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1.
An. bras. dermatol ; 94(3): 287-292, May-June 2019. tab
Artigo em Inglês | LILACS, Sec. Est. Saúde SP, SESSP-ILSLPROD, Sec. Est. Saúde SP, SESSP-ILSLACERVO, Sec. Est. Saúde SP | ID: biblio-1011110

RESUMO

Abstract: Background: Renal transplant recipients are submitted to immunosuppression to avoid graft rejection, which makes them susceptible to various conditions. Furthermore, these individuals present malignant tumors more frequently than the general population, including nonmelanoma skin cancer. The individual genetic basis that acts in the pathogenesis of cutaneous cancer may present a protection or susceptibility factor for disease development. One of these factors is the HLA complex. Objective: To investigate HLA alleles association to the occurrence of nonmelanoma skin cancer in renal transplant recipients from São Paulo State. Methods: A total of 213 patients (93 renal transplant recipients with nonmelanoma skin cancer and 120 renal transplant recipients without nonmelanoma skin cancer) were evaluated by retrospective and cross-sectional study. Epidemiological, clinical and HLA typing data were found in databases. HLA class I (A, B) and class II (DR) alleles were compared to establish their association with nonmelanoma skin cancer. Results: Comparing renal transplant recipients with and without nonmelanoma skin cancer, the HLA-B*13 allele was associated with higher risk of developing nonmelanoma skin cancer while B*45 and B*50 alleles were associated with protection. Study limitations: The HLA A, B and DR alleles identification for the kidney transplantation routine is done by low and medium resolution techniques that do not allow discrimination of specific alleles. Conclusion: The involvement of HLA alleles in nonmelanoma skin cancer in renal transplant recipients was confirmed in this study. Renal transplant recipients with HLA-B*13 showed higher risk for developing a skin cancer (OR= 7.29) and should be monitored for a long period of time after transplantation.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Cutâneas/genética , Transplante de Rim/efeitos adversos , Antígenos HLA/genética , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/epidemiologia , Brasil/epidemiologia , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Antígenos HLA-DR/genética , Estudos de Casos e Controles , Estudos Transversais , Estudos Retrospectivos , Predisposição Genética para Doença/genética , Alelos , Transplantados
2.
Prensa méd. argent ; 104(5): 261-264, jul2018.
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1049760

RESUMO

Relación entre osteoartritis y HLA - A en pacientes iraquíes. (HLA: acrónimo inglés de antcígenos leucocitarios humanos - Human Leucocyte Antigens). La osteoartritis e la afección más común que involucra el aparato osteo-articular. Representa a un grupo heterogéneo de condiciones resultante de cambios comunes histopatológicos y radiológicos. Existen múltiples factores de riesgo para la osteoartritis: edad, obesidad, y el antígeno genético. El leococitario humano (HLA) como parte del sistema inmune, teniendo un rol en el proceso nosológico. Diversos estudios han determinado la diferente asociación entre la clase HLA - I y la II. El objetivo de esta investigación fue el de determinar la eventualidad de una relación entre el HLA-I y el II en la osteocondritis. Los resultados obtenidos se discuten en el artículo.


Background: Osteoarthritis (OA) is the most common type of joint disease. It represents a heterogeneous group of conditions resulting in common histopathologic and radiologic changes. There are multiples risk factors for osteoarthritis includes the following: Age, Obesity and Genetics. Human leukocyte antigen (HLA) as part of immune system has a role in the disease process. Many reported studies have pointted to different HLA classs I and II association. Aim: To investigate whether there is an association between HLA class II and OA. Patients and methods: A cross sectional comparatives study including patient with primary osteoarthritis attending the department of orthopedic in Al-Kindy teaching hospital Baghdad, Iraq between September 2016-September 2017. Patient's selection was done by the orthopaedics. The HLA-A tuping was performed in HLA research unit at Al-Kindy College of Medicine using PCR-SSO according to the manufacturer instruction using both Amplification and Hybridization kit by Automated method using Autolipa - 48Innogenities-Belgium. The results ewre interepted using LIRAS version 5.0 software innogenetics - Belgium, odds ratio were used to test signifcant differences. Results: Thirty five Iraqi Arab Muslims patients with primary osteoarthritis. The control group was comprised from 75 healtht unrelated sex and age matched volunteers among the staff of Al-Kindey college of medicine that didn't have a history of osteoarthritis. There was an increased frequencies of HLA-A*0101,0202,6802 in patients with osteoarthritis compared with healthy controls (P value=0.001,<0.001,<0.001 respectively)


