Enfermedad granulomatosa crónica: fisiopatología genética y molecular. Pruebas diagnósticas vigentes / Chronic granulomatous disease: genetic and molecular pathophysiology. Effective diagnostic tests

Introducción: La enfermedad granulomatosa crónica es una inmunodeficiencia primaria congénita del sistema inmune innato, originada por defectos en el complejo enzimático nicotinamida adenina dinucleótido fosfato oxidasa presente en células fagocíticas. Estos defectos funcionales causan incapacidad para producir especies reactivas del oxígeno en los fagocitos, que afectan la eliminación de algunos microorganismos patógenos dentro del fagolisosoma. El diagnóstico de esta enfermedad se realiza actualmente mediante la prueba de 1,2,3-dihidrorodamina asistida por citometría de flujo multiparamétrica, o la tinción de fagocitos con nitroazul de tetrazolio asistida por microscopio óptico. Objetivos: Describir los aspectos fisiopatológicos y moleculares de la enfermedad granulomatosa crónica; y discutir aspectos relacionados con las pruebas de diagnóstico antes mencionadas. Métodos: Se realizó una investigación bibliográfica-documental a partir de artículos científicos publicados desde 1933 hasta 2018, para ello fueron consultadas las bases de datos SciELO, PubMed y Springer. Desarrollo: Se exponen las características fisiopatológicas de la enfermedad granulomatosa crónica, así como la relación entre las mutaciones genéticas más abundantes en la población afectada y la gravedad de las manifestaciones clínicas que presentan los pacientes. Además, se analizan críticamente los beneficios y las deficiencias de dos técnicas que se utilizan actualmente para diagnosticar la enfermedad. Conclusiones: La enfermedad granulomatosa crónica puede generar consecuencias inmunológicas e inflamatorias graves, que se hallan en consonancia con las características genéticas expresadas en el complejo enzimático dañado. El diagnóstico de la enfermedad resulta más confiable, exhaustivo y específico, mediante la citometría de flujo y su prueba de 1,2,3-dihidrorodamina(AU)

Introduction: Chronic granulomatous disease is a congenital primary immunodeficiency of the innate immune system, caused by defects in the nicotinamide adenine dinucleotide phosphate oxidase enzyme complex present in phagocytic cells. These functional defects cause inability to produce reactive oxygen species in phagocytes, affecting the elimination of some pathogenic microorganisms within the phagolysosome. The diagnosis of this disease is currently made by means of the 1,2,3-dihydrorodamine test assisted by multiparametric flow cytometry, or the staining of phagocytes with nitro-blue tetrazolium assisted by light microscopy. Objectives: To characterize molecular and pathophysiologically the chronic granulomatous disease; and to discuss aspects related to the aforementioned diagnostic tests. Methods: In this work, a bibliographic-documentary research was carried out from scientific articles published from 1933 to 2018, for which the SciELO, PubMed and Springer databases were consulted. Development: The pathophysiological characteristics of chronic granulomatous disease are exposed, as well as the relationship between the most abundant genetic mutations in the affected population, and the severity of the clinical manifestations presented by the patients. In addition, the benefits and deficiencies of two techniques currently used to diagnose the disease are critically analyzed. Conclusions: Chronic granulomatous disease can generate severe immunological and inflammatory consequences, which are in line with the genetic characteristics expressed in the damaged enzyme complex. The diagnosis of the disease is more reliable, exhaustive and specific, using flow cytometry and its 1,2,3-dihydrorodamine test(AU)

Coronary Microembolization with Normal Epicardial Coronary Arteries and No Visible Infarcts on Nitrobluetetrazolium Chloride-Stained Specimens: Evaluation with Cardiac Magnetic Resonance Imaging in a Swine Model

OBJECTIVE: To assess magnetic resonance imaging (MRI) features of coronary microembolization in a swine model induced by small-sized microemboli, which may cause microinfarcts invisible to the naked eye. MATERIALS AND METHODS: Eleven pigs underwent intracoronary injection of small-sized microspheres (42 microm) and catheter coronary angiography was obtained before and after microembolization. Cardiac MRI and measurement of cardiac troponin T (cTnT) were performed at baseline, 6 hours, and 1 week after microembolization. Postmortem evaluation was performed after completion of the imaging studies. RESULTS: Coronary angiography pre- and post-microembolization revealed normal epicardial coronary arteries. Systolic wall thickening of the microembolized regions decreased significantly from 42.6 +/- 2.0% at baseline to 20.3 +/- 2.3% at 6 hours and 31.5 +/- 2.1% at 1 week after coronary microembolization (p < 0.001 for both). First-pass perfusion defect was visualized at 6 hours but the extent was largely decreased at 1 week. Delayed contrast enhancement MRI (DE-MRI) demonstrated hyperenhancement within the target area at 6 hours but not at 1 week. The microinfarcts on gross specimen stained with nitrobluetetrazolium chloride were invisible to the naked eye and only detectable microscopically. Increased cTnT was observed at 6 hours and 1 week after microembolization. CONCLUSION: Coronary microembolization induced by a certain load of small-sized microemboli may result in microinfarcts invisible to the naked eye with normal epicardial coronary arteries. MRI features of myocardial impairment secondary to such microembolization include the decline in left ventricular function and myocardial perfusion at cine and first-pass perfusion imaging, and transient hyperenhancement at DE-MRI.

