Protective effects of Wuwei Xiaodu Drink against chronic osteomyelitis through Foxp3+CD25+CD4+ Treg cells via the IL-2/STAT5 signaling pathway / 中国天然药物

To explore the effectiveness and safety of a Chinese medicinal decoction Wuwei Xiaodu Drink (WWXDD) in inhibiting chronic osteomyelitis via regulatory T cells signaling. The effective constitutes of WWXDD and osteomyelitis related genes were screened. Target proteins were cross-validated using the Venny database. GO function and KEGG pathway analysis were performed for target proteins, while pharmacological network was constructed. The bone properties were analyzed by HE staining and the concentrations of immune factors were measured by ELISA. The expression of CTLA-4 and Foxp3 mRNA and STAT5, p-STAT5, CTLA-4 and Foxp3 protein were detected using Real-time PCR and Western blot, respectively. FACS was used to analyze the percentages of cells. A total of 117 genes overlapped between 785 target genes of the active compounds of WWXDD and 912 osteomyelitis related genes. Inflammation-related genes, including IL-6, TNFα, IL-1β and IL-2 showed high connection degree in the drug-compound-disease-target network. GO function and KEGG pathway analysis revealed that 117 intersection genes mainly enriched in virus infection related pathways, immune related pathways and chemokine signaling pathway. Furthermore, the development of chronic osteomyelitis was suppressed in model rats after treatment with WWXDD. Meanwhile, the concentrations of IL-2 and CD4+CD25+Foxp3 Treg percentages together with the levels of p-STAT5, CTLA-4 and Foxp3 were also down-regulated. Furthermore, IL-2 and WWXDD drug-containing serum exhibited opposite effects on regulating IL-2, IL-10, TGF-β1, Foxp3, CTLA4 and STAT5. In addition, a STAT5 phosphorylation inhibitor suppressed the expression of Foxp3 and CTLA-4. WWXDD can treat chronic osteomyelitis through suppressing the main regulating factors of Tregs and interfere its immunodepression. Our results bring a new solution for chronic osteomyelitis.

Importancia diagnóstica de leucoencefalopatía multifocal progresiva cerebelosa

RESUMEN Introducción: La leucoencefalopatía multifocal progresiva es una enfermedad desmielinizante del sistema nervioso central, de etiología viral. Se presenta en pacientes con enfermedades inmunosupresoras y la localización en fosa posterior es rara. Debido a sus formas clínicas inespecíficas se hace infrecuente su diagnóstico lo que conlleva a daño irreversible y/o a la muerte del paciente. Objetivo: Orientar sobre la posibilidad de leucoencefalopatía multifocal progresiva cerebelosa en pacientes inmunodeprimidos con manifestaciones neurológicas de daño en fosa posterior. Caso clínico: Paciente masculino, de 25 años de edad, sin antecedentes de enfermedades aparentes, que comienza con lenguaje escandido, temblor mixto dismetría y ataxia. Se diagnostica leucoencefalopatía multifocal progresiva cerebelosa por cuadro clínico, neuroimagen y presencia de virus JC en líquido cefalorraquídeo, además de una inmunosupresión severa causada por virus de inmunodeficiencia humana diagnosticado por pruebas serológicas. Conclusiones: Considerar leucoencefalopatía multifocal progresiva cerebelosa en todo paciente con manifestaciones neurológicas de afectación en fosa posterior y estudiar causas de inmunosupresión subyacente.

ABSTRACT Introduction: Progressive multifocal leukoencephalopathy is a demyelinating disease of viral etiology that affects the central nervous system. It presents in patients with immunosuppressive conditions and location in the posterior fossa is rare. Due to its unspecific clinical forms, its diagnosis is infrequent, leading to irreversible damage and/or the patient's death. Objective: Instruct about the possibility of cerebellar progressive multifocal leukoencephalopathy in immunocompromised patients with neurological manifestations of posterior fossa damage. Clinical case: A case is presented of a male 25-year-old patient without apparent pathological antecedents who started out with slurred speech, mixed tremor, dysmetria and ataxia. Cerebellar progressive multifocal leukoencephalopathy was diagnosed by clinical picture, neuroimaging and the presence of JC virus in the cerebrospinal fluid, alongside severe immunosuppression caused by human immunodeficiency virus diagnosed by serological testing.