Assuntos
Humanos , Osteoartrite/diagnóstico , Osteocondrite/patologia , Reação em Cadeia da Polimerase , Fatores de Risco , Alelos , Antígenos HLA/imunologia
3.
Rev. colomb. cir ; 33(1): 100-106, 2018. tab, fig
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-905306

RESUMO

Introducción. El trasplante de intestino mejora la supervivencia de pacientes con falla intestinal secundaria al síndrome de intestino corto. Estos receptores tienen gran riesgo de rechazo agudo, por lo cual, de manera protocolaria y como método de referencia, se practican biopsias intestinales. En este reporte de caso se hizo el seguimiento inmunológico de anticuerpos anti-HLA por tecnología Luminex™ (LSA) de un paciente con trasplante de intestino más biopsias por protocolo para un diagnóstico temprano, y una adecuada correlación histológica. Presentación del caso. Se trata de un paciente de 20 años de edad con síndrome de intestino corto, que ingresó a la Fundación Valle del Lili (Cali, Colombia) y requirió un trasplante aislado de intestino. El seguimiento inmunológico se hizo con tecnología Luminex™ y biopsias intestinales mensuales. Según la tamización contemplada en el protocolo previo al trasplante, el paciente tuvo anticuerpos anti-HLA (PRA de clase I y II) negativos; y a los 11 meses después del trasplante, los anticuerpos anti-HLA de clase I y II fueron positivos. Con la prueba de LSA se detectó un anticuerpo específico contra donantes (Donor Specific Antibodies, DSA) y varios anticuerpos contra otros subtipos moleculares. Se tomó una biopsia que mostró un leve rechazo celular agudo y se inició tratamiento con plasmaféresis. Hasta 21 meses después del trasplante, el paciente no ha presentado rechazos clínicos y ha tenido una adecuada evolución clínica y paraclínica Conclusión. Este es el primer trasplante de intestino en nuestro centro, en el que se hace seguimiento inmunológico con tecnología Luminex™. Consideramos que la detección con DSA es un buen marcador de rechazo agudo humoral, que permitiría una aproximación diagnóstica y una intervención oportuna


Background: Small bowel transplant improves survival of the recipients that have intestinal failure secondary to short bowel syndrome. These patients have a high risk of acute rejection; for this reason bowel biopsies are performed as protocol and is the gold standard. Immunological follow-up of anti-HLA antibodies with Luminex® technology (LSA) was carried out in a patient with intestinal transplant and biopsies were performed to achieve an early diagnosis and a suitable histological correlation. Case report: A 20-year-old patient with short bowel syndrome secondary to extensive intestinal resection due to a complicated appendicitis underwent isolated bowel transplantation. The post-transplant immunological follow-up was performed with LSA and monthly intestinal biopsies. Antibodies with mean fluorescence intensity greater than 1500 were positive. During the pre-transplant protocol, the patient was screened for anti-HLA antibodies with negative results. Eleven months post-transplant, the screening test for anti-HLA Class I and II antibodies was positive; the specificity of the LSA test detected one specific donor antibody (DSA) and several antibodies against other molecular subtypes. The biopsy result was a mild acute cellular rejection and plasmapheresis therapy was started. The patient has not presented a clinical rejection, and at 21 months post-transplantation exhibits an adequate clinical and paraclinical evolution. Conclusions: This is the first small bowel transplant where immunological follow-up is done with LSA. We believe that the detection of DSA is a marker of acute humoral rejection that allows a diagnostic approach and a timely intervention


Assuntos
Humanos , Transplante de Órgãos , Rejeição de Enxerto , Antígenos de Histocompatibilidade , Antígenos HLA , Imunologia de Transplantes
4.
Rev. bras. hematol. hemoter ; 39(3): 229-236, July-Sept. 2017. tab, graf
Artigo em Inglês | LILACS | ID: biblio-898929

