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1.
J Virol ; 90(3): 1499-506, 2016 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-26581993

RESUMEN

UNLABELLED: A critical early step in murine norovirus (MNV) pathogenesis is crossing the intestinal epithelial barrier to reach the target cells for replication, i.e., macrophages, dendritic cells, and B cells. Our previous work showed that MNV replication decreases in the intestines of mice conditionally depleted of microfold (M) cells. To define the importance of Peyer's patch (PP) M cells during MNV pathogenesis, we used a model of BALB/c mice deficient in recombination-activating gene 2 (Rag2) and the common gamma chain (γc) (Rag-γc(-/-)), which lack gut-associated lymphoid tissues (GALT), such as Peyer's patches, and mature GP2(+) M cells. Rag-γc(-/-) mice were infected intraperitoneally or perorally with MNV-1 or CR3 for 24 or 72 h. Although the intestinal laminae propriae of Rag-γc(-/-) mice have a higher frequency of certain MNV target cells (dendritic cells and macrophages) than those of wild-type mice and lack others (B cells), Rag-γc(-/-) and wild-type BALB/c mice showed relatively similar viral loads in the intestine following infection by the intraperitoneal route, which provides direct access to target cells. However, Rag-γc(-/-) mice were not productively infected with MNV by the oral route, in which virions must cross the intestinal epithelial barrier. These data are consistent with a model whereby PP M cells are the primary route by which MNV crosses the intestinal epithelia of BALB/c mice. IMPORTANCE: Noroviruses (NoVs) are prevalent pathogens that infect their hosts via the intestine. Identifying key factors during the initial stages of virus infection in the host may provide novel points of intervention. Microfold (M) cells, antigen-sampling cells in the intestine, were previously shown to provide a gateway for murine NoV (MNV) into the host, but the relative importance of this uptake pathway remained unknown. Here we show that the absence of gut-associated lymphoid tissues (GALT), such as Peyer's patches, which contain high numbers of mature M cells, renders BALB/c mice refractory to oral infection with MNV. These findings are consistent with the model that M cells represent the primary route by which MNV crosses the intestinal epithelial barrier and infects underlying immune cells during a productive infection.


Asunto(s)
Infecciones por Caliciviridae/inmunología , Infecciones por Caliciviridae/virología , Interacciones Huésped-Patógeno , Norovirus/fisiología , Ganglios Linfáticos Agregados/virología , Internalización del Virus , Animales , Modelos Animales de Enfermedad , Ratones Endogámicos BALB C , Ratones Noqueados
2.
Med Sci Educ ; 34(2): 379-385, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38686170

RESUMEN

Small group-based instructional approaches such as case-based learning (CBL) and team-based learning (TBL) are widely used in medical education to promote collaboration and team learning. During the pandemic, many medical schools shifted from face-to-face instruction to online settings. While CBL/TBL are intended to foster collaborative skills, it is unclear how its use evolves in an online setting and whether the online setting impacts students' perceptions and behaviors in collaboration. This study examined how the change from in-person to online CBL/TBL impacted students' collaboration. We used a mixed-methods sequential design, first collecting and analyzing retrospective cohort quantitative data with the Class of 2023 through peer evaluation surveys followed by six focus groups. Students' assessment of their peers was generally positive. Nonparametric testing showed significant differences for two questions with less positive perceptions in the virtual setting compared to when students had in-person CBL/TBL. The focus group results identified several themes related to collaboration and learning communities. In the virtual setting, students not only lost collaboration opportunities with their group members in CBL/TBL, but also learning opportunities and social connections with other groups and the community as a whole. Virtual learning environments may have presented challenges for collaborative learning and the establishment of a sense of community.

