Capacidade terapêutica da fitoterapia na odontologia: uma análise abrangente das proteínas antimicrobianas, anti-inflamatórias e reparadoras / Therapeutic capacity of phytotherapy in dentistry: a comprehensive analysis of antimicrobial, anti-inflammatory, and reparative properties

Introdução: A fitoterapia se baseia na utilização de plantas medicinais, através de diferentes formulações farmacêuticas com fins terapêuticos. Na Odontologia, os fitoterápicos têm sido alvo de estudos, devido suas propriedades benéficas, além de apresentarem biocompatibilidade, baixo custo e fácil acesso. Objetivo: Realizar um levantamento na literatura científica sobre a utilização da fitoterapia na Odontologia, com vistas aos efeitos antimicrobiano, anti-inflamatório e reparador. Material e Métodos: A busca ocorreu entre fevereiro a julho/2023, nas bases PubMed e LILACS, além de livre busca, cruzando-se os descritores "Phytotherapy", "Dentistry", "Anti-inflamatory Agents", "Anti-Infective Agents", "Wound Healing", "Fitoterapia", "Odontologia", "Anti-inflamatório", "Antimicrobiano" e "Cicatrização". Após leitura inicial, seguida da análise crítica com aplicação dos critérios estabelecidos, foram selecionadas 50 referências. Desenvolvimento: Diversas plantas são empregadas sob a forma de fitoterapia, como Aloe vera (babosa), Matricaria recutita (camomila), Copaifera (copaíba), Punica granatum (romã), Uncaria tomentosa (unha-de-gato), Malva sylvestris (malva), Althaea officinalis (malvaísco), Myracrodruon urundeuva (Aroeira), Lippia sidoides (Alecrim pimenta) e Glycyrrhiza glabra (Alcaçuz). Na Odontologia, pesquisas evidenciaram resultados satisfatórios para o tratamento de afecções da cavidade oral, especialmente com caráter inflamatório e infeccioso, além de aclerar a cicatrização. Esses achados apontam que a fitoterapia é um tratamento eficaz, acessível e com mínimos efeitos colaterais. Considerações finais: Com base na literatura revisada, a fitoterapia parece ser uma alternativa promissora no tratamento de afecções orais, devido aos seus notáveis efeitos cicatrizantes, antimicrobianos e anti-inflamatórios. Contudo, mais pesquisas com metodologias adequadas são necessárias para que se estabeleçam protocolos clínicos seguros e eficazes.

Introduction: Phytotherapy is based on the use of medicinal plants through different pharmaceutical formulations for therapeutic purposes. In Dentistry, phytotherapeutics have been the subject of studies due to their beneficial properties, as well as their biocompatibility, low cost, and easy accessibility. Objective: To conduct a literature review on the use of phytotherapy in Dentistry, focusing on antimicrobial, anti-inflammatory, and reparative effects. Materials and Methods: The search took place between February and July 2023, using PubMed and LILACS databases, in addition to a free search, crossing the descriptors "Phytotherapy," "Dentistry," "Anti-inflammatory Agents," "Anti-Infective Agents," "Wound Healing," "Fitoterapia," "Odontologia," "Anti-inflammatory," "Antimicrobial," and "Cicatrização." After an initial reading, followed by critical analysis with the application of established criteria, 50 references were selected. Development: Various plants are employed in phytotherapy, such as Aloe vera (aloe), Matricaria recutita (chamomile), Copaifera (copaiba), Punica granatum (pomegranate), Uncaria tomentosa (cat's claw), Malva sylvestris (mallow), Althaea officinalis (marshmallow), Myracrodruon urundeuva (Brazilian copaiba), Lippia sidoides (rosemary pepper), and Glycyrrhiza glabra (licorice). In Dentistry, research has shown satisfactory results for the treatment of oral cavity conditions, especially those with inflammatory and infectious characteristics, as well as accelerating healing. These findings suggest that phytotherapy is an effective, accessible treatment with minimal side effects. Final considerations: Based on the reviewed literature, phytotherapy appears to be a promising alternative in the treatment of oral conditions due to its notable healing, antimicrobial, and anti-inflammatory effects. However, more research with appropriate methodologies is necessary to establish safe and effective clinical protocols.

Limitations on the ethno-directed approach as a tool for the selection of medicinal plants with antimicrobial activity / Limitaciones en el uso del enfoque etnodirigido como herramienta para la selección de plantas antimicrobianas

In this work, we evaluate the antimicrobial properties of three groups of plants selected by the ethnopharmacological method, reported ashaving antimicrobial and/or anti-inflammatory properties by a rural community in the Brazilian State of Pernambuco. The samples were divided into groups of seven plants reported as having antimicrobial properties (GI), another seven as having anti-inflammatory properties (GII) and eight plants reported to have both (GIII). The antimicrobial properties of these groups were compared using the disc-diffusion method for nine microorganisms: Gram-positive and Gram-negative bacteria, acid-alcohol resistant bacillus (BAAR) and yeast. Among the samples of GI, 28.6% demonstrated activity against the micro-organisms tested, compared with 57.1% for the GII plants and 100% of GIII. This study shows, then, that the selected species should be looked more carefully that greater care should be taken in selecting species recommended by ethnopharmacological reports for studies of antimicrobial properties, since plants reported to have anti-inflammatory properties may be more active than those reported as being antimicrobial.

Evaluar la actividad antimicrobiana de tres grupos de plantas seleccionadas por el método etnodirigido, citadas como antimicrobianas y/o antiinflamatorias por una comunidad rural del estado de Pernambuco, Brasil. Las muestras de las especies seleccionadas fueron divididas en grupos de siete plantas citadas como antimicrobianas (GI), siete plantas citadas como antiinflamatorias (GII) y otro grupo con ocho plantas citadas para ambas situaciones (GIII). Se realizó una comparación de las actividades antimicrobianas de estos grupos mediante el método de difusión en disco frente a nueve microorganismos: Gram-positivos, Gram-negativos, bacilos ácido-alcohol resistentes (BAAR) y levadura. De las plantas citadas como antimicrobianas (GI), el 28,6% mostró actividad frente a los microorganismos probados, mientras que de las plantas pertenecientes al GII, el 57,1% presentó actividad y todas las plantas citadas para ambas situaciones (GIII) fueron activas en un 100%. Se necesita tener cuidado en la selección de especies provenientes del enfoque etnodirigido para estudios que buscan actividad antimicrobiana, ya que las plantas citadas como antiinflamatorias fueron más activas que las citadas como antimicrobianas.

Pretreatment with kuanxiong aerosol protects against coronary microvascular dysfunction / El pretratamiento con aerosol de kuanxiong protege contra la disfunción microvascular coronaria

This study investigates the efficacy and mechanisms of Kuanxiong Aerosol (KXA) on coronary microvascular dysfunction (CMD) in rats. Thirty-two Sprague-Dawley rats were divided into control, model, KXA, and nicorandil groups, receiving respective treatments for three weeks. The CMD model was established byinjecting lauric acid into the left ventricle. Compared to the model group, the KXA group showed significant reductions in serum CK-MB, LDH, cTnI, ET-1, TNF-α, IL-6, MDA, and ROS (p<0.01) and increased NO and SOD levels (p<0.01). KXA mitigated apoptosis and ameliorated CMD-associated pathological alterations. Pretreatment with KXA improves endothelial function and microvascular structure by counteracting inflammation, oxidative stress, and apoptosis, thereby improving CMD.

