New perspectives on traumatic bone infections / 中华创伤杂志(英文版)

In this paper, we review the results of previous studies and summarize the effects of various factors on the regulation of bone metabolism in traumatic bone infections. Infection-related bone destruction incorporates pathogens and iatrogenic factors in the process of bone resorption dominated by the skeletal and immune systems. The development of bone immunology has established a bridge of communication between the skeletal system and the immune system. Exploring the effects of pathogens, skeletal systems, immune systems, and antibacterials on bone repair in infectious conditions can help improve the treatment of these diseases.

Consecuencias de la infección malárica gestacional en la función inmune y en la inmunomodulación de la madre y el neonato / Consequences of gestational malaria infection in the immune function and immunomodulation of mother and newborn

Resumen La malaria asociada al embarazo es un evento poco estudiado en América Latina. Los abundantes trabajos sobre el problema en África llevan a pensar que esta infección genera una modulación de la respuesta inmune y alteraciones en el ambiente placentario, eventos cruciales para el adecuado desarrollo del feto y el neonato. La inmunidad contra Plasmodium spp es compleja porque involucra diversos factores que amplían las posibilidades de desenlaces, los que finalmente conducen a los diferentes fenotipos clínicos de la enfermedad. Uno de los desenlaces inmunológicos en infecciones por Plasmodium spp es la modulación de la respuesta inmune hacía un perfil regulador. Esta regulación inducida por la infección malárica resulta ventajosa para la persistencia del parásito en el hospedero, y adicionalmente, podría generar eventos adversos en la respuesta inmune general de los individuos infectados. El objetivo de esta revisión es abordar los mecanismos con los cuales Plasmodium spp modula la respuesta inmune del hospedero y exponer las consecuencias de las infecciones maláricas en el contexto madre-neonato.

Pregnancy-associated malaria is an understudied event in Latin America. Most works about malaria in pregnancy have been conducted in Africa. These studies indicate that the infection generates immune response modulation and alterations in the placental environment, key factors for the proper development of the fetus and neonate. Immunity against Plasmodium spp is complex since involves several factors that increase the possible infection outcomes. One of these immunological outcomes is the immune response modulation towards a regulatory profile, which is advantageous for the persistence of the parasite in the host; additionally, it could generate adverse events in the general immune response of infected individuals. The objective of this review is to address the Plasmodium spp mechanisms of modulation in the host immune response and expose the consequences of malarial infections in the mother-neonate context.

Immunology of breast milk / Imunologia do leite materno

Summary In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Colostrum is the most potent natural immune booster known to science. Breastfeeding protects infants against infections mainly via secretory IgA (SIgA) antibodies, but also via other various bioactive factors. It is striking that the defense factors of human milk function without causing inflammation; some components are even anti-inflammatory. Protection against infections has been well evidenced during lactation against, e.g., acute and prolonged diarrhea, respiratory tract infections, including otitis media, urinary tract infection, neonatal septicemia, and necrotizing enterocolitis. The milk’s immunity content changes over time. In the early stages of lactation, IgA, anti-inflammatory factors and, more likely, immunologically active cells provide additional support for the immature immune system of the neonate. After this period, breast milk continues to adapt extraordinarily to the infant’s ontogeny and needs regarding immune protection and nutrition. The need to encourage breastfeeding is therefore justifiable, at least during the first 6 months of life, when the infant’s secretory IgA production is insignificant.

Resumo Na fase crítica de imaturidade imunológica do recém-nascido, em especial do sistema imune de mucosas, o lactente recebe grandes quantidades de componentes bioativos através do colostro e do leite materno. O colostro é o reforço imunológico natural mais potente conhecido pela ciência. O aleitamento materno protege o lactente de infecções principalmente por meio dos anticorpos IgA secretores (IgAS), mas também por meio de vários outros fatores bioativos. É surpreendente que os fatores de defesa do leite humano ajam sem causar inflamação e alguns componentes são, de fato, anti-inflamatórios. A proteção contra infecções tem sido bem evidenciada durante a lactação, combatendo, por exemplo, diarreia aguda e prolongada, infecções do trato respiratório, incluindo otite média, infecção do trato urinário, sepse neonatal e enterocolite necrosante. O conteúdo imunológico do leite evolui ao longo do tempo: nas fases iniciais de lactação, IgAS, fatores anti-inflamatórios e, mais provavelmente, as células imunologicamente ativas provêm ajuda adicional para o sistema imune imaturo do neonato. Depois desse período, o leite materno continua a adaptar-se extraordinariamente à ontogenia infantil, às suas necessidades de proteção imune e nutricionais. Entende-se, portanto, a necessidade de se estimular o aleitamento materno pelo menos durante o primeiro semestre de vida, período em que a produção própria de IgA secretória é ainda pouco significativa.