3.
J Gen Virol ; 94(Pt 8): 1761-1768, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23636823

RESUMEN

Dendritic cells (DCs) are permissive to murine norovirus (MNV) infection in vitro and in vivo. However, their roles during infection in vivo are not well defined. To determine the role of DCs during infection, conventional DCs were depleted from CD11c-DTR mice and infected with a persistent MNV strain. Viral titres in the intestine and secondary lymphoid organs were determined at early time points during infection, and anti-MNV antibody responses were analysed later during infection. Depletion of conventional DCs resulted in increased viral loads in intestinal tissues, impaired generation of antibody responses, and a failure of MNV to efficiently infect lymphoid tissues. These data suggest that DCs play multiple roles in MNV pathogenesis, in both innate immunity and the efficient generation of adaptive immune responses against MNV, as well as by promoting the dissemination of MNV to secondary lymphoid tissues. This is the first study to probe the roles of DCs in controlling and/or facilitating a norovirus infection in vivo and provides the basis for further studies aimed at defining mechanisms by which DCs control MNV replication and promote viral dissemination.


Asunto(s)
Infecciones por Caliciviridae/inmunología , Células Dendríticas/inmunología , Norovirus/inmunología , Animales , Anticuerpos Antivirales/sangre , Modelos Animales de Enfermedad , Intestinos/virología , Procedimientos de Reducción del Leucocitos , Tejido Linfoide/virología , Ratones , Carga Viral
4.
J Immunol ; 186(1): 183-94, 2011 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-21098225

RESUMEN

Protracted psychological stress elevates circulating glucocorticoids, which can suppress CD8(+) T cell-mediated immunity, but the mechanisms are incompletely understood. Dendritic cells (DCs), required for initiating CTL responses, are vulnerable to stress/corticosterone, which can contribute to diminished CTL responses. Cross-priming of CD8(+) T cells by DCs is required for initiating CTL responses against many intracellular pathogens that do not infect DCs. We examined the effects of stress/corticosterone on MHC class I (MHC I) cross-presentation and priming and show that stress/corticosterone-exposed DCs have a reduced ability to cross-present OVA and activate MHC I-OVA(257-264)-specific T cells. Using a murine model of psychological stress and OVA-loaded ß(2)-microglobulin knockout "donor" cells that cannot present Ag, DCs from stressed mice induced markedly less Ag-specific CTL proliferation in a glucocorticoid receptor-dependent manner, and endogenous in vivo T cell cytolytic activity generated by cross-presented Ag was greatly diminished. These deficits in cross-presentation/priming were not due to altered Ag donation, Ag uptake (phagocytosis, receptor-mediated endocytosis, or fluid-phase uptake), or costimulatory molecule expression by DCs. However, proteasome activity in corticosterone-treated DCs or splenic DCs from stressed mice was partially suppressed, which limits formation of antigenic peptide-MHC I complexes. In addition, the lymphoid tissue-resident CD11b(-)CD24(+)CD8α(+) DC subset, which carries out cross-presentation/priming, was preferentially depleted in stressed mice. At the same time, CD11b(-)CD24(+)CD8α(-) DC precursors were increased, suggesting a block in development of CD8α(+) DCs. Therefore, glucocorticoid-induced changes in both the cellular composition of the immune system and intracellular protein degradation contribute to impaired CTL priming in stressed mice.


Asunto(s)
Corticosterona/fisiología , Reactividad Cruzada/inmunología , Citotoxicidad Inmunológica/efectos de los fármacos , Células Dendríticas/inmunología , Terapia de Inmunosupresión , Activación de Linfocitos/efectos de los fármacos , Estrés Psicológico/inmunología , Linfocitos T Citotóxicos/inmunología , Animales , Células Cultivadas , Técnicas de Cocultivo , Corticosterona/biosíntesis , Reactividad Cruzada/efectos de los fármacos , Citotoxicidad Inmunológica/inmunología , Células Dendríticas/metabolismo , Inmovilización , Activación de Linfocitos/inmunología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Ovalbúmina/inmunología , Ovalbúmina/metabolismo , Linfocitos T Citotóxicos/citología , Linfocitos T Citotóxicos/metabolismo
5.
Int J Med Educ ; 14: 36-42, 2023 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-37027504