Comparação entre duas metodologias para a realização do teste de redução do tetrazólio nitroazul (NBT) em caprinos / Comparison among two methodologys at realization nitroblue tetrazolium reduction test (NBT) in caprines

O teste de redução do tetrazólio nitroazul (NBT) é um dos métodos mais utilizados para a avaliação do metabolismo oxidativo dos neutrófilos. Porém, o custo por amostra e o tempo de utilização do corante são desvantagens do método. O objetivo deste trabalho foi comparar duas metodologias para realização do teste do NBT a fim de maximizar a sua utilização e diminuir o custo por amostra processada. Foram utilizadas 10 cabras, adultas clinicamente sadias e colhidas amostras de sangue por meio de venipunção jugular em tubos de 10mL sendo retirada uma alíquota de 500µL em tubo "eppendorff" contendo 2µL de heparina. Através desta alíquota foram realizadas três metodologias para o teste do NBT: A) técnica original Park & Good (1970); B) redução de 50% do volume do corante; C) redução de 50% e armazenamento do corante a -20°C por 180 dias. Foram confeccionados e corados esfregaços sanguíneos (May Grünwald-Giemsa) das amostras com as metodologias propostas e realizada contagem de 100 neutrófilos em microscopia óptica para determinar o percentual de neutrófilos reativos ao NBT. A análise estatística pelo método de Análise de Medidas Repetida (ANOVA) demonstrou diferenças significativas (P<0,05) entre os dois métodos e o original (A=14,4±4,6; B=1,9±1,4; C=1,1±0,9), porém apresentou alta correlação pelo teste de Spearman entre os métodos (rs=0,82 (AxB), rs=0,75 (BxC) e rs=0,93 (AxC)). Conclui-se que o teste de Redução do Tetrazólio Nitroazul (NBT) segundo a metodologia descrita por Park & Good (1970) e a redução do corante em 50% do seu volume e a sua redução associada ao congelamento por 180 dias a -20ºC podem ser realizadas em caprinos, porém os valores devem ser comparados com as respectivas metodologias utilizadas.(AU)

The nitroblue tetrazolium reduction test (NBT) is one of the most used methods to evaluate the oxidative metabolism of neutrophils. However, the cost for each sample and dye's life-time are disadvantages of the method. This paper aim was to compare two NBT test methodologies in order to maximize its use and decrease the cost for each sample. It was made using 10 adult and healthy goats and blood samples were taken through venipuncion in jugular vein, using 10mL tubes, and then a 500µL sample was taken in eppendoff tubes with 2µL of heparin. Using this sample were made three methodologies for the NBT test: A) Park & Good (1970) original technique; B) dye reduction in 50% of the volume; C) 50% reduction and dye storage at -20°C for 180 days. It was made and dyed the blood smear (May Grünwald-Giemsa) from the samples, using the proposed methodologies and then made the counting of 100 neutrophils in optic microscopy, to determinate the percentage of NBT reactive neutrophils. The statistic analysis by the method of Repeated Measuring Analysis (ANOVA) evinced significant differences (P<0,05) between the two methods and the original (A=14.4±4.6; B=1.9±1.4; C=1.1±0.9), however it showed high correlation by the Spearman test between the methods (rs=0,82 (AxB), rs=0,75 (BxC) e rs=0.93 (AxC)). It was concluded that the original Park & Good (1970) method and two methodologies for dye reduction in 50% and it's reduction associated with NBT dye freezing for 180 days can be used in caprines, but the values should be compared with their respective methodologies.(AU)

Leucograma e metabolismo oxidativo de neutrófilos em cabras da raça Saanen nos períodos de gestação, parto e pós-parto / Leukocyte count and neutrophil oxidative burst in Saanen goats in the pregnancy, parturition and postpartum periods