Este estudio investiga la eficacia y los mecanismos del Aerosol de Kuanxiong (KXA) sobre la disfunción microvascular coronaria (CMD) en ratas. Treinta y dos ratas Sprague-Dawley se dividieron en grupos de control, modelo, KXA y nicorandil, recibiendo los respectivos tratamientos durante tres semanas. El modelo de CMD se estableció inyectando ácido láurico en el ventrículo izquierdo. En comparación con el grupo modelo, el grupo KXA mostró reducciones significativas en los niveles séricos de CK-MB, LDH, cTnI, ET-1, TNF-α, IL-6, MDA y ROS (p<0.01) y un aumento en los niveles de NO y SOD (p<0.01). KXA mitigó la apoptosis y mejoró las alteraciones patológicas asociadas con la CMD. El pretratamiento con KXA mejora la función endotelial y la estructura microvascular al contrarrestar la inflamación, el estrés oxidativo y la apoptosis, mejorando así la CMD.

Propagación in vitrode Anredera vesicaria / In vitro propagation of Anredera vesicaria

Anredera vesicaria is a plant whit high anti-inflammatory activity. The work objective was to establish in vitro propagation of A. vesicaria. Nodal segments were used as explants and two disinfection times in 1% sodium hypochlorite (15 and 20 minutes) were evaluated during in vitro establishment. Combinations of AG3 (2,5 and 5,0 mg/L) and IAA (0,05 and 0,1 mg/L) were evaluated in the multiplication phase and the effect of IBA (0,5 and 1,0 mg /L) and Pectimorf (1,0 and 5,0 mg/L) for in vitro rooting. Acclimatization was carried out in a mixture of soil-cow manure-zeolite. Disinfection was achieved with 1% sodium hypochlorite for 15 minutes and in vitro establishment in the MS (1962) culture medium. High values of multiplication and rooting in vitro were obtained, as well as acclimatization of plants in vitro.

Anredera vesicaria es una planta con elevada actividad antiinflamatoria. El objetivo del trabajo fue establecer la propagación in vitro de A. vesicaria. Como explantes se utilizaron segmentos nodales y se evaluaron dos tiempos de desinfección en hipoclorito de sodio al 1% (15 y 20 minutos) durante el establecimiento in vitro. Se evaluaron combinaciones de AG3 (2,5 y 5,0 mg/L) y AIA (0,05 y 0,1 mg/L) en la fase de multiplicación y el efecto del AIB (0,5 y 1,0 mg/L) y el Pectimorf (1,0 y 5,0 mg/L) en el enraizamiento in vitro. La aclimatización se realizó en una mezcla de suelo-estiércol vacuno-zeolita. Se logró la desinfección con hipoclorito de sodio al 1% durante 15 minutos y el establecimiento in vitro en el medio de cultivo MS (1962). Se obtuvieron altos valores de multiplicación y enraizamiento in vitro, así como de aclimatización de plantas in vitro.

Croton stipulaceus Kunth, a native Mexican medicinal plant with antioxidant and anti-inflammatory activities / Croton stipulaceus Kunth, planta medicinal mexicana con actividad antioxidante y antiinflamatoria

Leaves of Croton stipulaceuswere extracted (EHex, ECHCl3and EEtOH extracts) to assesstheir antioxidant potential, anti-inflammatory activity in murine models and acute toxicity. EEtOH showed the highest effect in DPPH (37.80% inhibition), FRAP (1065.00 ± 55.30 µmolFe2+) and total polyphenols (231.24 ± 9.05 meq AG/gM). EHex was the most active, ~ 50% inhibition of TPA-induced ear edema; while EEtOH (dose of 2 mg/ear) showed the highest inhibition in the chronic model (97% inhibition), and inhibited MPO activity (48%). In carrageenan-induced edema, ECHCl3(dose 500 mg/kg) was the most active. None of the extracts showed acute toxicity (LD50) at 2 g/kg (p.o.). This work is the first report that supports the traditional use of C. stipulaceusas an anti-inflammatory.

De las hojas de Croton stipulaceusse obtuvieron diferentes extractos (EHex, ECHCl3y EEtOH) evaluando el potencial antioxidante y la actividad antiinflamatoria en modelos murinos y la toxicidad aguda. El EEtOH mostró mayor efecto en DPPH (37.80% inhibición), FRAP (1065.00 ± 55.30 µmolFe2+) y polifenolestotales (231.24 ± 9.05 meq AG/gM). El EHex fue el más activo, cercano al 50% de inhibición del edema auricular inducido con TPA; mientras que el EEtOH (dosis de 2 mg/oreja) mostró la mayor inhibición en el modelo crónico (97% inhibición), e inhibió la actividad de la MPO (48%). En el edema inducido con carragenina, el ECHCl3(dosis 500 mg/kg) fue el más activo. Ninguno de los extractos mostró una toxicidad aguda (DL50) mayor a 2 g/kg (p.o). Este trabajo es el primer reporte que sustenta el uso tradicional de C. stipulaceuscomo antiinflamatorio.

Protective effects of tigernut (Cyperus esculentus) on Bisphenol A- induced testicular toxicity in Wistar rats / Efectos protectores de la Chufa (Cyperus esculentus) sobre la toxicidad testicular inducida por bisfenol A en ratas Wistar

Bisphenol A (BPA) have been reported to induced reprotoxicity in rats. This study was conducted to find out the ameliorative properties of aqueous extract of Cyperus esculentus (tigernut) on BPA induced testicular toxicity in Wistar rats.Methods: Twenty male rats were divided randomly into 4 groups (n=5): group A: (Control); group B: Bisphenol A (BPA) (25 mg/kg b.w/day); group C: tigernut (200 mg/kg b.w); group D: (25 mg/kg of BPA+ 200 mg/kg of tigernut extract. 25 mg/kg of BPA was dissolved in 0.2 ml of olive oil as vehicle and administration was given by oral gavage for 4 weeks. The body weights were measured. Blood were collected for the testosterone (T) and luteinizing hormone (LH) assays; the epididymis were processed for sperm count, sperm motility, sperm viability and sperm abnormality test; while the testes were harvested for histologyResults: There was a significantly (p < 0.05) decreased in body weight; reduced (sperm count, motility, viability, serum testosterone and luteinizing hormone) in BPA compared with control group. These parameters however increased significantly (p < 0.05) in tigernut (200mg) and BPA + tigernut (200mg) compared with BPA. Also, histological examination showed widened interstitial spaces, some distorted seminiferous tubules, degeneration of basement membrane, scanty Leydig cells, fewer spermatozoa and vacuolation While BPA + tigernut (group D); showed improved testicular architecture (preserved interstitial spaces and interstitial cells. restoration of the loss of the basement membrane and closely packed seminiferous tubules with well-arranged germinal epithelium. Supplementation with tigernuts following BPA administration produces a reversal of the deleterious effect of BPA on the testis.