RESUMEN

Objectives: To explore whether and how preclinical medical students changed perceptions and behaviors related to professionalism in small group learning activities from face-to-face to virtual during the pandemic. Methods: The study used a mixed-methods sequential research design. We first retrospectively examined quantitative data from 101 medical students who completed mandatory peer evaluation surveys assessing professional behaviors of small group members in two courses (one face-to-face, the other online). Differences between student perceptions in two settings were compared using the Wilcoxon signed-rank test. Findings from the quantitative stage were probed further using focus groups at the qualitative stage. Six focus groups (n = 27) were conducted using purposeful sampling. Interviews were transcribed and inductive thematic coding was used to identify emerging themes. Results: We found a significant decrease in perceptions of punctuality and attendance in the virtual setting compared to face-to-face learning (Z=-6.211, p<.001), despite lower expectations of their peers in online learning. Five major themes emerged from the qualitative data: punctuality/participation, camera usage, dress code/conversational style, multitasking, and engagement/accountability. Participants showed sensitivity when conceptualizing professional conduct, indicating the dynamic process of professional identity formation at the early stage of their career. Conclusions: Results show that students' perceptions of professionalism become contextualized, significantly influenced by the background of the virtual learning environment. Intentional communication about professionalism within specific sociocultural and educational contexts is vital for individual professional identity formation. These findings support of the importance of considering context when educational programs develop curricula and establish expectations related to professionalism.


Asunto(s)
Educación de Pregrado en Medicina , Estudiantes de Medicina , Humanos , Profesionalismo , Estudios Retrospectivos , Educación de Pregrado en Medicina/métodos , Aprendizaje
6.
J Immunol ; 184(4): 1867-75, 2010 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-20089700

RESUMEN

The systemic elevation of psychological stress-induced glucocorticoids strongly suppresses CD8(+) T cell immune responses resulting in diminished antiviral immunity. However, the specific cellular targets of stress/glucocorticoids, the timing of exposure, the chronology of immunological events, and the underlying mechanisms of this impairment are incompletely understood. In this study, we address each of these questions in the context of a murine cutaneous HSV infection. We show that exposure to stress or corticosterone in only the earliest stages of an HSV-1 infection is sufficient to suppress, in a glucocorticoid receptor-dependent manner, the subsequent antiviral immune response after stress/corticosterone has been terminated. This suppression resulted in early onset and delayed resolution of herpetic lesions, reduced viral clearance at the site of infection and draining popliteal lymph nodes (PLNs), and impaired functions of HSV-specific CD8(+) T cells in PLNs, including granzyme B and IFN-gamma production and the ability to degranulate. In knockout mice lacking glucocorticoid receptors only in T cells, we show that these impaired CD8(+) T cell functions are not due to direct effects of stress/corticosterone on the T cells, but the ability of PLN-derived dendritic cells to prime HSV-1-specific CD8(+) T cells is functionally impaired. These findings highlight the susceptibility of critical early events in the generation of an antiviral immune response to neuroendocrine modulation and implicate dendritic cells as targets of stress/glucocorticoids in vivo. These findings also provide insight into the mechanisms by which the clinical use of glucocorticoids contributes to altered immune responses in patients with viral infections or tumors.


Asunto(s)
Corticosterona/farmacología , Células Dendríticas/inmunología , Células Dendríticas/patología , Herpes Simple/inmunología , Herpes Simple/patología , Herpesvirus Humano 1/inmunología , Inmunosupresores/farmacología , Estrés Psicológico/inmunología , Animales , Linfocitos T CD8-positivos/inmunología , Linfocitos T CD8-positivos/patología , Linfocitos T CD8-positivos/virología , Corticosterona/metabolismo , Células Dendríticas/virología , Herpes Simple/virología , Inmovilización , Inmunosupresores/metabolismo , Ganglios Linfáticos/inmunología , Ganglios Linfáticos/patología , Ganglios Linfáticos/virología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Proteínas del Envoltorio Viral/inmunología
7.
Antiviral Res ; 132: 46-9, 2016 08.
Artículo en Inglés | MEDLINE | ID: mdl-27210811

RESUMEN

The recently developed human norovirus (HuNoV) B cell culture and mouse models hold promise for drug discovery and development but their suitability for antiviral studies has not been assessed. We demonstrate the inhibitory effect of the nucleoside analogue 2'-C-methylcytidine (2CMC) on HuNoV replication in the human B cell BJAB cell line and in Balb/c Rag/gamma chain-deficient (Rag-γc(-/-)) mice. These data suggest the applicability of both models for future study and development of antiviral drugs for the treatment of HuNoV infections.