O presente estudo teve como objetivo a avaliação do leucograma e do metabolismo oxidativo de neutrófilos em fêmeas caprinas da raça Saanen, nos períodos de gestação, parto e pós-parto. Amostras de sangue foram colhidas de 20 fêmeas nulíparas da raça Saanen, clinicamente sadias por venipunção jugular aos 49 (M1), 42 (M2), 35 (M3), 28 (M4), 21 (M5), 14 (M6), sete (M7), três (M8) dias antes do parto, no dia do parto (M9), três (M10) e sete (M11) dias após o parto, para a realização do leucograma e dosagens séricas de cortisol, estradiol e progesterona. A partir de 28 dias (M4) antes do parto até sete dias do pós-parto (M11) foram colhidas amostras de sangue para a avaliação do metabolismo oxidativo de neutrófilos por meio do teste de redução do tetrazólio nitroazul (NBT). Os resultados demonstraram que no dia do parto houve aumento nas concentrações séricas de cortisol e estradiol, e diminuição da progesterona, leucocitose por neutrofilia e desvio à esquerda leve, diminuição dos linfócitos, aumento da relação neutrófilo:linfócito, eosinopenia, monocitose e basofilia. No sétimo dia do pós-parto houve leucocitose por neutrofilia e aumento da relação neutrófilo:linfócito. Não houve nos períodos de gestação, parto e pós-parto alterações significativas no metabolismo oxidativo dos neutrófilos. Conclui-se que o parto determina elevação da concentração sérica de cortisol e estradiol, e diminuição da progesterona determinando quadro de leucocitose por neutrofilia e desvio à esquerda leve, com diminuição dos linfócitos, aumento da relação neutróflo:linfócito, eosinopenia, monocitose e basofilia. Ao sétimo dia do pós-parto há leucocitose por neutrofilia, aumento da relação neutrófilo:linfócito e do fibrinogênio. A gestação, o parto e o período do pós-parto não alteram o metabolismo oxidativo de neutrófilos avaliado por meio do teste de redução do NBT.

The purpose of this study was to evaluate the leukocyte count and the oxidative metabolism of neutrophil in Saanen goats during periods of pregnancy, parturition and postpartum. Were used 20 Saanen goats, clinically healthy and serologically negative for caprine arthritis encephalitis virus (CAEV). Blood samples were collected by jugular venipuncture 49 (M1), 42 (M2), 35 (M3), 28 (M4), 21 (M5), 14 (M6), seven (M7), three (M8) days before the parturition, on the day of birth (M9), three (M10) and seven (M11) days postpartum, for the leukocyte count, and serum for cortisol, estradiol and progesterone determination. From 28 days (M4) before parturition until seven days postpartum (M11) blood samples were collected for evaluation of oxidative metabolism of neutrophils by the nitroblue tetrazolium reduction test (NBT). The results showed that at parturition day there were an increase in cortisol and estradiol levels and a decrease in progesterone serum, neutrophilic leukocytosis and left shift slight, decrease of lymphocytes, increase in the neutrophil: lymphocyte, eosinopenia, monocytosis and basophilia. There was a neutrophilic leukocytosis and an increase in the neutrophil: lymphocyte on the seventh day postpartum. There were not significant alterations in oxidative metabolism of neutrophils during pregnancy, parturition and postpartum. It was concluded that parturition causes an elevation in cortisol and estradiol levels and a decrease in progesterone serum determining a neutrophilic leukocytosis and left shift slight, with a reduction of lymphocytes, increase in the neutrophil:lymphocyte, eosinopenia, monocytosis and basophilia. Neutrophilic leukocytosis, increase in the neutrophil: lymphocyte and fibrinogen are detected on the seventh day postpartum. Pregnancy, parturition and the postpartum do not change the oxidative metabolism of neutrophils evaluated by NBT reduction test.

Serum zinc and neutrophil function in lower, middle and upper socioeconomic groups

To assess the serum zinc and neutrophil function levels in different socioeconomic groups. A total of 100 healthy subjects of 10-30 years of age, both male and female were investigated. Out of these, 50 [25 males and 25 females] belonged to the lower socioeconomic [LSEC] group and 50 [25 males and 25 females] belonged to the upper / upper middle socioeconomic [USEC] group. Serum zinc was determined by colorimetric method and neutrophil function was estimated by the Nitroblue Tetrazolium reduction test [NBT]. Both the parameters were compared in the two socioeconomic [SEC] groups. It was found that serum zinc was significantly lower in the LSEC group. Similarly NBT percentage phagocytosis was also significantly lower in the LSEC group as compared to the USEC group. NBT percentage phagocytosis did not show significant gender difference in the LSEC group, however it was significantly higher in females than in males in the USEC group. Generally a significant positive correlation was found between serum zinc and neutrophil phagocytic function. The LSEC class has low serum zinc levels and low NBT percentage phagocytosis and hence is at greater risk of developing infections.