Wound healing treatment by high frequency ultrasound, microcurrent, and combined therapy modifies the immune response in rats

BACKGROUND: Therapeutic high-frequency ultrasound, microcurrent, and a combination of the two have been used as potential interventions in the soft tissue healing process, but little is known about their effect on the immune system. OBJECTIVE: To evaluate the effects of therapeutic high frequency ultrasound, microcurrent, and the combined therapy of the two on the size of the wound area, peritoneal macrophage function, CD4+ and CD8+, T lymphocyte populations, and plasma concentration of interleukins (ILs). METHOD: Sixty-five Wistar rats were randomized into five groups, as follows: uninjured control (C, group 1), lesion and no treatment (L, group 2), lesion treated with ultrasound (LU, group 3), lesion treated with microcurrent (LM, group 4), and lesion treated with combined therapy (LUM, group 5). For groups 3, 4 and 5, treatment was initiated 24 hours after surgery under anesthesia and each group was allocated into three different subgroups (n=5) to allow for the use of the different therapy resources at on days 3, 7 and 14 Photoplanimetry was performed daily. After euthanasia, blood was collected for immune analysis. RESULTS: Ultrasound increased the phagocytic capacity and the production of nitric oxide by macrophages and induced the reduction of CD4+ cells, the CD4+/CD8+ ratio, and the plasma concentration of IL-1β. Microcurrent and combined therapy decreased the production of superoxide anion, nitric oxide, CD4+-positive cells, the CD4+/CD8+ ratio, and IL-1β concentration. CONCLUSIONS: Therapeutic high-frequency ultrasound, microcurrent, and combined therapy changed the activity of the innate and adaptive immune system during healing process but did not accelerate the closure of the wound.

Efecto modulador de la ozonoterapia sobre la actividad del sistema inmune / Modulator effect of ozone therapy over immune system activity

El empleo de la medicina biológica ha permitido aplicar terapias sistémicas beneficiosas donde el cuerpo es tratado como un todo. La ozonoterapia es una técnica interesante en el campo de aplicación de la medicina biológica; es un proceder terapéutico, seguro, natural y factible, con resultados alentadores en el tratamiento de enfermedades inmunológicas, por el impacto social y económico que se genera tras su aplicación. Existen evidencias experimentales que aseveran esta afirmación. En este artículo se describen las propiedades inmunomoduladoras de la ozonoterapia, al caracterizar los efectos biológicos del ozono sobre las células del sistema inmune, mediadores solubles y otros tipos celulares

The employment of biological medicine has allowed the application of beneficial and systemic therapies where the body is treated as a whole. The ozone therapy is a modality of the biological medicine, it is a natural therapeutical procedure that has represented an extremely safe medical therapy, free from side effects, an effective and feasible method in the field of treatment of immunological diseases, with encouraging results for the social and economic impact that is generated after its application. There are experimental evidences that assert this statement. We hereby describe the immunomodulatory property of ozone therapy, the biological effects of the ozone on the cells of the immune system cells, other cellular types and different immune mediators

Intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo / Intercurrence of enzootic leucosis and brucellosis in buffaloes (Bubalus bubalis) in extensive production system

Objetivou-se com este estudo avaliar a intercorrência entre leucose enzoótica e brucelose em búfalos (Bubalus bubalis) em sistema de produção extensivo, pelo estabelecimento da prevalência de bubalinos reagentes às provas diagnósticas específicas. Foram analisados sorologicamente 232 animais, pela técnica de imunodifusão dupla em gel de agarose para diagnóstico de leucose enzoótica e o teste do antígeno acidificado tamponado, seguida pelos testes confirmatórios 2-mercaptoetanol e soroaglutinação lenta em tubos para diagnóstico de brucelose. As prevalências de búfalos que apresentaram positividade para leucose e brucelose foram 4,21% (10/232) e 5,18% (12/232), respectivamente. Os resultados obtidos nesta pesquisa permitiram concluir que as infecções estudadas encontram-se presentes na população avaliada, entretanto, com baixa prevalência e sem dependência de ocorrência entre ambas.

This study was carried out to evaluate the intercurrence of brucellosis and enzootic leucosis in buffaloes in extensive production system by establishing the prevalence of reagent buffaloes for specific diagnostic tests. We analyzed 232 animals serologically by the technique of double immunodiffusion in agarose gel (AGID) for diagnostic of leucosis and the tampon acidified antigen (TAA) test, followed by confirmatory tests of 2-mercaptoethanol (2-ME) and slow serum agglutination (SSA) in tubes for diagnostic of brucellosis. The prevalence of buffaloes that were positive for leucosis and brucellosis tests were 4.21% (10/232) and 5.18%(12/232) respectively. The results of this investigation indicated that the diseases occur in the population studied, however, with low prevalence and without depending on the occurrence of both.