RESUMO

Abstract Background Bone marrow transplantation has been used in the treatment of various diseases, especially hematologic diseases. The success of this treatment, among other factors, requires human leukocyte antigens (HLA) compatibility between patient and donor. Knowing the human leukocyte antigens allele group and haplotype frequencies as well as the linkage disequilibrium between alleles of different human leukocyte antigens loci can shorten the search time for a compatible bone marrow donor. Objective To assemble and analyze data on human leukocyte antigens frequencies available in the Laboratory of Immunogenetics and Histocompatibility (LIGH) database of the Universidade Federal do Paraná adding an estimation of the Hardy-Weinberg equilibrium and linkage disequilibrium. Methods The sample was composed of seven populations grouped by self-declared ancestry or inferred from the surname as follows: Laboratory of Immunogenetics and Histocompatibility database (all groups), descendants of Italians, Poles, and Asians, Afro-Brazilians, Mulattos (mixed ancestry) and Amerindians. Human leukocyte antigens genotyping was carried out using the polymerase chain reaction-sequence specific primers (PCR-SSP) and -sequence specific oligonucleotide (PCR-SSO) technologies. Results There were high frequencies of the HLA-A*02, HLA-B*35 and HLA-DRB1*13 allelic groups in all groups. The same was observed for the HLA-A*01-B*08-DRB1*03 haplotype except for Asian descendants. It was observed that the human leukocyte antigens Laboratory of Immunogenetics and Histocompatibility database and the Asian group are not in Hardy-Weinberg equilibrium. The Italian, Polish, Asian, Mulatto and Amerindian descendants showed haplotypes in complete linkage disequilibrium. Our results were compared with data on the human leukocyte antigens in the Paraná population available from the Brazilian Voluntary Bone Marrow Donor Registry (REDOME) and data published on the population of Curitiba and the northern region of Paraná. Conclusions Haplotypes frequent in the Asian group were not the most frequently observed in the Laboratory of Immunogenetics and Histocompatibility database and the National Bone Marrow Donor Registry for the state of Paraná. Linkage disequilibrium information may prove useful in the search for bone marrow donors for patients awaiting a suitable donor.


Assuntos
Humanos , Polimorfismo Genético , Transplante , Desequilíbrio de Ligação , Histocompatibilidade , Antígenos HLA
5.
An. bras. dermatol ; 91(4): 410-421, July-Aug. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-792428

RESUMO

Abstract: Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue.


Assuntos
Humanos , Masculino , Feminino , Psoríase/genética , Psoríase/patologia , Língua/patologia , Glossite Migratória Benigna/genética , Glossite Migratória Benigna/patologia , Psoríase/complicações , Língua Fissurada/patologia , Biópsia , Imuno-Histoquímica , Marcadores Genéticos , Glossite Migratória Benigna/complicações , Glossite Migratória Benigna/terapia , Antígenos HLA/análise , Ilustração Médica
6.
Rev. méd. hered ; 27(2): 111-114, abr.-jun. 2016.
Artigo em Espanhol | LILACS | ID: biblio-982865

RESUMO

La introducción de la compatibilidad en los antígenos leucocitarios humanos (HLA) en la selección de los injertos para trasplante renal ha mejorado la sobrevida y el pronóstico del órgano trasplantado, a corto y largo plazo. Sin embargo, recientes observaciones sugieren que la importancia relativa de los HLA ha disminuido en décadas recientes. Posibles explicaciones para este fenómeno incluyen la reciente utilización de terapias inmunosupresoras más potentes, una mayor importancia relativa de antígenos no HLA y factores no inmunológicos.


The introduction of compatibility tests for human leukocyte antigens (HLA) in the selection of donors for renal transplant has improved the survival and the prognosis of the transplant itself at both short and long-term periods of time. However, recent observations suggest less importance of HLA typing. Possible explanations for this phenomenon include the recent utilization of more potent immunosuppressive therapies, a greater importance of non HLA antigens, and non immunologic factors.


Assuntos
Humanos , Sobrevivência de Enxerto , Antígenos HLA , Transplante de Rim , Complexo Principal de Histocompatibilidade
7.
Rev. bras. hematol. hemoter ; 38(1): 1-6, Jan.-Feb. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-777433

RESUMO

ABSTRACT Background: Successful transfusion of platelet refractory patients is a challenge. Many potential donors are needed to sustain human leukocyte antigen matched-platelet transfusion programs because of the different types of antigens and the constant needs of these patients. For a highly mixed population such as the Brazilian population, the pool size required to provide adequate platelet support is unknown. Methods: A mathematical model was created to estimate the appropriate size of an unrelated donor pool to provide human leukocyte antigen-compatible platelet support for a Brazilian population. A group of 154 hematologic human leukocyte antigen-typed patients was used as the potential patient population and a database of 65,500 human leukocyte antigen-typed bone marrow registered donors was used as the donor population. Platelet compatibility was based on the grading system of Duquesnoy. Results: Using the mathematical model, a pool containing 31,940, 1710 and 321 donors would be necessary to match more than 80% of the patients with at least five completely compatible (no cross-reactive group), partial compatible (one cross-reactive group) or less compatible (two cross-reactive group) donors, respectively. Conclusion: The phenotypic diversity of the Brazilian population has probably made it more difficulty to find completely compatible donors. However, this heterogeneity seems to have facilitated finding donors when cross-reactive groups are accepted as proposed by the grading system of Duquesnoy. The results of this study may help to establish unrelated human leukocyte antigen-compatible platelet transfusions, a procedure not routinely performed in most Brazilian transfusion services.