Asunto(s)
Antivirales/farmacología , Linfocitos B/efectos de los fármacos , Linfocitos B/virología , Infecciones por Caliciviridae/virología , Norovirus/efectos de los fármacos , Norovirus/fisiología , Animales , Infecciones por Caliciviridae/tratamiento farmacológico , Línea Celular , Modelos Animales de Enfermedad , Humanos , Ratones , Ratones Noqueados , Replicación Viral/efectos de los fármacos
8.
Physiol Genomics ; 16(1): 8-18, 2003 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-14559974

RESUMEN

A cDNA microarray resource enhanced for transcripts specific to the bovine mammary gland (BMAM) has been developed and used in pilot studies to examine gene expression profiles in the mammary gland. One goal driving development of this resource was to shed some light on the pathways and mechanisms specifically related to bovine mammary gland growth and development. To accomplish this, gene expression patterns from bovine adipose, liver, adrenal, lymph, spleen, thymus, gut, and developing mammary tissue were compared using the BMAM microarray. We have thus identified a putative set of 16 genes being preferentially expressed in developing mammary gland. Another of our long-term goals is to elucidate the genes and pathways associated with bovine lactation and involution and to use these as a model for human mammary gland development as it relates to human breast cancer risks. To begin this process, we conducted a pilot study, comparing gene expression profiles of lactating bovine mammary tissue against nonlactating tissue on the BMAM microarray. Our results have yielded many novel and interesting genes exhibiting differential expression in lactating mammary tissue, including oncogenes (VAV3, C-myc), mediators of apoptosis (Caspase 8), and cell cycle regulators (LASP1).


Asunto(s)
ADN Complementario/genética , Perfilación de la Expresión Génica , Glándulas Mamarias Animales/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Animales , Bovinos , Etiquetas de Secuencia Expresada , Regulación de la Expresión Génica , Humanos , Lactancia/genética , Glándulas Mamarias Animales/crecimiento & desarrollo , Glándulas Mamarias Animales/fisiología , Neoplasias Mamarias Animales/genética , Especificidad de Órganos , Proyectos Piloto , Reacción en Cadena de la Polimerasa , ARN Mensajero/análisis , ARN Mensajero/genética
9.
Microbiome ; 1(1): 7, 2013 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-24451302

RESUMEN

BACKGROUND: Murine norovirus (MNV) is the most common gastrointestinal pathogen of research mice and can alter research outcomes in biomedical mouse models of inflammatory bowel disease (IBD). Despite indications that an altered microbiota is a risk factor for IBD, the response of the murine intestinal microbiota to MNV infection has not been examined. Microbiota disruption caused by MNV infection could introduce the confounding effects observed in research experiments. Therefore, this study investigated the effects of MNV infection on the intestinal microbiota of wild-type mice. RESULTS: The composition of the intestinal microbiota was assessed over time in both outbred Swiss Webster and inbred C57BL/6 mice following MNV infection. Mice were infected with both persistent and non-persistent MNV strains and tissue-associated or fecal-associated microbiota was analyzed by 16S rRNA-encoding gene pyrosequencing. Analysis of intestinal bacterial communities in infected mice at the phylum and family level showed no major differences to uninfected controls, both in tissue-associated samples and feces, and also over time following infection, demonstrating that the intestinal microbiota of wild-type mice is highly resistant to disruption following MNV infection. CONCLUSIONS: This is the first study to describe the intestinal microbiota following MNV infection and demonstrates that acute or persistent MNV infection is not associated with major disruptions of microbial communities in Swiss Webster and C57BL/6 mice.