El bisfenol A (BPA) ha sido reportado por inducir reprotoxicidad en ratas. Este estudio se llevó a cabo para determinar las propiedades paliativas del extracto acuoso de Cyperus esculentus (chufa) sobre la toxicidad testicular inducida por BPA en ratas Wistar. Métodos: Veinte ratas macho fueron divididas aleatoriamente en 4 grupos (n=5): grupo A: (Control); grupo B: Bisfenol A (BPA) (25 mg/kg de peso corporal/día); grupo C: chufa (200 mg/kg de peso corporal); grupo D: (25 mg/kg de BPA + 200 mg/kg de extracto de chufa). Se disolvió 25 mg/kg de BPA en 0.2 ml de aceite de oliva como vehículo y se administró por gavaje oral durante 4 semanas. Se midieron los pesos corporales. Se recogió sangre para los ensayos de testosterona (T) y hormona luteinizante (LH); los epidídimos se procesaron para contar espermatozoides, motilidad espermática, viabilidad espermática y prueba de anormalidades espermáticas; mientras que los testículos se recolectaron para histología. Resultados: Hubo una disminución significativa (p < 0.05) en el peso corporal; reducción en el conteo de espermatozoides, motilidad, viabilidad, testosterona sérica y hormona luteinizante en el grupo BPA en comparación con el grupo control. Estos parámetros aumentaron significativamente (p < 0.05) en el grupo chufa (200 mg) y BPA + chufa (200 mg) en comparación con el BPA. Además, el examen histológico mostró espacios intersticiales ampliados, algunos túbulos seminíferos distorsionados, degeneración de la membrana basal, células de Leydig escasas, menos espermatozoides y vacuolización en el grupo BPA. En cambio, el grupo BPA + chufa mostró una mejora en la arquitectura testicular (preservación de los espacios intersticiales y células intersticiales, restauración de la membrana basal perdida y túbulos seminíferos cercanamente empaquetados con epitelio germinal bien organizado). Conclusión: La suplementación con chufas después de la administración de BPA produce una reversión del efecto perjudicial del BPA sobre el testículo.

Pharmacotherapeutic potential of Vitis vinifera(grape) in age-related neurological diseases / Potencial farmacoterapéutico de Vitis vinifera(uva) en enfermedades neurológicas asociadas a la edad

Age-related neurological disorders (ANDs), including neurodegenerative diseases, are complex illnesses with an increasing risk with advancing years. The central nervous system's neuropathological conditions, including oxidative stress, neuroinflammation, and protein misfolding, are what define ANDs. Due to the rise in age-dependent prevalence, efforts have been made to combat ANDs. Vitis viniferahas a long history of usageto treat a variety of illness symptoms. Because multiple ligand sites may be targeted, Vitis viniferacomponents can be employed to treat ANDs. This is demonstrated by the link between the structure and action of these compounds. This review demonstrates that Vitis viniferaand its constituents, including flavonoids, phenolic compounds, stilbenoidsandaromatic acids, are effective at reducing the neurological symptoms and pathological conditions of ANDs. This is done by acting as an antioxidant and anti-inflammatory. The active Vitis vinifera ingredients have therapeutic effects on ANDs, as this review explains.

Las enfermedades neurológicas asociadas a la edad (AND, por su sigla en inglés) incluyendo las enfermedades neurodegenerativas, son enfermedades complejas con un riesgo creciente con la edad. Las condiciones neuropatológicas del sistema nervioso central, que incluyen el estrés oxidativo, la neuro inflamación, y el plegado erróneo de proteínas, son lo que define las AND. Debido al aumento en la prevalencia dependiente de la edad, se han hecho esfuerzos para combatir las AND. Vitis vinifera tiene una larga historia de uso para el tratamiento de síntomas. Puesto que puede hacer objetivo a muchos sitios ligando, los componentes de Vitis viniferase pueden utilizar para tratar AND. Esto se demuestra por el vínculo entre la estructura y la acción de estos compuestos. Esta revisión demuestra que la Vitis viniferay sus constituyentes, incluídos los flavonoides, componentes fenólicos, estilbenoides, y ácidos aromáticos, son efectivos para reducir los síntomas neurológicos y las condiciones patológicas de AND. Esto se produce por su acción como antioxidante y antiinflamatorio. Los ingredientes activos de Vitis vinifera tienen efectos terapéuticos en AND, y esta revisión lo explica.

Disfunções respiratórias felinas: caracterizando e diferenciando a asma e bronquite felinas / Feline respiratory dysfunctions: characterizing and differentiating feline asthma and bronchitis / Disfunciones respiratorias felinas: caracterización y diferenciación del asma y bronquitis felinas

As doenças respiratórias são consideradas doenças graves e potencialmente deletérias. Dentre elas, a asma e a bronquite crônica caracterizam-se como disfunções respiratórias que ameaçam constantemente o bem-estar dos gatos. Os pacientes apresentam mudanças na estrutura respiratória, reversíveis ou não, devido ao extenso quadro inflamatório, que obstrui o fluxo de ar, permite o acúmulo de muco e reduz o lúmen das vias aéreas. Os gatos acometidos apresentam tosses, respiração ruidosa, dispneia, e, em muitos casos, assumem posição ortopneica. O diagnóstico pode ser obtido através de exames de rotina, uso de radiografias torácicas, coleta e análise de fluidos broncoalveolares, e testes alergênicos. O manejo terapêutico baseia-se, combinado ou não, no uso de drogas como broncodilatadores, antiinflamatórios esteroidais, mucolíticos, antibióticos, agentes inalatórios e mudanças ambientais com objetivo de redução da exposição aos possíveis agentes alergênicos responsáveis pela incitação do quadro respiratório.

Respiratory diseases are considered serious and potentially harmful diseases. Among them, asthma and chronic bronchitis are characterized as respiratory disorders that constantly threaten the well-being of cats. The patients present changes in the respiratory structure, reversible or not, due to the extensive inflammatory condition, which obstructs the air flow, allows the accumulation of mucus and reduces the lumen of the airways. Affected cats have coughs, wheezing, dyspnoea, and in many cases assume an orthopneic position. The diagnosis can be obtained through routine exams, use of chest x-rays, collection and analysis of bronchoalveolar fluids, and allergen testing. Therapeutic management is based, combined or not, on the use of drugs such as bronchodilators, steroidal anti-inflammatory, mucolytics, antibiotics, inhalational agents and environmental changes in order to reduce exposure to possible allergenic agents responsible for the incitation of the respiratory condition.

Las enfermedades respiratorias son consideradas enfermedades graves y potencialmente dañinas. Entre ellos, el asma y la bronquitis crónica se caracterizan por ser trastornos respiratorios que amenazan constantemente el bienestar de los gatos. Los pacientes presentan cambios en la estructura respiratoria, reversibles o no debido al cuadro inflamatorio extenso, que obstruye el flujo de aire, permite la acumulación de moco y reduce la luz de las vías respiratorias. Los gatos afectados presentan tos, respiración ruidosa, disnea y, en muchos casos, adoptan una posición ortopneica. El diagnóstico se puede obtener mediante exámenes de rutina, uso de radiografías de tórax, recolección y análisis de líquidos broncoalveolares, y pruebas de alérgenos. El manejo terapéutico se basa, combinado o no, en el uso de fármacos como broncodilatadores, antiinflamatorios esteroides, mucolíticos, antibióticos, agentes inhalatorios y cambios ambientales con el objetivo de reducir la exposición a posibles agentes alergénicos responsables de incitar la afección respiratoria.