Assuntos
Humanos , Medula Óssea , Antígenos HLA , Transfusão de Plaquetas
8.
São Paulo; s.n; 2016. [128] p. ilus, graf, tab.
Tese em Português | LILACS | ID: biblio-870894

RESUMO

As moléculas HLA são os principais alvos da rejeição nos transplantes de órgãos sólidos. A influência dos anticorpos anti-HLA pré-formados e da compatibilidade HLA no transplante de fígado ainda não está bem definida. A maioria dos transplantes é realizada sem a pesquisa de anticorpos anti-HLA pré-formados e sem pareamento HLA. OBJETIVOS: Avaliar as associações dos anticorpos anti-HLA pré-formados e da compatibilidade HLA à rejeição celular aguda (RCA) em até 90 dias após o transplante. MÉTODOS: Coorte prospectiva de transplantes de fígado ABO compatíveis/idênticos realizados entre janeiro de 2012 e dezembro de 2013. Enxertos que sobreviveram além de 4 dias foram incluídos. A pesquisa de anticorpos anti-HLA classes I e II foram realizadas por meio de ensaios de fase sólida (LABScreen® Mixed e LABScreen® Single Antigen). MFI (Mean Fluorescence Intensity) >= 1.000 foi onsiderado omo positi o para anticorpos anti-HLA. Tipificação HLA-A, B e DR, de receptores e doadores foi feita por meio de PCR (Polymerase Chain Reaction). Conforme o número de alelos HLA incompatíveis, os transplantes foram classificados em compatíveis (0-3 incompatibilidades) e incompatíveis (4-6 incompatibilidades). Apenas episódios de RCA comprovados por biópsia, associados a alterações das provas hepáticas, foram considerados. O critério Banff foi utilizado para diagnóstico e os episódios foram estratificados em leves, moderados e graves. Modelos de regressão de Cox foram realizados e as razões de risco (RR) associadas foram determinadas. Sobrevidas livres de RCA foram obtidas por meio do estimador de Kaplan Meier e comparadas entre os grupos pelo teste log-rank. RESULTADOS: Cento e vinte e nove transplantes foram analisados. Incidência global de RCA em 90 dias foi de 14,7%. A pesquisa de anticorpos anti-HLA pré-formados foi considerada positiva em 35,6% dos transplantes. Em relação à compatibilidade HLA, 91,5% dos transplantes foram classificados como...


Human leucocyte antigens (HLA) molecules are the main targets of rejection in solid organ transplantation. Significance of anti-HLA preformed antibodies and HLA compatibility remains unclear in liver transplantation. Majority of liver transplants are performed without assessment of preformed anti-HLA antibodies and HLA-matching. OBJECTIVES: Evaluate associations of preformed anti-HLA antibodies and HLA compatibility with acute cellular rejection (ACR) in the first 90 days after transplantation. METHODS: Prospective cohort of ABO-identical/compatible liver transplants between January 2012 and December 2013. Grafts that survived more than 4 days were included. Anti-HLA class I and II antibodies were determined by solid phase assays (LABScreen® Mixed and LABScreen® ingle Antigen). A mean fluores en e intensity ( I) >= 1.000 was considered as positive for anti-HLA antibodies. Recipients and donors HLA typing for HLA-A, B and DR were performed using polymerase chain reaction (PCR) assays. According to HLA mismatches (MM), transplants were divided in compatible (0-3 MM) and incompatible (4-6 MM). Only biopsy proven ACR episodes, associated with abnormal liver tests, were considered. Banff criteria was used for diagnosis of ACR and episodes were graded as mild, moderate and severe. Cox proportional hazards models were performed and associated hazard ratios (HR) were determined. Free ACR rates were estimated with Kaplan-Meier analysis and were compared between groups with the log-tank test. RESULTS: One hundred twenty nine transplants were analyzed. Overall incidence of ACR was 14.7% in 90 days. Assessment of anti-HLA pre-formed antibodies was considered positive in 35.6% of transplants. Regarding HLA compatibility, 91.5% were considered incompatible. Anti-HLA antibodies sensitization was associated with an increased risk of ACR (HR= 4.3; CI 95%=1,3 - 13,5; p=0.012). According to class of antibody, we could observe that class II was associated with an...