Src Family Kinase Inhibitor PP2 Has Different Effects on All-Trans-Retinoic Acid or Arsenic Trioxide-Induced Differentiation of an Acute Promyelocytic Leukemia Cell Line / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Leukemic promyelocytes have the unique ability to undergo differentiation after exposure to retinoic acid and both differentiation and apoptosis after exposure to arsenic trioxide (ATO). Recent studies have shown that inhibition of Src family kinases (SFKs) resulted in enhancement of retinoic acid-induced myeloid differentiation. MATERIALS AND METHODS: In this study, we investigated the question of whether the SFK inhibitor PP2 enhanced the differentiation of NB4 cells when combined with ATO as well as when combined with all-trans-retinoic acid (ATRA). In addition, we attempted to determine the difference in retinoic acid-induced gene expression between cells treated with PP2 in combination with ATRA and in combination with ATO. RESULTS: SFK inhibitor PP2 induced significant enhancement of ATRA- or ATO-induced differentiation of NB4 cells. A significantly stronger synergistic effect was observed when PP2 was combined with ATRA than when combined with ATO. Flow cytometric analysis demonstrated a significant increase in CD11b-positive granulocytes up to 60.73% and 31.58%, respectively. These results were confirmed by nitroblue tetrazolium staining. These effects were not related to apoptosis. Results of Annexin-V-fluorescein staining revealed that PP2 combined with ATRA or PP2 combined with ATO did not induce apoptosis in NB4 cells. Retinoic acid-induced gene expression was different in both groups. Intercellular adhesion molecule-1 expression showed a significant increase in cells treated with PP2 in combination with ATRA, whereas cathepsin D expression showed a significant increase in cells treated with PP2 in combination with ATO. CONCLUSION: Our data showed that SFK inhibitor PP2 enhanced acute promyelocytic leukemia cell differentiation when combined with either ATRA or ATO with difference in activation of retinoic acid-induced genes.

Leukocytes respiratory burst and lysozyme level in pacu (Piaractus mesopotamicus Holmberg, 1887) / Atividade respiratória de leucócitos e nível de lisozima em pacu (Piaractus mesopotamicus)

Innate immune responses are useful to determine the health status of fish and to evaluate the effect of immunomodulatory substances in fish farming. Leukocytes respiratory burst was measured in pacu (Piaractus mesopotamicus) using chemiluminescence assay and nitroblue tetrazolium (NBT) reduction assay. The nitroblue tetrazolium reduction seemed more adequate than chemiluminescence assay for leukocytes oxidative burst determination, since it was difficult to isolate the blood leucocytes for chemiluminescence assay. Plasma and serum lysozyme were measured using a turbidimetric assay. The heating of serum and plasma samples (56 ºC for 30 minutes) for complement system inactivation darkened the plasma samples and interfered in the results. The lysozyme activity in serum was higher than in plasma, suggesting that serum samples are more appropriate for the analysis. This study established protocols that can be useful tools in the study of immune mechanisms of the tropical fish pacu.

Respostas imunológicas inatas são úteis para determinar o estado de saúde de peixes e avaliar o efeito de substâncias imunomoduladoras no cultivo destes animais. A atividade respiratória de leucócitos foi medida em pacu (Piaractus mesopotamicus) através de ensaio de quimioluminescência e ensaio de redução do nitroblue tetrazolium (NBT). O ensaio de redução do nitroblue tetrazolium pareceu mais adequado que o ensaio de quimioluminescência para determinação da atividade respiratória de leucócitos, uma vez que foi difícil isolar com êxito os leucócitos do sangue para o ensaio de quimioluminescência. Lisozima sérica e plasmática foram medidas por meio de ensaio turbidimétrico. Com o objetivo de inativar as proteínas do sistema complemento, as amostras de soro e plasma foram aquecidas (56 ºC por 30 minutos). Porém, este procedimento provocou a turvação das amostras de plasma e interferiu nos resultados. A atividade de lisozima no soro foi maior que no plasma, sugerindo que amostras de soro são mais apropriadas para esta análise. Este estudo estabeleceu protocolos que podem ser utilizados como ferramentas no estudo de mecanismos imunológicos do peixe tropical pacu.