Challenges in the diagnosis and control of Marek's disease virus in Colombia / Retos en el diagnóstico y control del virus de la enfermedad de Marek en Colombia

ABSTRACT Although the Colombian poultry industry has almost doubled its production in the last decade, our ability to diagnose and characterize avian pathogens is deficient, and there is little information of the circulating viral pathogens. One of these pathogens is Marek disease virus (MDV), which is an immunosuppressive agent that can cause high mortality rates and substantial production losses. Currently, there are few documented clinical cases due to the implementation of mass vaccination programs with GaHV-2 strains (serotype I) and HVT (serotype III). However, losses in production rates are likely occurring-due to immunosuppression and subclinical infections. The objective of this review is to describe MDV and the current status of the infection in Colombia.

RESUMEN Aunque la industria avícola colombiana ha crecido casi el doble en producción durante la última década, el diagnóstico de agentes infecciosos y caracterización de estos aún es escasa, y es poca la información acerca de las cepas virales circulantes en el país. Dentro de estos agentes se encuentra el Virus de la Enfermedad de Marek (VEM), el cual es un patógeno inmunosupresor que puede causar mortalidad elevada y graves pérdidas en la producción. Aunque es poco probable que ocurran casos clínicos de la enfermedad causada por el VEM, debido a los programas de vacunación generalizada con GaHV-2 (serotipo I) y HVT (serotipo III), la inmunosupresión que causan las infecciones subclínicas puede estar causando pérdidas considerables en la producción avícola nacional. El objetivo de esta revisión es describir brevemente la enfermedad de Marek y el estado actual del estudio de la infección en Colombia.

Sepsis grave en la unidad de terapia intensiva del Instituto de Medicina Tropical Pedro Kourí / Severe sepsis in the intensive care unit of Pedro Kourí Tropical Medicine Institute

Introducción: La última década muestra aumento de la prevalencia de sepsis grave por microorganismos multidrogorresistentes, lo que representa una alerta para los gobiernos y sistemas de salud en el manejo de la multirresistencia. Objetivo: Identificar los microorganismos causantes de sepsis grave y sensibilidad a los antimicrobianos, así como relacionar los niveles de proteína C reactiva con la sepsis grave. Métodos: Estudio descriptivo de corte transversal que incluyó a 30 pacientes con diagnóstico de sepsis grave ingresados en la Unidad de Cuidados Intensivos del hospital del Instituto de Medicina Tropical Pedro Kourí durante el 2016. Resultados: Las neumonías fueron el foco primario dominante (43,3 por ciento), y las infecciones por gérmenes gramnegativos las más frecuentes. Los aislamientos microbiológicos (pseudomonas y acinetobacter baumannii) mostraron multidrogorresistencia que incluye a carbapenémicos y colistina, lo que sugiere utilización de forma indiscriminada y no justificada de antibióticos en pacientes inmunodeprimidos VIH. Se demostró asociación entre la infección por gérmenes gramnegativos y títulos elevados de proteína C reactiva con el desarrollo de sepsis grave y evolución desfavorable. El aumento de las supervivencias de los pacientes VIH con las terapias antirretrovilales, demostraron la predisposición de estos enfermos a infecciones por gérmenes multidrogorresistentes. Conclusiones: Los pacientes VIH tienen predisposición a infecciones por microorganismos multidrogorresistentes, la proteína C reactiva es útil como marcador de sepsis grave en estos enfermos. Estudios de este tipo demuestran a los sistemas de salud la necesidad trazar estrategias a corto plazo para el manejo de pacientes con VIH y sepsis grave por microorganismos multidrogorresistentes(AU)