Assuntos
Humanos , Masculino , Feminino , Anticorpos , Rejeição de Enxerto , Histocompatibilidade , Antígenos HLA , Transplante de Fígado
9.
Fortaleza; s.n; 2016. 68 p. ilus, tab.
Tese em Português | LILACS | ID: biblio-971948

RESUMO

A anemia falciforme (AF) é uma doença hereditária, frequente, mas não exclusiva, em indivíduos de origem africana. Na população negra brasileira há uma prevalência de 0,1 a 0,3% tendendo a atingir parcelas cada vez maiores devido à miscigenação. Alelos específicos do sistema HLA e seus haplótipos podem influenciar o risco de surgimento de manifestações clínicas em pacientes com AF, ao passo que os seus genótipos podem atuar como marcadores úteis na identificação do risco para determinadas manifestações clínicas. O estudo foi do caso-controle randomizado, com o intuito de avaliar a associação dos alelos do sistema HLA de classe II com características clínicas e parâmetros hematológicos de pacientes com AF. Foram realizadas genotipagens para os loci DRB1 e DQB1 de 62 indivíduos com diagnóstico de AF, e de 86 indivíduos saudáveis(HbA2)usados como controle. As frequências alélicas (Fa) foram obtidas pela contagem direta, e calculadas pela fórmula Fa = a/2n.No grupo com AF oscinco alelos HLA-DRB1 mais frequentes foram DRB1*04 (16,9%), DRB1*01 (12,9%), DRB1*08 (12,1%), DRB1*07 e DRB1*11 (ambos com 11,3%), os quais representam 64,5% da variabilidade total das 13 especificidades analisadas...


Sickle cell anemia(SCA) is an inherited disease, often, but not exclusively, in individuals of African origin. In the black Brazilian population there is a prevalencefrom 0.1 to 0.3% tending to affect an ever larger portions due to miscegenation. Specific alleles of the HLA system and may influence the risk of appearance of clinical symptoms in patients with SCA, whereas their genotypes may serve as useful markers in identifying the risk for certain clinical manifestations. The study was a randomized-case control in order to evaluate the association of alleles of the HLA class II system with clinical features and hematological parameters of patients with SCA. The genotyping were performed for the DRB1 and DQB1 loci from 62 individuals diagnosed with SCAand 86 healthy individuals(HbA2)used as controls. Allele frequencies (Fa) were obtained by direct countingand calculated by the formula Fa= a / 2n. In the group with SCAthe five most common HLA-DRB1 alleles were DRB1*04 (16.9%), DRB1*01 (12.9%),DRB1 * 08 (12.1%),DRB1 * 07 and DRB1 * 11 (both 11.3%), which represent 64.5% of the total variability of the 13 analyzed specificities. The three most frequent alleles were HLA-DQB1 DQB1*03 (45.2%), DQB1*05 (18.5%) and DQB1*06 (16.9%), corresponding to 80.6% of the total variability of the 5analyzed specificities...


Assuntos
Humanos , Anemia Falciforme , Alelos , Antígenos HLA
10.
Rev. latinoam. enferm. (Online) ; 23(4): 620-627, July-Aug. 2015.
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: lil-761695

RESUMO

AbstractObjective: to analyze the meanings of leprosy for people treated during the sulfonic and multidrug therapy periods.Method: qualitative nature study based on the Vigotski's historical-cultural approach, which guided the production and analysis of data. It included eight respondents who have had leprosy and were submitted to sulfonic and multidrug therapy treatments. The participants are also members of the Movement for Reintegration of People Affected by Leprosy.Results: the meanings were organized into three meaning cores: spots on the body: something is out of order; leprosy or hanseniasis? and leprosy from the inclusion in the Movement for Reintegration of People Affected by Leprosy.Conclusion: the meanings of leprosy for people submitted to both regimens point to a complex construction thereof, indicating differences and similarities in both treatments. Health professionals may contribute to the change of the meanings, since these are socially constructed and the changes are continuous.


ResumoObjetivo:analisar significados da hanseníase para as pessoas que foram tratadas no período sulfônico e no período da poliquimioterapia.Método:estudo de natureza qualitativa fundamentado na abordagem histórico-cultural de Vigotski, a qual orientou a construção e análise dos dados. Foram incluídos oito entrevistados que já tiveram hanseníase e que realizaram tratamento no período sulfônico e da poliquimioterapia, sendo participantes do Movimento de Reintegração das Pessoas Atingidas pela Hanseníase.Resultados:os significados foram organizados em três núcleos de significação: manchas no corpo: alguma coisa está fora de ordem; lepra ou hanseníase? e hanseníase a partir da inserção no Movimento de Reintegração das Pessoas Atingidas pela Hanseníase.Conclusão:os significados de hanseníase para pessoas tratadas nos dois períodos apontam para a construção complexa dos mesmos, indicando diferenças e semelhanças nos dois períodos. Os profissionais de saúde podem contribuir para a mudança de significados, pois esses são socialmente construídos e as transformações são contínuas.