Metabolismo oxidativo dos neutrófilos de bezerros das raças Nelore e Limousin nos primeiros quatro meses de vida / Neutrophil oxidative burst in Nelore and Limousin calves in the first four months of life

To study some defence mechanisms of beef calves kept on range conditions, 90 healthy calves, 45 Nelore and 45 Limousin, were bled at 24 to 36 hours of life, 15, 30, 60, 90 and, 120 days. Leukogram and neutrophil oxidative burst through the non-stimulated and the stimulated NBT tests were determined. The parasitemia with Anaplasma marginale, Babesia bigemina and B. bovis was investigated. Repeated measure ANOVA was used to analyse the age effect on leukocyte counts. Variation of positive neutrophil throughout the age was analysed through Krushkal-Wallis test. Comparisons among breeds were done using the Mann-Whithney test. The white blood cell count increased with age in both breeds, with a decrease in neutrophil and an increase in lymphocyte counts. The neutrophil lymphocyte ratio had been inverted before 15 days of life. The neutrophil oxidative burst was less effective in the newborn calves increasing with age. Limousin calves' neutrophils had higher capacity to reduce NBT in advanced ages. The observed differences between taurine and Zebu calves had no effects on calves' health and could be atributed to Anaplasma marginale natural and asynptomatic infection.

Com o objetivo de investigar alguns mecanismos de defesa em bezerros de raças de corte criadas a campo, foram utilizados 90 animais recém-nascidos aparentemente sadios, 45 da raça Nelore e 45 da raça Limousin. Amostras de sangue foram colhidas de cada bezerro entre 24 e 36 horas de vida e aos 15, 30, 60, 90 e 120 dias. Determinaram-se o leucograma e o metabolismo oxidativo dos neutrófilos por meio do teste da redução do tetrazólio de nitroazul (NBT), provas não estimulada (NBT-NE) e estimulada (NBT-E). Investigou-se a taxa de parasitemia determinada por Anaplasma marginale, Babesia bigemina e B. bovis. Utilizou-se a análise de variância de medidas repetidas para estudar o comportamento das variáveis hematológicas com o avançar da idade. O teste de Krushkal-Wallis foi empregado para caracterizar a variação da porcentagem de neutrófilos reativos relacionada à idade. Comparações entre as raças foram realizadas em cada idade por meio do teste de Mann-Whithney. A contagem total de leucócitos aumentou com a idade nas duas raças estudadas. Observou-se diminuição do número de neutrófilos e aumento do de linfócitos, ocorrendo sua inversão antes dos 15 dias de idade. A capacidade oxidativa dos neutrófilos foi menor nos bezerros recém-nascidos e aumentou com o avançar da idade. Os neutrófilos dos bezerros Limousin apresentaram maior capacidade de redução do NBT do que os dos bezerros Nelore, notadamente após o segundo mês de vida. Essa diferença não provocou reflexos sobre a saúde dos animais e pode ser resultado da infecção natural e assintomática com o Anaplasma marginale.

Korean Mistletoe (Viscum album Coloratum) Extract Induces Eel (Anguilla japonica) Non-specific Immunity

BACKGROUND: The immunomodulatory effects of Korean mistletoe (Viscum album Coloratum) on the innate immune responses of eel (Anguilla japonica) were studied. METHODS: Mistletoe, Freund's complete adjuvant (FCA), or phosphate-buffered saline (PBS) as a control was injected into eel peritoneal cavities. RESULTS: Nitroblue tetrazolium (NBT)-positive cells in the head kidney of eel were significantly augmented by the second day post-injection of mistletoe. Reactive oxygen intermediates (ROI) were more produced in mistletoe-injected fish kidney leucocytes than in FCA-injected ones. The level of lysozyme activity in the serum of fish 2 days after injection with mistletoe was also significantly higher than that in the serum of the control fish. The optimal concentration of mistletoe in inducing the highest serum lysozyme activity was revealed to 500microgram/200 g of fish. In phagocytic activity assay, mistletoe-sensitized eel kidney phagocytes captured more zymosan than did the control fish. CONCLUSION: Korean mistletoe appeared to be a good activator of the non-specific immune responses of eel.

Invasive pulmonary aspergillosis in infancy: a rare presentation of chronic granulomatous disease

We report a rare case of chronic granulomatous disease in a three-month-old female infant who presented with a chest mass, and was found to have invasive pulmonary aspergillosis and rib osteomyelitis, which was confirmed by culture and histopathology. The diagnosis of chronic granulomatous disease in this patient was made by the Nitroblue Tetrazolium test. The patient was successfully treated with surgery and antifungal agents

Carrier screening and prenatal detection of chronic granulomatous disease in Iran