10.
Immunology ; 122(2): 279-90, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17848165

RESUMEN

Dendritic cells (DC) play a critical role in initiating and directing adaptive immune responses against pathogens and tumours. Immature DC are thought to act as sentinels in peripheral tissues where their main function is to capture antigen at sites of infection, whereas mature DC are highly efficient at priming T-cell-mediated immune responses against infectious pathogens. The DC maturation process is thought to be an important step in the efficient generation of cytotoxic T lymphocytes (CTL). It is well established that many aspects of immune function, including CTL-mediated antiviral immunity, are modulated by neuroendocrine-derived products. Corticosterone (CORT), an adrenal hormone produced at increased concentrations during a stress response, has been shown to play a role in impaired CTL responses in stressed animals, leading to high mortality in mice normally resistant to viral infection. While direct effects of neuroendocrine mediators on CTL have been studied, little is known about their effects on DC that are critical for CTL priming. Here, we found that physiologically relevant concentrations of CORT, acting via the glucocorticoid receptor, functionally compromise DC maturation. DC exposed to CORT remained phenotypically and functionally immature after stimulation with lipopolysaccharide and were impaired for the production of interleukin (IL)-6, IL-12, and tumour necrosis factor-alpha. These effects were biologically significant, as CORT treatment resulted in a marked reduction in the ability of DC to prime naive CD8(+) T cells in vivo. These findings offer a potential mechanism underlying stress-associated immunosuppression.


Asunto(s)
Corticosterona/farmacología , Células Dendríticas/efectos de los fármacos , Animales , Antígenos de Superficie/metabolismo , Linfocitos T CD8-positivos/inmunología , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Citocinas/biosíntesis , Células Dendríticas/inmunología , Células Dendríticas/fisiología , Endocitosis/efectos de los fármacos , Antígenos de Histocompatibilidad Clase II/metabolismo , Tolerancia Inmunológica/efectos de los fármacos , Lipopolisacáridos/antagonistas & inhibidores , Masculino , Ratones , Ratones Endogámicos C57BL , Receptores de Glucocorticoides/fisiología , Regulación hacia Arriba/efectos de los fármacos
11.
Infect Immun ; 72(3): 1409-22, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-14977946

RESUMEN

In cattle and other ruminants, infection with the intracellular pathogen Mycobacterium avium subsp. paratuberculosis results in a granulomatous enteritis (Johne's disease) that is often fatal. The key features of host immunity to M. avium subsp. paratuberculosis infection include an appropriate early proinflammatory and cytotoxic response (Th1-like) that eventually gives way to a predominant antibody-based response (Th2-like). Clinical disease symptoms often appear subsequent to waning of the Th1-like immune response. Understanding why this shift in the immune response occurs and the underlying molecular mechanisms involved is critical to future control measures and diagnosis. Previous studies have suggested that M. avium subsp. paratuberculosis may suppress gene expression in peripheral blood mononuclear cells (PBMCs) from infected cows, despite a continued inflammatory reaction at sites of infection. In the present study, we tested the hypothesis that exposure to M. avium subsp. paratuberculosis suppresses a proinflammatory gene expression pattern in PBMCs from infected cows. To do this, we examined expression of genes encoding interleukin-1alpha (IL-1alpha), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p35, IL-16, and IL-18, as well as genes encoding gamma interferon (IFN-gamma), transforming growth factor beta (TGF-beta), and tumor necrosis factor alpha (TNF-alpha), in PBMCs, intestinal lesions, and mesenteric lymph nodes of cattle naturally infected with M. avium subsp. paratuberculosis. Cytokine gene expression in these cells and tissues was compared to expression in similar cells and tissues from control uninfected cattle. Our comprehensive results demonstrate that for most cytokine genes, including the genes encoding IFN-gamma, TGF-beta, TNF-alpha, IL-1alpha, IL-4, IL-6, IL-8, and IL-12p35, differential expression in PBMCs from infected and control cattle did not require stimulation with M. avium subsp. paratuberculosis. In fact, stimulation with M. avium subsp. paratuberculosis tended to reduce the differential expression observed in infected and uninfected cows for genes encoding IFN-gamma, IL-1alpha, and IL-6. Only IL-10 gene expression was consistently enhanced by M. avium subsp. paratuberculosis stimulation of PBMCs from subclinically infected cattle. In ileal tissues from M. avium subsp. paratuberculosis-infected cattle, expression of the genes encoding IFN-gamma, TGF-beta, IL-5, and IL-8 was greater than the expression in comparable tissues from control uninfected cattle, while expression of the gene encoding IL-16 was lower in tissues from infected cattle than in control tissues. Mesenteric lymph nodes draining sites of M. avium subsp. paratuberculosis infection expressed higher levels of IL-1alpha, IL-8, IL-2, and IL-10 mRNA than similar tissues from control uninfected cattle expressed. In contrast, the genes encoding TGF-beta and IL-16 were expressed at lower levels in lymph nodes from infected cattle than in tissues from uninfected cattle. Taken together, our results suggest that cells or other mechanisms capable of limiting proinflammatory responses to M. avium subsp. paratuberculosis develop in infected cattle and that a likely place for development and expansion of these cell populations is the mesenteric lymph nodes draining sites of infection.