ResumenObjetivo:analizar los significados de la lepra para las personas que fueron tratadas en el período sulfónico y en el período de poliquimioterapia.Método:estudio de naturaleza cualitativa fundamentado en el abordaje histórico cultural de Vygotsky, el cual orientó la construcción y análisis de los datos. Fueron incluidos ocho entrevistados que ya tuvieron lepra y que realizaron tratamiento en el período sulfónico y de poliquimioterapia, siendo participantes del Movimiento de Reintegración de Personas Afectadas por la Lepra.Resultados:los significados fueron organizados en tres núcleos de significación: manchas en el cuerpo: alguna cosa está fuera de orden; ¿Lepra o enfermedad de Hansen?; y lepra a partir de la inserción en el Movimiento de Reintegración de Personas Afectadas por la Lepra. Conclusión: los significados de la lepra para las personas tratadas en los dos períodos apuntan para la construcción compleja de los mismos, indicando diferencias y semejanzas en los dos períodos. Los profesionales de la salud pueden contribuir para el cambio de significados, ya que estos son socialmente construidos y las transformaciones son continuas.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/mortalidade , Antígenos HLA/imunologia , Isoanticorpos/imunologia , Transplante de Rim , Intervalo Livre de Doença , Rejeição de Enxerto/sangue , Antígenos HLA/sangue , Isoanticorpos/sangue , Taxa de Sobrevida
11.
Acta sci., Health sci ; 37(2): 175-179, jul.-dez. 2015. tab
Artigo em Inglês | LILACS | ID: biblio-832091

RESUMO

While a 42-year-old male patient was being prepared for deceased-donor renal transplantation, anti-HLA-A2 antibodies were detected in the serum by enzyme-linked immunosorbent assay (ELISA) method. The patient denied any transfusion history and previous transplant. Crossmatch by complement dependent cytotoxicity (CDC) and CDC with anti -human globulin (CDC-AHG) proved negative with a four-cell panel with positive typing for HLA-A2. Adsorption of antibodies with platelets and analysis of eluate were suggested to elucidate discrepancies in results by ELISA and by CDC-AHG. ELISA showed that adsorbed serum with platelets did not reveal antibodies for HLA-A2 specificity and suggested that they were removed by their specific binding with HLA-A2 antigens on the platelet surface. Eluate analysis by ELISA showed antibodies for HLA-A2 specificity. No antibodies for HLA-A2 specificity in the non-adsorbed serum were detected by CDC-AHG method. Revision of patient's data showed that a previous transfusion had occurred, which may have been the source of HLA sensitization. The suggested method may be a contribution towards the evaluation of sensitivity between CDC-AHG and ELISA methods for characterizing antibodies in the patient's serum.


Enquanto um paciente do sexo masculino de 42 anos de idade estava sendo preparado para o transplante renal de doador falecido, anticorpos anti-HLA-A2 foram detectados no soro pelo método de ensaio imunoenzimático (ELISA). O paciente negava história de transfusão e transplante anterior. Prova-cruzada por citotoxicidade dependente de complemento (CDC) e CDC com antiglobulina humana (CDC-AGH) foram negativos com um painel de quatro células com tipagem positiva para HLA-A2. O método de adsorção de anticorpos com plaquetas e análise do eluato foi sugerido para explicar as discrepâncias dos resultados de ELISA e CDC-AGH. O método de ELISA mostrou que o soro adsorvido com plaquetas não revelou anticorpos para especificidade HLA-A2, sugerindo que eles foram removidos por meio de sua ligação específica com os antígenos HLA-A2 na superfície das plaquetas. A análise do eluato por ELISA mostrou anticorpos para especificidade HLA-A2. Nenhum anticorpo para especificidade HLA-A2 foi detectada no soro não adsorvido pelo método de CDC-AGH. Revisão dos dados do paciente mostrou que houve transfusão anterior, podendo ter sido a fonte de sensibilização HLA. O método sugerido é uma contribuição para avaliação da sensibilidade entre os métodos de CDC-AGH e ELISA em caracterizar anticorpos no soro do paciente.