Enfermedad de Caffey: reporte de un caso clínico / Caffey's disease: report of a clinical case / Doença de Caffey: relato de um caso clínico

Introducción: La enfermedad de Caffey es una patología ósea inflamatoria, rara, autolimitada, casi exclusiva de lactantes. Objetivos: Jerarquizar el abordaje diagnóstico de una patología poco frecuente. Caso clínico: 4 meses 22 días, varón, consulta por irritabilidad y edema de miembro inferior izquierdo de 4 días de evolución. Sin traumatismos ni fiebre. Examen físico: edema indurado en tercio medio e inferior de pierna izquierda, no rubor ni calor local. Dolor a la palpación de cara anterior y lateral de tibia y peroné. Limitación funcional, no resaltos óseos. Radiografía: engrosamiento del periostio en tibia y peroné a nivel diafisario. Hemograma: Glóbulos blancos 15.380 KU/L, Hemoglobina 10,8 g/dL, Plaquetas 816.400 10/ul, proteína C reactiva 13,90 mg/dl. Con planteo de probable infección osteoarticular se inicia clindamicina ( gentamicina e ingresa a cuidados moderados. Dada la persistencia de edema e irritabilidad, al quinto día se solicita resonancia magnética: hallazgos sugerentes de un probable proceso inflamatorio- infeccioso de partes blandas con compromiso óseo. Completa 14 días de clindamicina y 7 días de gentamicina intravenosa, hemocultivo negativo. Persiste con edema, irritabilidad y dolor. A los 21 días, se revalora la presentación clínica-imagenológica, se plantea enfermedad de Caffey. Se inicia anti-inflamatorio con buena evolución. Conclusiones: La enfermedad de Caffey es una colagenopatía rara, que afecta lactantes. El diagnóstico es clínico - radiológico (irritabilidad, tumefacción de partes blandas y alteraciones radiológicas). El pronóstico a largo plazo suele ser favorable. Es importante considerar el diagnóstico en lactantes que se presentan con esta sintomatología para evitar retrasos diagnósticos e instauración de tratamientos innecesarios.

Introduction: Caffey's disease is a rare disease that is reported almost exclusively in infants. Objective: Describe the case of a rare pathology, prioritizing the diagnostic approach. Clinical case: 4 month -old, healthy male. Consultation due to irritability and edema of the left lower limb for 4 days. No trauma or fever. Physical examination: indurated edema in the left leg, no redness or local heat. Pain on palpation of the anterior and lateral aspect of the tibia and fibula. Functional limitation, no bony protusions. Leg x-ray: thickening of the periosteum in the tibia and fibula at the diaphyseal level. Hemogram: White Blood Cells 15,380 KU/L Hemoglobin: 10.8 g/dL. Platelets: 816,400 10/ul, C-reactive protein: 13.90 mg/dl. He was admitted with a suggestion of probable osteoarticular infection. Clindamycin ( gentamicin is started. Given the persistence of edema and irritability despite treatment, on the fifth day an MRI was requested: findings suggestive of a probable inflammatory-infectious process of soft tissues with bone involvement. Completed 14 days of clindamycin and 7 days of intravenous gentamicin, blood culture negative. It persists with edema, irritability and pain. After 21 days, the clinical-imaging presentation was reassessed and Caffey's disease was considered. Anti-inflammatory begins with good evolution. Conclusions: Caffey's disease is a rare collagenopathy, that affects infants. The diagnosis is clinical - radiological (irritability, soft tissue swelling and radiological alterations). The long-term prognosis is usually favorable. It is important to consider the diagnosis in infants who present with these symptoms to avoid diagnostic delays and initiation of unnecessary treatments.

Introdução: A doença de Caffey é uma patologia óssea inflamatória rara, autolimitada, quase exclusiva de lactentes. Objetivos: Priorizar a abordagem diagnóstica de uma patologia rara. Caso clínico: 4 meses 22 dias, sexo masculino, consulta por irritabilidade e edema do membro inferior esquerdo de 4 dias de evolução. Sem trauma ou febre. Exame físico: edema endurecido em terço médio e inferior da perna esquerda, sem vermelhidão ou calor local. Dor à palpação das faces anterior e lateral da tíbia e fíbula. Limitação funcional, sem saliências ósseas. Radiografia: espessamento do periósteo na tíbia e fíbula ao nível diafisário. Hemograma: Glóbulos brancos 15.380 KU/L, Hemoglobina 10,8 g/dL, Plaquetas 816.400 10/ul, Proteína C reativa 13,90 mg/dl. Com sugestão de provável infecção osteoarticular, foi iniciada clindamicina + gentamicina e internado em cuidados moderados. Dada a persistência do edema e da irritabilidade, no quinto dia foi solicitada ressonância magnética: achados sugestivos de provável processo inflamatório-infeccioso de partes moles com envolvimento ósseo. Completou 14 dias de clindamicina e 7 dias de gentamicina intravenosa, hemocultura negativa. Persiste com edema, irritabilidade e dor. Após 21 dias, o quadro clínico-imagem foi reavaliado e considerada doença de Caffey. O antiinflamatório começa com uma boa evolução. Conclusões: A doença de Caffey é uma colagenopatia rara que afeta lactentes. O diagnóstico é clínico-radiológico (irritabilidade, edema de partes moles e alterações radiológicas). O prognóstico a longo prazo é geralmente favorável. É importante considerar o diagnóstico em lactentes que apresentam esses sintomas para evitar atrasos no diagnóstico e início de tratamentos desnecessários.

Aceite de rosa mosqueta (Rosa rubiginosa) disminuye marcadores inflamatorios en células hepáticas humanas HepG2 tratadas con lipopolisacárido / Rosa mosqueta (Rosa rubiginosa) oil decreases inflammatory markers in human liver cells HepG2 treated with lipopolysaccharide

La alteración de la microbiota intestinal es uno de los factores claves que afecta el inicio y la progresión de esteatosis hepática, al aumentar la permeabilidad intestinal e inducir un aumento circulante de la endotoxina lipopolisacárido (LPS). El LPS puede llegar al hígado a través de la vena porta, donde desencadena procesos inflamatorios y pro-oxidantes. Por otro lado, alimentos ricos en aceites esenciales podrían tener la capacidad de contrarrestar los efectos deletéreos del LPS a nivel hepático. El objetivo de este estudio fue evaluar el efecto del aceite de rosa mosqueta (ARM) en la prevención de procesos inflamatorios y oxidantes en hepatocitos humanos HepG2 tratados con LPS. Células HepG2 fueron expuestas a diferentes dosis de ARM (1,5, 3, 4,5, 6 y 7,5 µg/mL) por 24 horas y luego estimuladas con LPS (100 ng/mL) por 4 horas. Se evaluaron los niveles de expresión de citoquinas proinflamatorias (TNF-α, IL-6, IL-1ß, CCL2) y de la proteína antioxidante hemo oxigenasa 1 (HO-1), además de los niveles de activación de NF-κB. El tratamiento con 6 µg/mL de ARM resultó en un incremento en la viabilidad celular. El pretratamiento con ARM (1,5 - 4,5 µg/mL) fue efectivo para disminuir la expresión (TNF-α, IL-6 y CCL2) y secreción (TNF-α) de citoquinas proinflamatorias. Sin embargo, dosis altas de ARM incrementaron la activación de NF- κB y disminuyeron la expresión de HO-1 en células tratadas con LPS. Estos resultados sugieren un efecto antinflamatorio y un posible rol en el proceso antioxidante para dosis bajas de ARM en hepatocitos humanos frente al daño con LPS.