Introduction: The last decade shows an increase in the prevalence of severe sepsis by multidrug resistant microorganisms which represent an alert for governments and health systems in relation with multiresistance management. Objective: To identify the microorganisms that cause severe sepsis and sensitivity to the antimicrobials, as well as to relate the levels of C-reactive protein with the severe sepsis. Methods: A descriptive, cross-sectional study was carried out involving 30 patients diagnosed with severe sepsis and admitted in 2016 to the Intensive Care Unit of the Hospital in Pedro Kourí Tropical Medicine Institute. Results: The prevalence of severe sepsis was 24.8 percent mainly in male patients (71.1 percent) and with ages from 41 to 50 years old (40.0 percent). Pneumonias were the predominant primary source (43.3 percent), and infections caused by negative Gram germs were the most frequent. Microbiological isolates (pseudomonas and acinetobacterbaumannii) showed multidrug resistance including carbapenems and colistin, which suggests an indiscriminate and non-justified use of antibiotics in HIV inmunodepressed patients. It was demonstrated a relation between infection by negative Gram germs and elevated levels of C-reactive protein with the development of severe sepsis and unfavorable evolution. The increasing survival rate in patients with HIV showed a predisposition of them to infections caused by multidrug resistant germs. Conclusions: HIV positive patients have a predisposition to infections caused by multidrug resistant microorganisms. C-reactive protein is useful as a marker of severe sepsis in this kind of patients. Studies of this type show to health systems the need to develop strategies in short term for managing HIV patients and the severe sepsis caused by multidrug resistant microorganisms(AU)

Fibrinous pleuropneumonia caused by Pasteurella multocida associated with bovine lymphoma / Pleuropneumonia fibrinosa causada por Pasteurella multocida associada a linfoma bovino

ABSTRACT: In this work, we describe an unusual case of fibrinous pleuropneumonia caused by Pasteurella multocida associated with generalized lymphadenomegaly in a bovine. The animal had a one-month history of generalized superficial lymphadenomegaly that progressed to anorexia and submandibular oedema, resulting in spontaneous death. At necropsy, the parenchyma of the lymph nodes and multiple organs was obliterated by a dense proliferation of round neoplastic cells (lymphoma). Additionally, the neoplasm presented multifocal areas of haemorrhage and necrosis, characteristic of lymphoma. The parietal and visceral pleura and parietal pericardium were enlarged and covered diffusely with large amounts of a yellowish fibrillary material. The lungs were mildly enlarged, non-collapsed, and firm and exhibited interlobular septae that were thickened with a gelatinous material. Histopathological examination showed that the parietal and visceral pleura were enlarged due to a diffuse and severe inflammatory infiltrate composed of degenerate neutrophils associated with severe fibrin deposition, characteristic of fibrinous pleuropneumonia. Pleura and parietal pericardium fragments were cultivated in aerobic and microaerobic microbiological conditions. Round greyish colonies of gram-negative coccobacilli that were shiny and non-haemolytic were observed in sheep blood agar. The biochemical profile was indicative of Pasteurella spp. Molecular identification was performed by partial 16S rRNA amplification following sequencing. Pasteurella multocida was confirmed as the primary bacterium associated with the bovine fibrinous pleuropneumonia. We are able to infer that the lymphoma caused immunodepression, which increased the animal's susceptibility to atypical infectious microorganisms such as pathogenic P. multocida.

RESUMO: Nesse trabalho, relatamos um caso de pleuropneumonia fibrinossupurativa causada por Pasteurella multocida associada à linfoadenomegalia em um bovino. O animal apresentava aumento generalizado de linfonodos há um mês progredindo para anorexia e edema submandibular por três dias culminando com óbito. Durante a necropsia, tanto dos linfonodos quanto de diversos órgãos evidenciaram proliferação neoplásica de células arredondadas e arranjadas em mantos (linfoma). Adicionalmente, áreas multifocais de hemorragia e necrose, características de linfoma, foram observadas. As pleuras parietal e visceral e pericárdio parietal apresentavam-se espessas e recobertas por acentuada quantidade de fibrina. Os pulmões estavam aumentados, não colabados, firmes e exibiam espessamento com edema moderado de septos interlobulares. À microscopia, cortes da pleura visceral exibiram acentuado infiltrado inflamatório de neutrófilos degenerados com intensa deposição de fibrina, características da pleuropneumonia fibrinossupurativa, além de neovascularização e proliferação de fibroblastos. Amostras de pulmão e da pleura foram cultivadas em aerobiose e microaerobiose. Evidenciou-se o crescimento puro no ágar sangue ovino de colônias redondas, acinzentadas, brilhantes e não-hemolíticas, sendo caracterizadas como cocobacilos gram-negativos. As características bioquímicas do isolado foram condizentes com Pasteurella spp. Procedeu-se a identificação molecular do isolado através da amplificação parcial do gene rRNA 16S com posterior sequenciamento do produto amplificado. Deste modo foi possível a confirmação do isolado como Pasteurella multocida, sendo o agente primário da pleuropneumonia fibrinosa. Com estes dados, podemos afirmar que o linfoma causou um quadro de imunodepressão, a qual aumenta a susceptibilidade dos animais a agentes infecciosos atípicos, como a P. multocida patogênica.