Efeito benéfico do exercício físico recreacional na susceptibilidade de infecções do trato respiratório superior / Beneficial effect of recreational exercise on the upper respiratory tract infection susceptibility

A regularidade do exercício físico de carga moderada pode diminuir a susceptibilidade as infecções do trato respiratório superior (ITRS), modulando a resposta do sistema imunológico nos praticantes. O presente estudo teve como objetivo avaliar, durante 28 semanas, as respostas imunológicas crônicas com relação à contagem total e diferencial dos leucócitos circulantes, incidências de ITRS e cargas de treinamento em mulheres adultas recreacionalmente ativas. Participaram deste estudo 12 mulheres (23,4 ± 2,7 anos) praticantes de um programa recreacional de treinamento em voleibol (GVR); e 12 mulheres não ativas fisicamente (23,4 ± 2,7 anos) (GC). A percepção subjetiva de esforço e o volume do treino em minutos foram coletados ao final de cada sessão, obtendo assim as cargas internas de treinamento do GVR durante o período avaliado. Coletas sanguíneas para obtenção dos resultados referentes ao hemograma foram realizadas ao inicio do estudo (M1), após 14 semanas (M2) e após 28 semanas (M3). Um recordatório infeccioso foi aplicado semanalmente para obtenção dos índices de ITRS. Foram observados diminuições em monócitos e eosinófilos no GVR e nos neutrófilos do GC no M2; aumentos nos linfócitos no GVR e nos neutrófilos, monócitos e linfócitos do GC no M3; GVR apresentou aproximadamente 427% menos incidências de ITRS em comparação ao GC no período M2-M3 (0,12 ± 0,06 contra 0,58 ± 0,09 respectivamente). Conclui-se assim que o esporte coletivo recreacional, especificamente o voleibol praticado nessas condições, modulou positivamente o sistema imunológico promovendo consequente diminuição nos episódios de ITRS.

Regular moderate exercise can decrease susceptibility to upper respiratory tract infections (URTI), modulating the immune response in participants. The objective of this study was to assess over a period of 28 weeks the chronic immunological response in relation to total and differential leukocytes counts, incidence of URTI and training loads in recreationally active adult women. Twelve women (23.4 ± 2.7 years) who are engaged in a recreational volleyball program training (GVR) and twelve non-physically-active women (23.4 ± 2.7 years) (GC) participated in this study. The level of perceived exertion and training volume in minutes was collected at the end of each session to assess internal training load of GVR during the study. Blood samples were taken at the beginning of the study (M1), after 14 weeks (M2) and after 28 weeks (M3). An illness report was completed every week regarding incidence of URTI symptoms. The results shows decreases on monocytes and eosinophils in the GVR and on neutrophils in the GC in M2; increases on lymphocytes in the GVR and on neutrophils, monocytes and lymphocytes in the GC in M3; the GVR presented 427% less URTI symptoms during M2-M3 period in relation to GC in the same period (0.12 ± 0.06 to GVR and 0.58 ± 0.09 to GC). We conclude that physically active individuals engaged in regular and moderate exercise programs are less susceptible to URTI than physically non-active individuals. Therefore, collective recreational sports, specifically volleyball practice under these conditions, can improve the defense capabilities of the immunological system to guard against incidences of URTI.

Caracterização de aspectos geneticos e imunologicos envolvidos no desenvolvimento de inibidores em hemofilia A e B / Genetic and immunologic aspects related to the development of inhibitors in hemophilia A and B