To develop an application that is simple and reliable using the nitroblue tetrazolium [NBT] method that clearly differentiates chronic granulomatous disease [CGD] patients with heterozygous carriers in groups suspected with CGD. This study was carried out in Shiraz University of Medical Sciences from October 2002 and March 2004. The study included 260 samples consisting of 123 children [2-24 months] and 106 neonates [<2 months], either suspected with bacterial infection or are immunodeficient, and 31 cord blood samples. Fifty healthy adult individuals were also diagnosed as normal control. Neutrophil reduction of NBT can be stimulated in vitro by protein kinase agonists such as phorbol myristate acetate [PMA], resulting to superoxide anion release. The PMA is an exceptionally powerful stimulant and when we used it in conjunction with adherence of glass slides, it causes transformation of nearly 100% of all normal neutrophils, and reduces NBT to formazan deposits. Of 260 blood samples, 12 unrelated CGD patients and 16 carriers of X-linked or autosomal recessive CGD patients were diagnosed. The carriers had a range of 15-75% stimulated neutrophils. We have established a PMA-stimulated NBT test for the detection of CGD patients, which clearly differentiate the CGD patients from heterozygote carriers. The results in the cord fetal blood samples indicate that this test may be used for antenatal diagnosis of affected boys, carrier females and autosomal recessive variants of CGD. The technique is simple, fast, inexpensive, and requires only a few microliters of blood

Antioxidant activity of extract from Polygonum aviculare L

Free radicals induce numerous diseases by lipid peroxidation, protein peroxidation, and DNA damage. It has been reported that numerous plant extracts have antioxidant activities to scavenge free radicals. Whether Polygonum aviculare L. (Polygonaceae) has antioxidant activity is unknown. In this study, dried Polygonum aviculare L. was extracted by ethanol, and the extract was lyophilized. The antioxidant activities of extract powder were examined by free radical scavenging assays, superoxide radical scavenging assays, lipid peroxidation assays and hydroxyl radical-induced DNA strand scission assays. The results show that the IC50 value of Polygonum aviculare L. extract is 50 µg/ml in free radical scavenging assays, 0.8 µg/ml in superoxide radical scavenging assays, and 15 µg/ml in lipid peroxidation assays, respectively. Furthermore, Polygonum aviculare L. extract has DNA protective effect in hydroxyl radical-induced DNA strand scission assays. The total phenolics and flavonoid content of extract is 677.4 ± 62.7 µg/g and 112.7 ± 13 µg/g. The results indicate that Polygonum aviculare L. extract clearly has antioxidant effects.

Spontaneous neutrophil activation in HTLV-1 infected patients

Human T cell lymphotropic Virus type-1 (HTLV-1) induces lymphocyte activation and proliferation, but little is known about the innate immune response due to HTLV-1 infection. We evaluated the percentage of neutrophils that metabolize Nitroblue tetrazolium (NBT) to formazan in HTLV-1 infected subjects and the association between neutrophil activation and IFN-gamma and TNF-alpha levels. Blood was collected from 35 HTLV-1 carriers, from 8 patients with HAM/TSP (HTLV-1- associated myelopathy); 22 healthy individuals were evaluated for spontaneous and lipopolysaccharide (LPS)-stimulated neutrophil activity (reduction of NBT to formazan). The production of IFN-gamma and TNF-alpha by unstimulated mononuclear cells was determined by ELISA. Spontaneous NBT levels, as well as spontaneous IFN-gamma and TNF-alpha production, were significantly higher (p<0.001) in HTLV-1 infected subjects than in healthy individuals. A trend towards a positive correlation was noted, with increasing percentage of NBT positive neutrophils and levels of IFN-gamma. The high IFN-gamma producing HTLV-1 patient group had significantly greater NBT than healthy controls, 43±24 percent and 17±4.8 percent respectively (p< 0.001), while no significant difference was observed between healthy controls and the low IFN-gamma-producing HTLV-1 patient group (30±20 percent). Spontaneous neutrophil activation is another marker of immune perturbation resulting from HTLV-1 infection. In vivo activation of neutrophils observed in HTLV-1 infected subjects is likely to be the same process that causes spontaneous IFN-gamma production, or it may partially result from direct IFN-gamma stimulation.

Mechanism, measurement, and prevention of oxidative stress in male reproductive physiology.

Numerous factors influence male fertility. Among these factors is oxidative stress (OS), which has elicited an enormous interest in researchers in recent period. Reactive oxygen species (ROS) are continuously produced by various metabolic and physiologic processes. OS occurs when the delicate balance between the production of ROS and the inherent antioxidant capacity of the organism is distorted. Spermatozoa are particularly sensitive to ROS as their plasma membrane contains polyunsaturated fatty acids (PUFA), which oxidizes easily. They also lack cytoplasm to generate a robust preventive and repair mechanism against ROS. The transition metal ions that are found in the body have a catalytic effect in the generation of ROS. Lifestyle behaviours such as smoking and alcohol use and environmental pollution further enhance the generation of ROS and thus, cause destructive effects on various cellular organelles like mitochondria, sperm DNA etc. This article analyzes the detrimental effects of OS on male fertility, measurement of OS and effective ways to decrease or eliminate them completely. We have also provided information on oxidative stress in other systems of the body, which may be applied to future research in the field of reproductive biology.