A method to improve success rate of mice melanoma metastasis model in vivo / 中国药理学通报

Aim To improve the rate of melanoma metastasis animal model and provide a reliable experimental modeling meth-od for the study of melanoma metastasis mechanism. Methods Five immunosuppressants were selected and then their targets were screened by network pharmacology. Intraperitoneal injection of immunosuppressants and intravenous injection of B16F10 cells were performed on C57BL/6 mice, then the mice were observed, and body weight were recorded daily. The contents of TNF-α, IL-6, IL-10, VEGF and MMP-9 in serum were measured with ELISA kit. The mice were dissected, then the metastasis situa-tion and the number of metastatic nodules in the lung and other organs were evaluated. HE-staining was involved to determine the morphology of metastatic tissues. Results The closeness centrality of cyclosporine and dexamethasone ranked the top and the targets were concentrated in lung and liver. No significant difference in body weight were observed after animal madel in-duced. The contents of TNF-α, IL-6 IL-10, VEGF and MMP-9 in the model group increased. The number of metastatic nodules in the lung significantly augmented with some kind of liver metas-tasis. HE-staining in the lung tissues showed that tumor presen-ted invasive growth. Conclusion By intraperitoneal injection of dexamethasone, the success rate of mice melanoma metastasis model can be greatly increased.

Advances in the relation between myeloid derived suppressor cells and digestive system tumors / 中华消化外科杂志

Myeloid derived suppressor cell (MDSC) is a kind of myogenic stem cells that are induced by tumor-derived cytokines.MDSCs not only have their own immunosuppressive effects,but also can mediate the immunosuppressive effects of T lymphocytes through different mechanisms.Recent studies have shown that MDSCs involved in tumor immune escape,immune tolerance as well as other pathological processes,and played an important role in promoting the generation and development of tumors.The advances of the generation,immunosuppressive effects of MDSCs and their relation with digestive system tumors were summarized in this paper,which would provide evidences for the clinical use of MDSCs in treating digestive system tumors.

Changes and Mechanisms of Immunodepression after Ischemic Stroke in Mice / 昆明医科大学学报

Objective To investigate the changes and mechanisms of immune function after ischemic stroke by studying the reaction of C57BL/6mice's lung and spleen after ischemic stroke.Methods Sixteen mice C57BL/6 were randomly assigned to experiment group (n=8) and control group (n=8).The acute ischemic stroke model was established in experiment group by Middle Cerebral Artery Occlusion (MCAO) and no stroke was performed in control group.Then we observed the lung inflammation by HE staining of the lung.And we measured the spleen weight,spleen weight index,the count and the apoptosis index of spleen cells of mice in two groups.Results Compared with the control group,the count of the inflammatory cells in lung of mice in the experiment group was higher,the spleen weight,spleen weight index and spleen cells count of the experiment group were decreased and the apoptosis index of spleen cells of the experiment group was higher.Conclusion The mice in the experiment group have inflammatory reaction in lung,the spleen atrophied and the apoptosis index of spleen cells is increased,which suggest that stroke-induced apoptosis of immunocytes may cause immunodepression after ischemic stroke and easily lead to the infection.