Assuntos
Humanos , Masculino , Adulto , Anticorpos , Testes Imunológicos de Citotoxicidade , Ensaio de Imunoadsorção Enzimática , Antígenos HLA , Transplante de Rim
12.
Rev. cuba. hematol. inmunol. hemoter ; 31(1): 32-40, ene.-mar. 2015.
Artigo em Espanhol | LILACS | ID: lil-743984

RESUMO

Introducción: el trasplante es la terapia que permite la mayor sobrevida a los pacientes con insuficiencia renal crónica. Para prevenir el rechazo del órgano, en primer lugar es necesario un estudio de la compatibilidad de los antígenos leucocitarios humanos (HLA) del paciente y de los posibles donantes. En Cuba solo se había realizado la tipificación HLA por métodos serológicos, pero en la actualidad se emplean técnicas moleculares. Objetivo: caracterizar el polimorfismo de los alelos HLA A, B, DR y DQ por métodos moleculares en pacientes cubanos en espera de trasplante renal. Métodos: se estudiaron 410 pacientes con insuficiencia renal crónica de las regiones occidental y central del país a los que se les realizó tipificación molecular de los loci mencionados. Los resultados se expresaron según la nueva nomenclatura y fueron registrados en una base de datos confeccionada al efecto. Se compararon las frecuencias alélicas de la población blanca y no blanca y se determinó el porcentaje de frecuencia de los haplotipos para los alelos clase I y II. Resultados: los alelos A*11, A*30, A*74, B*42, B*51 y B*53 fueron más frecuentes en la población blanca mientras que los alelos B*58 y DRB1* 15 predominaron en los no blancos. Las frecuencias haplotípicas más encontradas en la clase I en la población blanca fueron A*02 B*51, A*02 B*44, A*02 B*35; y en la no blanca, A*01B*08, A*02B*51, A*02B*44. Para los alelos de la clase II, en la población blanca fueron DQB1*03, DRB1*04, DQB1*06, DRB1*13, DRB1*05, DRB1*01; y en los no blancos, DQB1*03, DRB1*04, DQB1*06, DRB1*13, DQB1*05, DRB1*01. Conclusiones: la caracterización de los pacientes con insuficiencia renal crónica con respecto a su tipificación HLA permitirá trazar estrategias futuras relacionadas con la donación y el trasplante en todo el país(AU)


Introduction: transplantation is the therapy allowing the highest possible survival in patients with chronic kidney insufficiency. To prevent rejection of the organ, first of all it is necessary to make a compatibility test of human leukocyte antigens (HLA) from the patient and the possible donors. In Cuba, only serological HLA typing had been made but at present, molecular techniques are being applied. Aim: characterization of polimorfirsm of alleles HLA A, B, DR y DQ by molecular techniques in Cuban patients awaiting renal transplantation. Methods: four hundred and ten patients with chronic kidney insufficiency from Western and Central Cuba were studied by molecular typing of the above mentioned loci. Results were expressed by the new nomenclature and were registered In a data base prepared for that purpose. Allele frequencies of white and no white population were compared and percentage of haplotype frequencies for alleles class I and II were determined. Results: alleles A*11, A*30, A*74, B*42, B*51and B*53 were more frequent in white population while B*58 y DRB1*, 15 were mostly found in no whites. Haplotypic frequencies most found in class I in white population were A*02 B*51, A*02 B*44, A*02 B*35; and in no whites, A*01B*08, A*02B*51, A*02B*44. For class II alleles, DQB1*03, DRB1*04, DQB1*06, DRB1*13, DRB1*05, DRB1*01 were the most found in white population; and in no whites, DQB1*03, DRB1*04, DQB1*06, DRB1*13, DQB1*05, DRB1*01. Conclusions: characterization of patients with chronic kidney insufficiency in respect to HLA typing will allow future strategies related to kidney donation and transplantation in the whole country(AU)


Assuntos
Humanos , Masculino , Feminino , Antígenos HLA/imunologia , Insuficiência Renal Crônica/genética , Cuba , Teste de Histocompatibilidade/métodos , Transplante de Rim/métodos
13.
Einstein (Säo Paulo) ; 13(1): 153-156, Jan-Mar/2015.
Artigo em Inglês | LILACS | ID: lil-745865

RESUMO

The setting for the occurrence of an immune response is that of the need to cope with a vast array of different antigens from both pathogenic and non-pathogenic sources. When the first barriers against infection and innate defense fail, adaptive immune response enters the stage for recognition of the antigens by means of extremely variable molecules, namely immunoglobulins and T-cell receptors. The latter recognize the antigen exposed on cell surfaces, in the form of peptides presented by the HLA molecule. The first part of this review details the central role played by these molecules, establishing the close connection existing between their structure and their antigen presenting function.