Rosa mosqueta (Rosa Rubiginosa) oil decreases inflammatory markers in human liver HepG2 cells treated with lipopolysaccharide. Gut microbiota alteration is one of the key factors affecting the onset and progression of hepatic steatosis by enhancing intestinal permeability and inducing an increase in circulating endotoxin lipopolysaccharide (LPS). LPS reaches the liver through the portal vein, where triggers inflammatory and pro-oxidant processes. On the other hand, essential oils-rich foods may have the capacity to abolish the deleterious effects of LPS in the liver. The objective of this study was to evaluate the effect of rosa mosqueta oil (ARM) in the prevention of inflammatory and oxidative processes in human hepatic cells HepG2 treated with LPS. HepG2 cells were exposed to different doses of ARM (1.5, 3, 4.5, 6 y 7.5 µg/mL) for 24 hours and then stimulated with LPS (100 ng/mL) for 4 hours. NF-κB activation, proinflammatory cytokines expression level (TNF-α, IL-6, IL-1ß, CCL2), and the antioxidant protein expression of hem oxygenase 1 (HO-1) were evaluated. Treatment with 6 µg/mL increased cellular viability. ARM pretreatment was effective in decreasing the expression (TNF-α, IL-6 y CCL2) and secretion (TNF-α) of proinflammatory cytokines. On the other hand, high doses of ARM increased NF-κB activation and decreased HO-1 expression in cells treated with LPS. These results may suggest an anti-inflammatory effect and a possible role in the antioxidant process in the case of the lower doses of ARM in human hepatic cells treated with LPS.

Can adalimumab prevent from acute effects of lipopolysaccharide induced renal injury in rats?

Purpose: Lipopolysaccharides is well-known in the acute renal injury process. It causes widespread activation of inflammatory cascades. Tumor necrosis factor (TNF)-α and interleukin (Il)-6 are essential proinflammatory cytokines that can induce the production of other cytokines in host response. Adalimumab suppresses TNF-α, IL-1ß, and IL-6. We aimed to evaluate whether adalimumab would prevent the toxicity of lipopolysaccharide on the rat renal tissue. Methods: Adult female Wistar rats were divided into four groups. To the control group, only intraperitoneal saline injection procedure was carried out. For adalimumab group, adalimumab was injected at a dose for two days. For lipopolysaccharide group, animals were injected with lipopolysaccharide (a dose). For lipopolysaccharide-adalimumab group, animals were given adalimumab treatment before the injection of lipopolysaccharide. Histopathological changes and immunohistochemical analysis for TNF-α and IL-6 were determined. Results: The pathological changes and immunohistochemical staining for TNF-α or IL-6 were similar for control and adalimumab groups (p > 0.05). The lipopolysaccharide group had significantly higher distorted features in the renal tissues (p < 0.001), and also significantly prominent immunohistochemical staining for TNF-α or IL-6 (0.003), compared to the control group. No severe pathological feature was detected in the lipopolysaccharide-adalimumab group, but moderate necrosis was found in all cases (p = 0.003). TNF-α staining and IL-6 staining in the lipopolysaccharide group was found to significantly prominent compared to lipopolysaccharide-adalimumab group (p = 0.013). Conclusions: Because of its anti-inflammatory property, adalimumab pretreatment may have protective effects on experimental kidney injury. Adalimumab could be considered as a protective agent to acute effects of lipopolysaccharide induced renal injury.

Improvement effect of compound Ento-PB on oxazolone-induced ulcerative colitis in rats

Purpose: To investigate the impact of the Chinese medicine compound Ento-PB on oxazolone (OXZ)-induced ulcerative colitis (UC) in rats. Methods: UC rats induced by OXZ were treated with Ento-PB. The damage to the colon was assessed using several measures, including the disease activity index (DAI), colon length, colon weight/length ratio, colonic mucosal damage index, and histological score. The levels of interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-13 (IL-13), epidermal growth factor (EGF), inducible nitric oxide synthase, and total nitric oxide synthase (tNOS) in rat serum, as well as the levels of tumor necrosis factor-α (TNF-α) and myeloperoxidase (MPO) in rat colon tissue, were determined using enzyme-linked immunosorbent assay and conventional kits. Results: After being treated with Ento-PB, the DAI score and macroscopic lesion score of OXZ-induced UC rats were significantly reduced. Ento-PB prevented the shortening of rat colons, reduced the ratio of colon weight to length, and improved colon tissue lesions. Meanwhile, Ento-PB could significantly inhibit the activities of proinflammatory cytokines TNF-α, IL-13, and MPO, as well as tNOS and iNOS, while upregulating the expression of anti-inflammatory cytokines IL-4 and IL-10. Moreover, a significant increase in the expression level of EGF was observed in UC rats treated with Ento-PB, indicating that Ento-PB could enhance the repair of damaged intestinal epithelial tissue. Conclusions: Ento-PB demonstrates significant anti-UC activities in OXZ-induced UC rats by regulating the expression levels of inflammatory factors and promoting the repair of colon tissue. This study provides scientific evidence to support the further development of Ento-PB.

Effects of Hibiscus sabdariffa supplementation on metabolism and bladder in obese rats

Purpose: Hibiscus sabdariffa (HS) extract has several health benefits and anti-obesogenic effects. The aim of the present study was to assess whether the medicinal properties attributable to HS would prevent or mitigate bladder changes induced by obesity in an experimental model. Methods: Forty-eight male Wistar rats were submitted to one of four different dietary interventions (12 animals each): G1, standard diet and water (controls); G2, standard diet and HS tea; G3, a palatable high-fat diet and water; and G4, high-fat diet diet and HS tea. The animals were monitored for body weight, feed, and water and tea intake, according to the allocated group. After 16 weeks, the animals were euthanized, and the levels of creatinine, inflammatory cytokines, testosterone, cholesterol, triglycerides, and electrolytes were evaluated. In addition, histopathological analysis of the animals' bladder was performed. Results: Groups receiving HS (G2 and G4) showed decreased levels of the pro-inflammatory cytokine interleukin-1α. HS tea was able to reduce low-density lipoprotein and triglyceride levels in the G2 group compared to other groups. Only in the G3 there was a significant increase in the body weight when it was compared the 12th and 16th weeks. Leptin was shown to be elevated in the groups that received a high-fat diet. There was a significant decrease in the muscle fibers thickness and in the total collagen count in G4 bladder when compared with G1 and G3. Conclusions: HS has an anti-inflammatory role, can reverse hyperlipidemia in rats, and reduced deleterious effects of obesity on these animals' bladder.