Up-regulation of NKG2A inhibitory receptor on circulating NK cells contributes to transfusion-induced immunodepression in patients with β-thalassemia major / 华中科技大学学报（医学）（英德文版）

Accumulating evidence has shown that allogeneic blood transfusions can induce significant immunosuppression in recipients, and thereby increase the risk of postoperative infection and/or tumor relapse. Although it is well known that natural killer (NK) cells are responsible for the immunodepression effects of transfusion, the underlying mechanisms remain obscure. In this study, we investigated the role of NK cells in transfusion-induced immunodepression in β-thalassemia major. The proportion of circulating NK cells and the expression of NK receptors (NKG2A, CD158a, NKP30, NKP46 and NKG2D) as well as CD107a were detected by multicolor flow cytometry. IFN-γ production by circulating NK cells was detected by intracellular cytokine staining. Our results showed that the proportion and cytotoxicity (CD107a expression) of circulating NK cells in transfusion-dependent β-thalassemia major patients were remarkably lower than those of β-thalassemia minor patients or healthy volunteers. Expression of NKG2A inhibitory receptor on circulating NK cells in patients with β-thalassemia major was remarkably up-regulated, but there were no significant differences in the expression levels of NKP30, NKP46, NKG2D, CD158a and IFN-γ. These results indicate NKG2A inhibitory receptor may play a key role in transfusion-induced immunodepression of NK cells in patients with β-thalassemia major.

Malassezia spp detected at the edge of the eye of a white-eyed parakeet (Aratinga leucophthalma, statius muller, 1776) ­ a case report / Detecção de malassezia spp no limbo do olho de periquitão-maracanã (Aratinga leucophthalma, statius muller, 1776)

The white-eyed parakeet (Aratinga leucophthalma), also known in Brazil as "periquitãomaracanã," "aratinga-de-bando," "araguaí" and "maritaca," belongs to the family Psittacidae. The fungal genus Malassezia, which lives on the surface of the skin and mucosae of some mammals and birds, is a commensal organism that may sometimes act as a pathogen. This paper describes the presence of Malassezia spp at the edge of the eye of a white-eyed parakeet seized by IBAMA (Brazilian Institute of Environment and Renewable Natural Resources) and examined at the Federal University of Uberlândia (UFU) Veterinary Hospital. The examination of the bird revealed the presence of a small white rounded structure at the edge of its right eye. The bird was sedated and a fragment of the structure was removed and sent to the university's Laboratory of Infectious Diseases. This material was seeded in blood and MacConkey agars and a slide was prepared and stained by the Gram-staining technique; no biochemical assays were performed. Reading was performed in an optical microscope under 100X magnification, revealing flattened oval colonies resembling purplish footprints, indicative of Malassezia spp. The bird was not treated because the structure gradually diminished in size until it disappeared completely after the animal was isolated in a clean well ventilated place and supplied with water and good quality food suitable for the species. It is believed that the development of the atypical and uncommon foreign body in the bird's eye may have been caused by immunodepression resulting from the period of stress it underwent during wildlife trafficking.

O periquitão-maracanã (Aratinga leucophthalma), também conhecido como aratinga-de-bando, araguaí e maritaca, pertence à família Psittacidae. O gênero Malassezia vive na superfície da pele e mucosas de alguns mamíferos e aves; é um organismo comensal que, eventualmente, pode agir como patógeno. O objetivo deste foi relatar a presença de Malassezia spp no limbo do olho de um exemplar de periquitão-maracanã apreendido pelo IBAMA (Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis) e atendido no Hospital Veterinário da Universidade Federal de Uberlândia (UFU). Durante a anamnese, foi observada a presença de uma pequena estrutura branca no limbo do olho direito da ave. A ave foi sedada, e foi colhido um fragmento da estrutura, o qual foi encaminhado ao Laboratório de Doenças Infectocontagiosas da UFU. Esse material foi semeado em ágares Sangue e MacConkey. E, após observado o crescimento de colônias apenas no meio ágar Sangue, confeccionou-se uma lâmina, corando-a pelo método de Gram; não foram realizados testes bioquímicos . A leitura realizou-se em microscópio óptico no aumento de 100 vezes, e observaramse colônias ovaladas e achatadas, semelhantes a pegadas de sapatos, e de coloração púrpura, indicativo de Malassezia spp. Foi realizado o isolamento da ave em local limpo e arejado, e o fornecimento de água e alimentos de boa qualidade, compatíveis com a espécie, sendo estas as únicas alterações procedidas nesse período, não necessitando de tratamento, pois houve diminuição da estrutura até seu total desaparecimento. Acredita-se que o agente possa ter se desenvolvido de forma atípica e incomum no olho, devido à imunodepressão da ave, justificada pelo período de estresse ao qual ela foi submetida durante o tráfico.