Chronic granulomatous disease.

A 2(1/2)-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease.

Presence of free radicals in spinal cord injury: experimental evidence in rats / Presença de radicais livres em lesão medular: evidência experimental em ratos

Um total de 24 ratos da raça Wistar pesando 230 a 350g foram submetidos a uma compressão medular experimental e a liberação de radicais livres resultante foi detectada por um reagente óptico (nitro azul de tetrazolio). Os animais foram separados em 3 grupos de oito. No primeiro grupo foi realizada uma laminectomia e a medula examinada. Nos grupos II e III um clipe de aneurisma foi introduzido para comprimir a medula por 1 minuto e depois foi administrado o reagente óptico no espaço subpial. O material foi investigado pelo microscópio de luz e de transmissão. O grupo III revelou a ação dos radicais livres sobre a biomembrana em virtude da presença de restos membranosos eletrontranslucentes e cristas mitocondriais rompidas dentre outros achados.O íon superóxido foi considerado o radical livre mais freqüente na compressão medular murina pela maioria dos autores na revisão da literatura. O nitro azul de tetrazolio não é específico para este radical livre mas a maioria dos que chegaram a essa conclusão usaram-no. O conceito de síndrome de reperfusão é impreciso e segundo os diversos autores deve ser substituído por síndrome de anóxia-reoxigenação

Leucocyte migration and nitroblue tetrazolium assay in Nigerian children with bacteremia and malaria parasitemia.

The prevalence of malaria parasitemia, bacteremia, certain hematological parameters, leucocyte migration index and nitroblue tetrazolium dye reduction were determined in 147 Nigerian children (4.24+/-2.88 years of age). Sixty (40.8%), 28(19.1%) and 26(17.7%) had malaria parasitemia only, bacteremia only and both malaria parasitemia and bacteremia, respectively. Four genera of bacteria, i.e E. coli, Proteus, Staphylococcus and Salmonella, were detected in subjects with both malaria parasitemia and bacteremia. The 4 bacterial genera and Klebsiella were detected in subjects with bacterial infection only. P. falciparum (68%), P. malariae (25%) and P. ovale (7%) were the species of malaria parasites identified in our subjects. Bacteremia was most prevalent in subjects with hemoglobin AA (HbAA) (60.7%) followed by HbAC (21.45%). Packed cell volume (PCV) and Hb concentration were similar in all groups but mean counts of red blood cells (RBC) and white blood cells (WBC) were statistically significantly lower in subjects with malaria parasites only compared to the controls. Leucocyte migration was significantly reduced in children with bacteremia only or both malaria parasitemia and bacteremia compared to controls, while the nitroblue tetrazolium assay was significantly reduced in children with bacteremia only. It may be concluded that malaria parasitemia significantly affects both leucocyte migration and nitroblue tetrazolium assay.

Arachidonic acid triggers an oxidative burst in leukocytes

The change in cellular reducing potential, most likely reflecting an oxidative burst, was investigated in arachidonic acid- (AA) stimulated leukocytes. The cells studied included the human leukemia cell lines HL-60 (undifferentiated and differentiated into macrophage-like and polymorphonuclear-like cells), Jurkat and Raji, and thymocytes and macrophages from rat primary cultures. The oxidative burst was assessed by nitroblue tetrazolium reduction. AA increased the oxidative burst until an optimum AA concentration was reached and the burst decreased thereafter. In the leukemia cell lines, optimum concentration ranged from 200 to 400 æM (up to 16-fold), whereas in rat cells it varied from 10 to 20 æM. Initial rates of superoxide generation were high, decreasing steadily and ceasing about 2 h post-treatment. The continuous presence of AA was not needed to stimulate superoxide generation. It seems that the NADPH oxidase system participates in AA-stimulated superoxide production in these cells since the oxidative burst was stimulated by NADPH and inhibited by N-ethylmaleimide, diphenyleneiodonium and superoxide dismutase. Some of the effects of AA on the oxidative burst may be due to its detergent action. There apparently was no contribution of other superoxide-generating systems such as xanthine-xanthine oxidase, cytochromes P-450 and mitochondrial electron transport chain, as assessed by the use of inhibitors. Eicosanoids and nitric oxide also do not seem to interfere with the AA-stimulated oxidative burst since there was no systematic effect of cyclooxygenase, lipoxygenase or nitric oxide synthase inhibitors, but lipid peroxides may play a role, as indicated by the inhibition of nitroblue tetrazolium reduction promoted by tocopherol.