Single-Cell Mapping of Brain Myeloid Cell Subsets Reveals Key Transcriptomic Changes Favoring Neuroplasticity after Ischemic Stroke / 神经科学通报·英文版

Interactions between brain-resident and peripheral infiltrated immune cells are thought to contribute to neuroplasticity after cerebral ischemia. However, conventional bulk sequencing makes it challenging to depict this complex immune network. Using single-cell RNA sequencing, we mapped compositional and transcriptional features of peri-infarct immune cells. Microglia were the predominant cell type in the peri-infarct region, displaying a more diverse activation pattern than the typical pro- and anti-inflammatory state, with axon tract-associated microglia (ATMs) being associated with neuronal regeneration. Trajectory inference suggested that infiltrated monocyte-derived macrophages (MDMs) exhibited a gradual fate trajectory transition to activated MDMs. Inter-cellular crosstalk between MDMs and microglia orchestrated anti-inflammatory and repair-promoting microglia phenotypes and promoted post-stroke neurogenesis, with SOX2 and related Akt/CREB signaling as the underlying mechanisms. This description of the brain's immune landscape and its relationship with neurogenesis provides new insight into promoting neural repair by regulating neuroinflammatory responses.

A review of structural modification and biological activities of oleanolic acid / 中国天然药物

Oleanolic acid (OA), a pentacyclic triterpenoid, exhibits a broad spectrum of biological activities, including antitumor, antiviral, antibacterial, anti-inflammatory, hepatoprotective, hypoglycemic, and hypolipidemic effects. Since its initial isolation and identification, numerous studies have reported on the structural modifications and pharmacological activities of OA and its derivatives. Despite this, there has been a dearth of comprehensive reviews in the past two decades, leading to challenges in subsequent research on OA. Based on the main biological activities of OA, this paper comprehensively summarized the modification strategies and structure-activity relationships (SARs) of OA and its derivatives to provide valuable reference for future investigations into OA.

Phytochemical profile and antioxidant, antibacterial, anti-inflammatory and antisickle cell activities of Vigna radiata (L.) R. Wilczek cultivated in DR Congo

Plants, especially medicinal varieties, play a vital role in human health. This study aims to analyze the phytochemical properties and evaluate the antisickling activity of Vigna radiata, cultivated in the Democratic Republic of Congo. Results indicate the presence of various chemical compounds, including total polyphenols (239.84 ± 0.57 mg EQ/g), flavonoids (8.089 ± 0.046 mg EQ/g), anthocyanins (0.503 ± 0.003 mg/g), hydrolyzable tannins (0.084 ± 0.002%), and condensed tannins (0.041 ± 0.001%), along with a foam index of 150 for saponins. The mineral composition, determined through X-ray fluorescence, revealed significant levels of Ca, K, Mg, Fe, Cu, Zn, and Mn. Extraction of V. radiata seeds was performed with solvents of increasing polarity, and the aqueous extract displayed notable antioxidant activity at 25 µg/mL, with an 81.92% inhibition rate. Furthermore, the DCM extract demonstrated anti-inflammatory effects at 3 mg/mL, inhibiting egg albumin denaturation by 22.72%. The aqueous extract exhibited antibacterial effects, inhibiting Escherichia coli (18 mm) and Salmonella SPS (22 mm), with Staphylococcus aureus showing intermediate sensitivity (10 mm), whereas Citrobacter diversus showed full resistance. Antisickling activity was significant in the aqueous extract, with normalization rates of 90%, 75%, and 60% at concentrations of 5 mg/mL, 2.5 mg/mL, and 1.25 mg/mL, respectively.

Les plantes de manière générale, et médicinales en particulier jouent un rôle important dans la santé humaine. Ce travail a pour objectif l'étude phytochimique et évaluation de l'activité antidrépanocytaire de Vigna radiata cultivé en République Démocratique du Congo. Cette espèce a montré la présence des groupes chimiques tels que les polyphenols totaux (239,84 ± 0,57 mg EQ/g), flavonoïdes (8,089 ± 0,046 mg EQ/g), Anthocyanes (0,503 ± 0,003 mg/g), tanins hydrolysables et condensés (0,084 ± 0,002% et 0,041 ± 0,001%), Saponines (indice de mousse de 150), Alcaloïdes, Terpénoïdes, etc. le dosage des éléments minéraux par fluorescence X a révélé la présence de Ca, K, Mg, Fe, Cu, Zn, Mn, etc. L'extraction à polarité croissante a été effectuée sur la poudre des graines V. radiata. L'extrait aqueux a montré une forte activité antioxydante à 25µg/mL avec un taux d'inhibition de 81,923% ; l'extrait au DCM a montré une forte activité antiinflammatoire à 3 mg/mL avec un taux d'inhibition de dénaturation de l'albumine de l'œuf de 22,72% ; pour l'activité antibactérienne, deux souches se sont révélées sensibles à l'extrait aqueux, l'Escherichia Coli (18mm) par rapport à la ciprofloxacine et la salmonelle SPS (22 mm) par rapport à la levomicine, les germes de staphylococcus aureus ont présenté face à l'extrait aqueux une sensibilité intermédiaire (10mm) par rapport à la ciprofloxacine, Alors que les germes de Citrobactere diversis ont exhibé une totale résistance par rapport aux différents extraits ; l'activité antifalcémiante s'est révélée très bonne pour l'extrait aqueux avec 90%, 75% et 60% du taux de normalisation des globules rouges falciformes à des concentrations de 5 mg/mL, 2,5 mg/mL et 1,25 mg/mL respectivement

ORAL MANIFESTATIONS IN A BONE MARROWTRANSPLANTED ADOLESCENT WITH SYSTEMIC SCLEROSIS: A CASE REPORT

Objective: to report oral manifestations in a bone marrow-transplanted adolescent with systemic sclerosis. Case report: a 12-year-old female teenager was referred to a specialized dental care center for patients with special needs with a complaint of dental malocclusion. In the anamnesis, the caregiver reported diagnosis of systemic sclerosis at birth and hematopoietic stem cell transplantation to control the disease at 6 years of age. The patient chronically uses antihypertensive and anti-inflammatory drugs and reports xerostomia and dysphagia. Telangiectasias, facial atrophy, leukomelanoderma, acrosclerosis, and sclerodactyly were observed in the extraoral physical examination. Microstomy, inadequate lip sealing, extrinsic pigmentation on teeth 12, 11, 21 and 22, marked horizontal overjet (11mm) and drug-induced gingival hyperplasia were also observed. Oral hygiene was satisfactory, and the patient had no carious lesions. The patient was referred for orthodontic treatment and is under follow-up with bimonthly preventive dental appointments. Conclusion: systemic sclerosis, even when controlled, can be associated with microstomy, inadequate lip sealing, extrinsic tooth staining, marked horizontal overjet, drug-induced gingival hyperplasia, and xerostomia. Therefore, it requires the prevention and control of oral diseases in order to improve dental management and monitor the patient's oral condition.