Asunto(s)
Enfermedades de los Bovinos/genética , Enfermedades de los Bovinos/inmunología , Citocinas/genética , Leucocitos Mononucleares/inmunología , Paratuberculosis/genética , Paratuberculosis/inmunología , Animales , Secuencia de Bases , Bovinos , Cartilla de ADN/genética , ADN Complementario/genética , Femenino , Expresión Génica , Íleon/inmunología , Técnicas In Vitro , Mediadores de Inflamación/metabolismo , Ganglios Linfáticos/inmunología , Mycobacterium avium subsp. paratuberculosis/inmunología , ARN Mensajero/genética , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/normas
12.
Infect Immun ; 71(11): 6487-98, 2003 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-14573671

RESUMEN

A bovine-specific cDNA microarray system was used to compare gene expression profiles of peripheral blood mononuclear cells (PBMCs) from control uninfected (n = 4) and Johne's disease-positive (n = 6) Holstein cows. Microarray experiments were designed so that for each animal, a direct comparison was made between PBMCs stimulated in vitro with Mycobacterium avium subsp. paratuberculosis and PBMCs stimulated with phosphate-buffered saline (nil-stimulated PBMCs). As expected, M. avium subsp. paratuberculosis stimulation of infected cow PBMCs enhanced expression of gamma interferon transcripts. In addition, expression of 15 other genes was significantly affected (>1.25-fold change; P < 0.05) by in vitro stimulation with M. avium subsp. paratuberculosis. Similar treatment of control cow PBMCs with M. avium subsp. paratuberculosis resulted in significant changes in expression of 13 genes, only 2 of which were also affected in PBMCs from the infected cow PBMCs. To compare gene expression patterns in the two cow infection groups (infected cows and uninfected cows), a mixed-model analysis was performed with the microarray data. This analysis indicated that there were major differences in the gene expression patterns between cells isolated from the two groups of cows, regardless of in vitro stimulation. A total of 86 genes were significantly differentially expressed (P < 0.01) in M. avium subsp. paratuberculosis-stimulated PBMCs from infected cows compared to expression in similarly treated PBMCs from control cows. Surprisingly, a larger number of genes (110 genes) were also found to be significantly differentially expressed (P < 0.01) in nil-stimulated cells from the two infection groups. The expression patterns of selected genes were substantiated by quantitative real-time reverse transcriptase PCR. Flow cytometric analysis indicated that there were no gross differences in the relative populations of major immune cell types in PBMCs from infected and control cows. Thus, data presented in this report indicate that the gene expression program of PBMCs from M. avium subsp. paratuberculosis-infected cows is inherently different from that of cells from control uninfected cows.


Asunto(s)
Perfilación de la Expresión Génica , Leucocitos Mononucleares/metabolismo , Paratuberculosis/inmunología , Animales , Bovinos , Femenino , Citometría de Flujo , Análisis de Secuencia por Matrices de Oligonucleótidos , Paratuberculosis/sangre , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
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