Traumatismos e inmunidad celular según el índice predictivo TRISS / Traumata and cellular immunity according to the TRISS predictive index

Introducción: las lesiones por traumatismos graves constituyen una amenaza constante para el individuo y estas adquieren particular interés, ya que afectan, por lo general, a personas jóvenes y sanas en plena capacidad productiva Objetivo: valorar el comportamiento en el tiempo de los componentes de la inmunidad celular en los pacientes traumatizados en general, en los que sufren complicaciones y en los que fallecen, y su relación con la probabilidad de sobrevida (PS) según el índice predictivo trauma injury severity score (TRISS) Métodos: se realizó un estudio prospectivo en 70 pacientes traumatizados con valores de injury severity score superiores a 8, ingresados en el Hospital Militar Central "Dr. Luis Díaz Soto", en un período de 2 años. Se realizaron estudios inmunitarios durante las primeras 24 h, a los 3 días y a los 7 días. Se aplicaron los métodos estadísticos análisis de componentes principales; clasificación aglomerativa Cluster Analysis, la cual estratificó la muestra según la PS en el grupo PS< 80 por ciento, entre 80 y 95 por ciento y PS> 95 por ciento; prueba de correlación de Pearson; prueba de regresión logística; análisis de tabla de contingencia y discriminación diagnóstica, según los conceptos de sensibilidad, especificidad, prevalencia, y valores predictivos de pruebas positivas y negativas. Resultados: se encontraron complicaciones infecciosas significativamente frecuentes (47,9 por ciento). El estudio cinético de la inmunidad celular, constató disminución a las 72 h de la actividad de los linfocitos T y de la capacidad de fagocitosis de los neutrófilos. Se observó depresión de estos componentes en los pacientes complicados y en los que después fallecieron, más marcada a las 72 h e intensificadas a los 7 días en estos últimos. En la medida en que disminuyó la PS, decrecieron la actividad de los linfocitos T (RA: p= 0,04; RE: p= 0,02) y la capacidad de fagocitosis de los neutrófilos

Introduction: injuries from severe traumata are a constant threat for subject acquiring a particular interest since generally they affect to young and healthy persons in a complete productive ability. Objective: To assess the behavior in time of components of the cellular immunity in trauma patients in general, in those underwent complications and in those deceased, ant its relation to survival probability (SP) according the "trauma injury severity score" (TRISS) predictive index. Methods: a prospective study was conducted in 70 trauma patients with "injury severity score" values higher to 8, admitted in the "Dr. Luis Díaz Soto" Central Military Hospital over two years. Immunity studies were conducted during the first 24 hours, at three days and at 7 days. The statistic methods including main components analysis, agglomerative Cluster Analysis classification, which stratified the sample according to SP in group SP< 80 percent, between 80 and 95 percent and SP> 95 percent; test of Pearson's correlation; logistic regression test, contingence table analysis and diagnostic discrimination, according to the sensitivity, specificity, prevalence concepts and the predictive values of positive and negative tests. Results: There were very frequent infectious complications (47.9 percent). The kinetic study of the cellular immunity confirmed a decrease at 72 hours of activity of phagocytosis of neutrophiles. It was noted a depression of components in complicated patients and in those after died, more marked at 72 hours and intensified at 7 days in this latter. According to SP reduction, also decreased the lymphocyte T activity (RA: p= 0.04; RE: p= 0.02) and the phagocytosis ability of neutrophiles. The deficiency of cellular immune response was accompanied by a great incidence of complicated and deceased patients. Conclusions: traumata are accompanied of cellular immunodepression and this is related to SP according to the TRISS predictive index

Traumatismos e inmunidad humoral según índice predictivo TRISS / Traumata and humoral immunity according to TRISS predictive index

