RESUMEN
A major concern in transplantation is the preservation of organ function. Ischemia time and microcirculatory disturbance of the organ cannot be avoided and may result in ischemia reperfusion injury (IRI), increasing the risk of delayed graft function (DGF) and acute and chronic rejection. Anti-thymocyte immunoglobulin (rATG) is a polyclonal antibody preparation with multiple effects when administered to recipients. Our objective has been to evaluate whether the administration of rATG to kidney donors instead of recipients, in an experimental model of syngeneic rat transplantation, ameliorates IRI and facilitates immediate graft function recovery. Urea and creatinine levels and necrosis severity scores were significantly lower in kidneys from donors that had received rATG (urea: control: 211±8mg/dl vs. treatment: 110±15mg/dl, p<0.001; creatinine: control: 4.6±0.24mg/dl vs. treatment: 2.6±0.22mg/dl, p<0.001; necrosis severity scores: control: 2.3 vs. treatment: 1.6, p<0.05). TUNEL staining showed 80±13 positive cells in control group and 9±3 (p<0.001) in treatment group. In situ expression of proinflammatory cytokines TNF-α, IL-6, IL-21 and TGF-ß1 was reduced in rATG group (p<0.01); the same was observed for KIM-1 and caspase 8 (p<0.001). Cytoprotective genes Bcl2 and HO-1 were upregulated in situ in treatment group (p<0.001). In situ expression of IL-17, caspase 9, IL-23a, CxCl3 and ICAM1 showed no difference between groups (p>0.05). Findings suggest ATG administered to donors may ameliorate the IRI process in kidney transplantation, expressed by lower necrosis and apoptosis scores and the improvement of renal function, which may be explained through the diminished in situ expression of inflammatory mediators.
Asunto(s)
Suero Antilinfocítico/administración & dosificación , Trasplante de Riñón , Daño por Reperfusión/prevención & control , Timocitos/inmunología , Donantes de Tejidos , Animales , Apoptosis , Caspasa 8/metabolismo , Moléculas de Adhesión Celular/metabolismo , Creatinina/análisis , Perfilación de la Expresión Génica , Genes bcl-2 , Hemo-Oxigenasa 1/genética , Interleucina-6/metabolismo , Interleucinas/metabolismo , Riñón/inmunología , Masculino , Necrosis , Distribución Aleatoria , Ratas , Ratas Wistar , Factor de Crecimiento Transformador beta1/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Regulación hacia Arriba , Urea/análisisRESUMEN
El propósito de este trabajo es evaluar, en nuestro medio, las manifestaciones gingivales en niños trasplantados renales. Fueron examinados 43 niños y adolescentes que reciben ciclosporina. Se observó agrandamiento gingival en el 86 por ciento de ellos. Los pacientes con mayor porcentaje de sitios con A.G. presentaron cálculo. Resultó significativamente menor el porcentaje de A.G. en los que reciben sólo ciclosporina, comparados con los que reciben ciclosporina y antihipertensivos bloqueantes de los canales de calcio. La presencia de placa y tiempo transcurrido desde el transplante no influyeron significativamente en el porcentaje de agrandamiento gingival