Atividade funcional neutrofílica em cabras com mastite induzida experimentalmente por Staphylococcus aureus e suplementadas com vitamina E (acetato DL-a-tocoferol) / Neutrophilic function activity in goats with mastitis experimentally induced by Staphylococcus aureus and supplemented with vitamin E (acetate DL-a-tocopherol)

Avaliou-se a função neutrofílica em cabras com mastite por Staphylococcus aureus, induzida experimentalmente, suplementadas com vitamina E (acetato DL-a-tocoferol). Foram utilizadas 14 cabras gestantes da raça Saanen, com idades entre 8 e 12 meses e com cultura bacteriológica do leite negativa. Sete cabras receberam 2000UI de vitamina E, via intramuscular, no dia do parto e no sétimo dia pós-parto. As outras sete não foram medicadas. No 10º dia pós-parto, os dois grupos foram inoculados com 300 unidades formadoras de colônias de Staphylococcus aureus, cepa ATCC 25923, diluídas em 10ml de solução fisiológica, na glândula mamária esquerda. A função de neutrófilos sangüíneos foi medida pelo teste nitroazul tetrazólio (NBT), antes da inoculação, no momento da infecção e 12, 24, 48 e 72 horas pós-infecção, quando foi instituído o tratamento intramamário com antimicrobiano, por três dias consecutivos. A colheita final de sangue foi realizada 48 horas após a última aplicação do medicamento. Amostras de sangue para determinação da vitamina E foram colhidas no dia do parto, no momento da infecção, 48 horas pós-infecção e 48 horas pós-tratamento e analisadas por cromatografia líquida de alta performance. Na prova não estimulada do NBT não foram verificadas diferenças entre grupos e entre momentos. Na prova estimulada do NBT (NBT-E) houve diferença entre tratamentos às 12 e 72 horas pós-infecção, com valores mais elevados de NBT-E nos animais sem suplementação. Conclui-se que a suplementação com vitamina E reduz o percentual de neutrófilos NBT-E positivos.

Evaluación de los mecanismos oxidativos del PMN neutrófilo de saliva de pacientes periodontalmente sanos por reducción de NBT / An evaluation of the oxidative mechanisms of salivary PMN neutrophil in saliva of periodontally healthy patients by NBT reduction

Antecedentes: en general, las enfermedades periodontales se caracterizan por cambios, tanto estructurales como bioquímicos en el ámbito tisular, y en su patogenia, por contraste de infecciones bacterianas, el neutrófilo es considerado como la célula más importante de la inmunidad innata. La importancia de esta célula radica en el hecho de estar presente en cada uno de los cuatro estadios que caracterizan el avance de la lesión, así como en los hallazgos de susceptibilidad a infecciones bacterianas recurrentes, incluyendo enfermedad periodontal, en pacientes con defectos cualitativos y cuantitativos en PMN neutrófilos de sangre periférica. Una de las alteraciones funcionales del neutrófilo asociada a la pérdida de la capacidad de defensa ejercida por esta célula contra bacterias extracelulares, la constituye el hecho de ser incapaz de acivar sus mecanismos oxidativos para producir la muerte intracelular de los microorganismos ingeridos. Objetivo: evaluar la capacidad del PMN neutrófilo de saliva y sangre periférica de pacientes periodontalmente sanos para activarse y utilizar losmecanismos microbicidas dependientes de oxígeno, para reconocer si el PMN neutrófilo, al migrar a través del surco gingival, conserva intacta su funcionalidad. Métodos: el estudio fue descriptivo comparativo, in vitro. Para su desarrollo se formaron muestras de saliva y de sangre periférica de 5 individuos. Los neutrófilos aislados fueron sometidos a activación con phorbol miristato acetato (PMA) y posteriormente a las pruebas de reducción del nitroazul de tetrazolio, el cual se puede cuantificar por observación directa al microscopio de luz. Resultados: los PMN neutrófilos obtenidos de sangre y saliva reducen el NBT en un porcentaje más ato que los PMN neutrófilos de sangre periférica, en ausencia de activación. Se encontró que los PMN neutrófilos de saliva tienen un estado de activación de base debido a su constante exposición a las bacterias de la cavidad bucal, y una vez que se activan, dichas células reducen el NBT en menor cantidad que los PMN neutrófilos de sangre periférica bajo iguales condiciones. Conclusiones: los PMN neutrófilos de saliva son células funcionales capaces de activarse, ya que mantienen intactos los mecanismos oxidativos una vez llegan a la saliva a través del surco gingival