Uma complicação decorrente do tratamento da hemofilia é a formação de anticorpos neutralizadores da atividade coagulante do fator VIII ou IX (inibidores). Diversos fatores estão relacionados com o desenvolvimento desses inibidores em indivíduos com hemofilia, incluindo fatores genéticos e ambientais. Entre os fatores genéticos, a mutação associada ao diagnóstico da hemofilia é um fator de risco bem documentado. Recentemente foi observada a maior ocorrência de inibidores em indivíduos da etnia negra. O objetivo deste trabalho foi analisar os aspectos genéticos e não genéticos envolvidos no desenvolvimento de inibidores. Foram incluídos nesse estudo 411 pacientes hemofílicos, sendo 321 com hemofilia A (HA) (238 famílias) e 99 com hemofilia B (HB) (59 famílias). A presença de inibidores foi constatada apenas entre os pacientes HA graves. Do total de 220 HA graves desse estudo, 46 (20,9%) apresentaram inibidor detectado em pelo menos uma ocasião após sua inclusão no estudo. Mutações consideradas de alto-risco para o desenvolvimento de inibidores foram identificadas em 125/220 pacientes HA graves (58,8%), e 33 deles desenvolveram inibidores (26,4%). Considerando o grupo étnico de acordo com traços físicos e ancestralidade, 38% dos pacientes HA graves foram classificados como negros. A incidência de inibidores foi maior nesse grupo de pacientes (31% do total de pacientes HA graves classificados como negros) quando comparada aos pacientes caucasóides (20% do total de pacientes HA graves classificados como caucasóides). Recentemente, foi observado que a maior incidência de inibidores em uma população norte-americana de pacientes com HA, estava relacionada com a presença de determinados haplótipos no gene do fator VIII...

The most serious complication of the treatment of hemophilia is the development of neutralizing antibodies to coagulation activity of factor VIII or IX (inhibitors). Several risk factors are related to the development of these inhibitors in patients with hemophilia, including genetic and environmental factors. Among genetic factors, the mutation associated with the diagnosis of hemophilia is a risk factor well documented. Recently, it was observed a higher incidence of inhibitors in African ancestry patients. The aim of this study was to analyze the genetic and non-genetic factors involved in the development of inhibitors. The study included 411 hemophilia patients, of which 321 with hemophilia A (HA) and 99 with hemophilia B (HB), belonging to a total of 238 and 59 families, respectively. The inhibitors were observed only in severe HA patients. From the 220 severe HA, 46 (20.9%) had inhibitor. The high risk mutation for the development of inhibitors were identified in 125 / 220 (58.8 %) severe HA patients, and 33 (26.4 %) of them developed inhibitors. Considering the ethnic group according to physical traits and ancestry, 38 % of severe HA patients were classified as black. The incidence of inhibitors is higher in this group of patients (31%) when compared to Caucasian patients (20%). The higher risk of inhibitor among African-Brazilians, could not be explained by the presence of the distinct factor VIII haplotypes, such as H3 and H4, as suggested in previous study.

Imunologia da retinocoroidite toxoplásmica / Immunology of the toxoplasmic retinochoroiditis

A infecção pelo Toxoplasma gondii é uma importante causa de doença ocular, tanto em indivíduos imunocomprometidos como em imunocompetentes. A patogênese da destruição retinocoroidiana associada a essa infecção ainda não está totalmente esclarecida. Nesta revisão, discute-se o papel do sistema imune no controle da infecção pelo Toxoplasma, especialmente, no olho.

Toxoplasma gondii infection is an important cause of ocular disease in both immunocompromised and immunocompetent subjects. The pathogenesis of retinochoroidal lesion associated with this infection is not fully understood. In this review, the role of the immune system in the control of Toxoplasma infection, especially in the eye, is discussed.

Factores virales y celulares que afectan la transmisión vertical del HIV-1 / Viral and cellular factors affecting vertical transmission of HIV-1

Distintos factores virales y celulares pueden condicionar la susceptibilidad a la infección por el HIV-1. La inmunidad innata constituye la primera línea de defensa contra el virus jugando un papel fundamental en la etapa temprana de la transmisión del HIV-1 previo al desarrollo del sistema inmune adaptativo. Está constituida por elementos celulares como las células NK, granulocitos, macrófagos, células dendríticas, etc. y solubles como quimioquinas, defensinas y proteínas de unión a azúcares (lectinas) capaces de ejercer actividad antiviral. Se ha demostrado que variaciones genéticas de componentes de la respuesta inmune pueden modificar el riesgo de transmisión del HIV-1 y desarrollo de sida. Entre ellos se encuentran primordialmente los co-receptores del virus CCR5 y CXCR4, y las proteínas del complejo mayor de histocompatibilidad clase I y II. Además, características biológicas y evolutivas del HIV-1 pueden modificar el riesgo de la transmisión viral.

Viral and cellular factors may condition susceptibility to HIV-1 infection. Innate immunity represents the fist line of defense against the virus with mayor relevance at initial stages of HIV-1 transmission prior to the development of the adaptative immune system. Cellular components, such as, NK cells, granulocytes, macrophages, dendritic cells, etc and soluble factors like chemokines, defensins and sugar binding proteins (lectins) have antiviral activity. Genetic variations of immune response components can modify the risk of HIV-1 transmission and AIDS development. These mainly include viral co-receptors CCR5 and CXCR4 and HLA class I and II. Furthermore, biologic and evolutionary characteristics of HIV-1 can modify the risk of viral transmission.