Introducción: el trauma, reconocido como epidemia no resuelta de la sociedad moderna, representa, en Cuba, un verdadero problema de salud. Objetivo: determinar el comportamiento cinético de la inmunidad humoral en los pacientes traumatizados, en general, y en los complicados en particular, precisar el momento de mayor afectación, así como sus relaciones con la probabilidad de sobrevida (PS) según índice predictivo trauma injury severity score (TRISS). Métodos: se realizó un estudio prospectivo en 70 pacientes traumatizados con valores de injury severity score superiores a 8, ingresados en el Hospital Militar Central "Dr. Luis Díaz Soto", en un período de 2 años. Se realizaron estudios inmunitarios durante las primeras 24 h, a los 3 días y a los 7 días. Se aplicaron las pruebas estadísticas necesarias para avalar el estudio. La muestra quedó estratificada en 3 grupos: PS< 80 %, entre 80 y 95 % y PS> 95 %. Resultados: hubo complicaciones infecciosas significativamente frecuentes (47,9 %). El estudio cinético de la inmunidad humoral constató disminución a las 72 h, del factor C-3 del complemento sérico, del complemento hemolítico total CH-50, y de las inmunoglobulinas G y M. Se observó depresión de estos componentes en los pacientes complicados y en los que fallecieron después, más marcada a las 72 h e intensificada a los 7 días en estos últimos. En la medida en que disminuyó la probabilidad de sobrevida, decrecieron los valores del complemento hemolítico total CH-50 (p= 0,009), de las inmunoglobulinas G y M (p= 0,004) y el factor C-3 del complemento sérico. La deficiencia de la respuesta inmunitaria humoral se acompañó de mayor incidencia de complicados y fallecidos. Conclusiones: los traumatismos se acompañan de inmunodepresión humoral y esta se relaciona con la probabilidad de sobrevida según índice predictivo TRISS.

Introduction: the trauma is recognized as a non-solved epidemic of the current society, in Cuba it is a real health problem. Objective: to determine the kinetic behavior of the humoral immunity in trauma patients, in general and in those complicated in particular, and to specify exactly the moment of great affection, as well as its relations to survival probability (SP) according the trauma predictive index "injury severity score" (TRISS). Methods: a prospective study was conducted in 70 trauma patients with values of "injury severity score" higher than 8 admitted in the "Dr. Luis Díaz Soto" Central Military Hospital over two years, as well as immunity studies over the first 24 hours, at 3 days and at 7 days. The needed statistic tests were applied to assess the study. Sample was stratified in three groups: SP< 80 %, between 80 and 95 % and SP>95 %. Results: there were infectious complications significantly frequent (47,9 %). The kinetic study of the humoral immunity confirmed a decrease at 72 hours, of C-3 factor of the serum complement, of the CH-50 total hemolytic complement, and of immunoglobulin G and M. Also, there was decrease of these components in the patients complicated and in those died after, more marked at 72 hours and intensified at 7 days en these latter. Insofar as the survival probability decreased, also decreased the values of the CH-50 total hemolytic complement (p= 0.009), of the immunoglobulin G and M (p= 0.004) and the C-3 factor of serum complement. The deficiency in the humoral response was accompanied of a greater incidence of complicated and deceased patients. Conclusions: the traumata are accompanied of humoral immunodepression and it is related to the survival probability according the predictive index-TRISS.

Revisión histopatológica de 20 casos de linfoma de Hodgkin infantil (0-14 años) provenientes de áreas de deficiente situación socioeconómica / Histopathological revision of 20 cases of Hodgkin's lymphoma of infants (0-14 years) coming from areas of poor socioeconomical conditions

Los resultados obtenidos en la revisión histopatológica de 20 casos con confirmación de su baja situación socioeconómica han mostrado que la totalidad de los mismos correspondieron a una forma histológica de mejor pronóstico y, por ende, a una aplicación terapéutica de menor agresividad para el paciente, permitiendo a su vez actuar sobre la hipotética causa primaria de la enfermedad con medidas dedicadas a mejorar la respuesta inmune del niño.

The results obtained from histopathological revision of 20 cases with corroboration of their bad socioeconomical condition proof about the total of the casuistry to pertain into a good prognostic histological type, and for this reason submitted to a low aggresive chemotherapy treatment for the patient, and consecutively to put in action the therapeutic to restore the immunological response.

