendency to a decreased cytotoxic activity and less production of TNF-alpha by NK cells in vitro as well as an increased proportion of the NK subset CD56-CD16+, in peripheral blood.