Objetivo: relatar as manifestações orofaciais em uma adolescente transplantada de medula óssea com esclerose sistêmica. Relato do Caso: uma adolescente de 12 anos foi encaminhada para um centro de referência em atendimento odontológico a pacientes com necessidades especiais com queixa de maloclusão dentária. Na anamnese, a cuidadora relatou diagnóstico de esclerose sistêmica ao nascimento e transplante de medula óssea para controle da doença aos 6 anos de idade. Paciente faz uso crônico de anti-hipertensivos e anti-inflamatórios e refere xerostomia e disfagia. Telangiectasias, atrofia facial, leucomelanodermia, acroesclerose e esclerodactilia foram observadas no exame físico extraoral. Microstomia, ausência de selamento labial, pigmentação extrínseca nos dentes 12, 11, 21 e 22, trespasse horizontal acentuado (11mm) e aumento gengival induzido por medicamentos também foram observados. A higiene bucal era satisfatória e o paciente não apresentava lesões cariosas. A paciente foi encaminhada para tratamento ortodôntico e segue em acompanhamento, por meio de consultas odontológicas preventivas bimestrais. Conclusão: a esclerose sistêmica, mesmo quando controlada, pode estar associada a microstomia, selamento labial inadequado, manchas extrínsecas nos dentes, trepasse horizontal acentuado, aumento gengival induzido por medicamentos e xerostomia. Portanto, requer prevenção e controle das doenças bucais, a fim de melhorar o manejo odontológico e monitorar a condição bucal do paciente.

Atividade Anti-Inflamatória In Vivo do D-Limoneno em um Modelo de Hipertensão Pulmonar Induzida por Monocrotalina em Ratos: Implicações à Função Cardíaca / In Vivo Anti-Inflammatory Activity of D-Limonene in a Rat Model of Monocrotaline-Induced Pulmonary Hypertension: Implications to the Heart Function

Resumo Fundamento O D-Limoneno (D-L) é o principal monoterpeno monocíclico com propriedades anti-inflamatórias encontrado em plantas citrus. A Hipertensão pulmonar (HP) pode causar disfunção cardíaca direita e aumentar o risco de morte, em parte devido à resposta inflamatória no coração. Objetivo Avaliar o possível efeito protetor do D-L sobre a função cardíaca em um modelo de HP induzida por Monocrotalina (MCT) (HP-MCT) em ratos. Métodos Monitoramento eletrocardiográfico in vivo. A técnica de coloração tricromo de Masson foi empregada para verificar fibrose no coração. A função de contratilidade do tecido atrial foi estudada usando o banho de órgãos isolados. O PCR quantitativo em tempo real foi aplicado para quantificar inflamação no ventrículo direito. Resultados O grupo HP-MCT mostrou remodelamento estrutural e elétrico do coração, com a presença de fibrose no tecido cardíaco e alterações eletrocardiográficas in vivo. O tratamento com D-L preveniu em parte o desenvolvimento de fibrose tecidual e o aumento na duração da onda P no grupo HP-MCT. As velocidades de contração e de relaxamento do átrio direito e do átrio esquerdo isolado foram aceleradas nos animais CTR e HP-MCT tratados com D-L. Finalmente, o D-L foi capaz de prevenir a expressão anormal das citocinas inflamatórias chave, interleucina 1-β, interleucina 6 e fator de necrose tumoral α, no ventrículo direito dos animais do modelo HP-MCT. D-L foi capaz de aumentar a produção da citocina anti-inflamatória interleucina-10. Conclusão Nossos resultados mostraram que a administração in vivo de D-L preveniu em parte o remodelamento molecular, estrutural e funcional do coração no modelo HP-MCT com atenuação da reposta inflamatória no coração.

Abstract Background D-limonene (D-L) is the major monocyclic monoterpene in citrus plants with anti-inflammatory properties. Pulmonary hypertension (PH) can cause right heart dysfunction and increases the risk of death, partially due to inflammatory response in the heart. Objective To evaluate the possible protective effect of D-L on cardiac function in a rat model of monocrotaline-induced PH (MCT-PH). Methods Electrocardiogram was monitored in vivo. Masson Trichrome technique was deployed to verify fibrosis in the heart. Contractility function of isolated atrial tissue was studied using organ bath chamber. Real-time quantitative PCR was applied to quantify inflammation in the right ventricle. Results The MCT-PH group showed electrical and structural heart remodeling, with the presence of fibrosis in the cardiac tissue and in vivo electrocardiographic changes. Treatment with D-L partially prevented the development of tissue fibrosis and the increase in P wave duration in the MCT-PH group. The contraction and relaxation velocity of isolated right and left atrium were accelerated in CTR and MCT-PH animals treated with D-L. Finally, D-L was able to prevent the abnormal expression of the key inflammatory cytokines (interleukin 1-β, interleukin 6 and tumor necrosis factor-α) in the right ventricle of MCT-PH animals. D-L was able to enhance the production of the anti-inflammatory cytokine Interleukin-10. Conclusion Our results showed that in vivo administration of D-L partially prevented the molecular, structural and functional remodeling of the heart in the MCT-PH model with attenuation of the inflammatory response in the heart.

Bacterial nanocellulose/calcium alginate hydrogel for the treatment of burns

Purpose: Bacterial cellulose (BC) has shown high capacity for the treatment of wounds and burns, providing a moisty environment. Calcium alginate can be associated with BC to create gels that aid in wound debridement and contribute to appropriate wound healing. This study is aimed at characterizing and evaluating the use of bacterial cellulose/alginate gel in skin burns in rats. Methods: Cellulose and cellulose/alginate gels were compared regarding the capacity of liquid absorption, moisture, viscosity, and potential cytotoxicity. The 2nd degree burns were produced using an aluminum metal plate (2.0cm) at 120ºC for 20s on the back of rats. The animals were divided into non-treated, CMC(Carboxymethylcellulose), Cellulose(CMC with bacterial cellulose), and Cellulose/alginate(CMC with bacterial cellulose and alginate). The animals received topical treatment 3 times/week. Biochemical (MPO, NAG and oxidative stress), histomorphometry and immunohistochemical assays (IL-1ß IL-10 and VEGF) were conducted on the 14th, 21st, 28th, and 35th days. Results: Cellulose/Alginate gel showed higher absorption capacity and viscosity compared to Cellulose gel, with no cytotoxic effects. Cellulose/alginate presented lower MPO values, a higher percentage of IL-10, with greater and balanced oxidative stress profile. Conclusions: The use of cellulose/alginate gel reduced neutrophils and macrophage activation and showed greater anti-inflammatory response, which can contribute to healing chronic wounds and burns.