Úlcera de lengua como presentación del Histoplasma capsulatum / Tongue ulceration as a presentation of Histoplasma capsulatum infection

La histoplasmosis diseminada progresiva es una enfermedad que se manifiesta como reactivación de una infección latente en pacientes inmunodeprimidos, especialmente en personas con déficit en la inmunidad celular. Existen formas agudas, subagudas y crónicas. Las lesiones focales, en especial úlceras mucocutáneas, predominan en la forma diseminada crónica. Reportamos el caso de una paciente con artritis reumatoidea, que controlaba su patología con fármacos antirreumáticos modificadores de la enfermedad (DMARD), la que consultó por úlcera de lengua como única manifestación de una histoplasmosis diseminada crónica. La histopatología fue compatible y el cultivo positivo para Histoplasma capsulatum. La serología para el HIV fue negativa. Existen pocos casos publicados de pacientes con esta localización atípica en forma aislada, en particular aquellos HIV negativos. El itraconazol y la anfotericina B son las dos drogas más utilizadas para tratar esta enfermedad. Los datos clínicos sobre los nuevos azoles, voriconazol y posaconazol son limitados.

The progressive disseminated histoplasmosis is a disease produced by reactivation of latent infection in immunocompromised host, specially in persons with defective cell-mediated immunity. There are acute, subacute and chronic forms in the progressive illness. Focal lesions, specially mucocutaneous ulcers, are most frequent in the chronic disseminated forms. We reported a patient with rheumatoid arthritis treated with disease modifying antirheumatic drug (DMARD), with an ulcer of the tongue as only clinical manifestation of a chronic disseminated histoplasmosis. The histopathology was compatible, and the culture was positive for Histoplasma capsulatum. The serology for the HIV was negative. There are few published cases of this isolated form, particularly in patients with HIV negative serological test. Itraconazole and amphotericin B are the most frequently drugs used for the treatment in this disease. Clinical data on the new azoles, voriconazole and posaconazole, are limited.

Mechanisms of Stroke-Induced Peripheral Immunodepression / 国际脑血管病杂志

The nervous system and the immune system maintain homeostasis mainly through the hypothalamo-pituitary-adrenal(HPA)axis,the sympathetic nervous system and the parasympathetic nervous system(vagal cholinergic pahway).The homeostasis is broken after stroke,and results in peripheral immunosuppression,which is called stroke-induced immunodepression syndrome.Its mechanism is still under investigation.The article reviews the mechanism and clinical significance of stroke-induced peripheral immunodepression through the above three mentioned pathways.

Mucormicosis renal aislada / Isolated renal mucormicosis

La mucormicosis es una infección causada por hongos de la clase Zygomycetes. Existen varias formas de presentación clínica, siendo las más comunes la rinocerebral y la pulmonar. La mucormicosis renal aislada es un tipo de mucormicosis muy poco frecuente hasta el momento; se han reportado 25 casos en la literatura. Se presenta el caso de una paciente con leucemia aguda que desarrolló mucormicosis renal aislada, y se revisa la literatura.

Mucormycosis is an infection caused by a class Zygomycetes fungi. The rhinocerebral and pulmonary are the most common clinical presentations. Renal mucormycosis is a very rare form. To date, only 25 cases have been reported in the literature. We describe the case of a patient with leukemia who developed isolated renal mucormycosis and review the literature.

Effect of Extract of Longyanshen(EL) on Immunodepression Induced by Cyclophosphamide in Mice / 中国药房

OBJECTIVE:To observe the effect of extract of longyanshen(EL)on immunodepression induced by cyclophosphamide in mice.METHODS:The immunodepression was induced by cyclophosphamide,the the different oral doses of EL were given to mice for 30 days,and control group took NS.RESULTS:The different doses of EL could significantly increase the killing function of neutrophil(P

Research for IL-2R? mimic peptide on skin allograft rejection in mice / 中国免疫学杂志

Objective:To study the effects of IL-2R? mimic peptide(CP) on skin allograft rejection in mice.Methods:Mouse skin allograft model was employed in all groups.The bioactivities were determined by lymphocyte proliferation,one-way MLR,assay of T lymphocyte subset and the level of cytokine in splenic cell culture supernatant.Results:CP inhibited lymphocyte proliferation;decreased the number of CD4+T lymphocytes in spleen and the value of CD4+/CD8+;down-regulated the level of IL-2 and IFN in splenic cell culture supernatant,as well as prolonged the mean survival times(MST) of skin allografts.The combination of CP and CsA showed cooperativities.Conclusion:CP,as the IL-2R? mimic peptide has the suppressive activities,which can efficiently inhibit skin allograft rejection in mice.