Hemosiderosis pulmonar secundaria a poliangeitis microscópica: a propósito de un caso / Pulmonary hemosiderosis secondary to microscopic polyangiitis: a clinical case study / Hemossiderose pulmonar secundária a poliangeíte microscópica: relato de caso

Introducción: la hemosiderosis pulmonar (HP) es una enfermedad crónica, rara, caracterizada por hemorragia alveolar y acumulación de hemosiderina en los macrófagos alveolares. Puede ocurrir como una enfermedad primitiva pulmonar o secundaria a vasculitis y enfermedades cardíacas. Objetivos: describir el abordaje diagnóstico y terapéutico de una niña con HP secundaria a poliangeitis microscópica. Caso clínico: 2 años, sexo femenino. Síndrome de Down (SD), comunicación auriculoventricular corregida. Bronquiolitis grave a los 22 meses, posteriormente sibilancias recurrentes. Un mes previo al ingreso, anemia severa de perfil ferropénico que requiere transfusión. Cuatro días previos instala síntomas respiratorios y fatiga progresiva en apirexia. Examen físico: reactiva, regular estado general, palidez cutánea no mucosa. Tirajes, sibilancias y subcrepitantes bilaterales. Soplo sistólico 2/6. Se realiza: oxigenoterapia, broncodilatadores y corticoides. Radiografía: infiltrado intersticial bilateral y difuso, sin cardiomegalia. Hemograma: anemia leve, microcítica, hipocrómica. Metabolismo del hierro confirma ferropenia. Orina: microhematuria transitoria. Función renal normal. Fibrobroncoscopía con lavado bronquioalveolar (LAB): macrófagos con gránulos amarronados sugestivos de hemosiderina. Estudios etiológicos, anticuerpos (Ac): antinucleares positivos (1/80), anticardiolipinas e inhibidor lúpico negativos. Ac antimembrana basal glomerular (MBG) negativo. Ac anticitoplasma de neutrófilo (ANCA) positivo patrón P-ANCA, Ac antimieloperoxidasa (MPO) positivos, Ac antiproteinasa 3 (PR3) negativo. Con planteo de poliangeitis microscópica se inicia metilprednisolona, luego corticoides orales e inmunosupresores. Mejoría clínica, sin recaídas, se suspende el oxígeno, no reitera microhematuria, continúa con micofenolato en seguimiento. Discusión: la anemia ferropénica severa con repercusión hemodinámica en un niño con SD orientó a HP. El LAB lo confirmó. La ausencia de afectación renal con microhematuria transitoria y Ac anti-MBG negativos alejó el síndrome de Goodpasture. Los Ac ANCA positivos con el patrón detectado orientaron a poliangeitis microscópica. El pronóstico es variable, siendo peor en casos con recaídas, corticodependencia o falta de recuperación completa. Se sugiere seguimiento individualizado, interdisciplinario, a largo plazo.

Introduction: pulmonary hemosiderosis (PH) is a rare, chronic disease characterized by alveolar hemorrhage and accumulation of hemosiderin in alveolar macrophages. It can occur as a primary lung disease or secondary to vasculitis and heart disease. Objectives: to describe the diagnostic and therapeutic approach used on a girl with PH secondary to microscopic polyangiitis. Clinical case: 2 years of age, female. Down syndrome (DS), corrected atrioventricular septal defect. Severe bronchiolitis at 22 months, later recurrent wheezing. One month prior to admission, severe iron deficiency anemia requiring transfusion. Four days prior, respiratory symptoms and progressive fatigue occur in apyrexia. Physical examination: reactive, fair general condition, non-mucosal skin pallor. Drawings, wheezing and bilateral subcrackles. Systolic murmur 2/6. We carried out oxygen therapy, bronchodilators and corticosteroids. Radiography: bilateral and diffuse interstitial infiltrate, without cardiomegaly. Hemogram: mild, microcytic, hypochromic anemia. Iron metabolism confirms iron deficiency. Urine: transient microhematuria. Normal kidney function. Fiberoptic bronchoscopy with bronchioalveolar lavage (LAB): macrophages with brownish granules suggestive of hemosiderin. Etiological studies: Antibodies (Ab): positive antinuclear (1/80), negative anticardiolipins and lupus inhibitor. Negative anti-glomerular basement membrane (GBM) Ab. Positive anti-neutrophil cytoplasmic Ab (ANCA), P-ANCA pattern, positive anti-myeloperoxidase Ab (MPO), negative anti-proteinase 3 Ab (PR3). After the presentation of microscopic polyangiitis, we started administering methylprednisolone, then oral corticosteroids and immunosuppressants. Clinical improvement, without relapses, oxygen was suspended, microhematuria did not recur, she continued receiving mycophenolate during follow-up. Discussion: severe iron deficiency anemia with hemodynamic repercussions in a child with DS led to HP. The LAB confirmed it. The absence of renal involvement with transient microhematuria and negative anti-GBM antibodies ruled out Goodpasture syndrome. Positive ANCA Abs with the detected pattern indicated microscopic polyangiitis. The prognosis is variable, usually worse in cases with relapses, corticosteroid dependence or lack of complete recovery. Individualized, interdisciplinary long-term follow-up is suggested.

Introdução: a hemossiderose pulmonar (HP) é uma doença crônica rara, caracterizada por hemorragia alveolar e acúmulo de hemossiderina nos macrófagos alveolares. Pode ocorrer como doença pulmonar primária ou secundária a vasculite e doenças cardíacas. Objetivos: descrever a abordagem diagnóstica e terapêutica de uma menina com HP secundária a poliangeíte microscópica. Caso clínico: 2 anos, sexo feminino. Síndrome de Down (SD), comunicação interatrioventricular corrigida. Bronquiolite grave aos 22 meses, posteriormente sibilância recorrente. Um mês antes da internação, anemia ferropriva grave necessitando de transfusão. Quatro dias antes, ocorrem sintomas respiratórios e fadiga progressiva na apirexia. Exame físico: reativo, estado geral razoável, palidez cutânea não mucosa. Desenhos, sibilos e subcrepitações bilaterais. Sopro sistólico 2/6. São realizados: oxigenoterapia, broncodilatadores e corticosteroides. Radiografia: infiltrado intersticial bilateral e difuso, sem cardiomegalia. Hemograma: anemia leve, microcítica e hipocrômica. O metabolismo do ferro confirma a deficiência de ferro. Urina: microhematúria transitória. Função renal normal. Broncoscopia com fibra ótica com lavagem bronquioalveolar (BAL): macrófagos com grânulos acastanhados sugestivos de hemossiderina. Estudos etiológicos: Anticorpos (Ab): antinuclear positivo (1/80), anticardiolipinas e inibidor lúpico negativos. Membrana basal anti-glomerular negativa (GBM) Ab. Ab citoplasmático antineutrófilo positivo (ANCA), padrão P-ANCA, Ab antimieloperoxidase positivo (MPO), Ab antiproteinase 3 negativo (PR3). Com apresentação de poliangeíte microscópica, inicia-se metilprednisolona, seguida de corticosteroides orais e imunossupressores. Melhora clínica, sem recidivas, suspensão de oxigênio, não houve recidiva de microhematúria, continuou com micofenolato para acompanhamento. Discussão: anemia ferropriva grave com repercussão hemodinâmica em criança com SD levou à PH. O LAB confirmou isso. A ausência de envolvimento renal com microhematúria transitória e anticorpos anti-GBM negativos descartaram a síndrome de Goodpasture. ANCA Abs positivo com o padrão detectado indicou poliangiite microscópica. O prognóstico é variável, sendo pior nos casos com recidivas, dependência de corticosteroides ou falta de recuperação completa. Sugere-se acompanhamento individualizado e interdisciplinar em longo prazo.