O cenário no qual ocorre a resposta imune é o da necessidade de fazer frente a uma vasta gama de antígenos diferentes, de fontes patogênicas e não patogênicas. Quando as primeiras barreiras contra infecção e a defesa inata falham, a resposta imune adaptativa entra em campo, para efetuar o reconhecimento dos antígenos, utilizando, para esse fim, moléculas extremamente variáveis, que são as imunoglobulinas e os receptores de células-T. Estes últimos reconhecem o antígeno, exposto na superfície das células como peptídeo apresentado pelas moléculas HLA. A primeira parte desta revisão detalha o papel central dessas moléculas, estabelecendo a conexão que existe entre a estrutura e a função de apresentação de antígenos.


Assuntos
Humanos , Apresentação do Antígeno/imunologia , Antígenos HLA/imunologia , Complexo Principal de Histocompatibilidade/imunologia , Alelos , Apresentação do Antígeno/genética , Antígenos HLA/genética , Complexo Principal de Histocompatibilidade/genética
14.
Einstein (Säo Paulo) ; 13(1): 157-162, Jan-Mar/2015.
Artigo em Inglês | LILACS | ID: lil-745874

RESUMO

The second part of this review deals with the molecules and processes involved in the processing and presentation of the antigenic fragments to the T-cell receptor. Though the nature of the antigens presented varies, the most significant class of antigens is proteins, processed within the cell to be then recognized in the form of peptides, a mechanism that confers an extraordinary degree of precision to this mode of immune response. The efficiency and accuracy of this system is also the result of the myriad of mechanisms involved in the processing of proteins and production of peptides, in addition to the capture and recycling of alternative sources aiming to generate further diversity in the presentation to T-cells.


A segunda parte desta revisão trata das moléculas e processos envolvidos no processamento e apresentação dos fragmentos antigênicos ao receptor de célula-T. Apesar de variar a natureza do antígeno apresentado, a classe mais significativa é a das proteínas, as quais são processadas dentro da célula para enfim serem reconhecidas na forma de peptídeos, o que confere um grau extraordinário de precisão a essa forma de resposta imune. A eficiência e a precisão desse sistema se devem também à miríade de mecanismos envolvidos no processamento de proteínas e produção de peptídeos, além da captura e reciclagem de fontes alternativas de antígenos com o objetivo de gerar ainda maior diversidade na apresentação à célula-T.


Assuntos
Humanos , Apresentação do Antígeno/imunologia , Peptídeos Penetradores de Células/metabolismo , Antígenos HLA/metabolismo , Complexo Principal de Histocompatibilidade/imunologia , Peptídeos Penetradores de Células/imunologia , Antígenos HLA/imunologia
15.
Acta sci., Health sci ; 37(1): 63-68, jan.-jun. 2015.
Artigo em Inglês | LILACS | ID: biblio-832154

RESUMO

Zinc (Zn) is an essential trace element for cellular viability, but concentrations above physiologic level may lead to cellular damage. The purpose of the present study was to evaluate the in vitro ZnCl2 genotoxicity and cytotoxicity in human leukocyte cells. This was assessed in an unprecedented way that correlated the level of intracellular Zn after cell exposition with the cellular damage. The exposure to increased Zn concentrations (2.5-20 µg mL-1), showed significantly reduced cellular leukocyte viability. However, significant DNA damages were observed only when the Zn exposure concentrations were from 10-20 µg mL-1. The Zn intracellular levels found in leukocytes was from 72.25-268.9 ρ g cell-1, starting to induce cytotoxicity and genotoxicity at concentrations of 95.68 and 126.2 ρg cell-1, respectively. The relationship between the exposure concentration and intracellular levels of Zn suggests that the influx of Zn, in the form of ZnCl2, occurs in human leukocytes under zero-order kinetics.


O Zinco (Zn) é um elemento traço essencial para a viabilidade celular, mas em concentrações acima dos níveis fisiológicos pode conduzir a danos celulares. A proposta do presente estudo foi avaliar a citotoxicidade e genotoxicidade do ZnCl2 em leucócitos humanos in vitro. De maneira sem precedentes, foi acessado o nível de Zn intracelular após exposição e relacionado com o nível de dano celular. A exposição a crescentes concentrações de Zn (2,5-20 µg mL-1), mostraram significante redução da viabilidade celular dos leucócitos. Entretanto, danos significativos ao DNA foram encontrados somente a partir das concentrações de exposição ao Zn de 10-20 µg mL-1. Os níveis intracelulares de Zn encontrados nos leucócitos foram de 72,25-268,9 ρg célula-1, começando a induzir citotoxicidade e genotoxicidade nas concentrações de 95,68 and 126,2 ρg célula-1, respectivamente. A relação entre a concentração de exposição e os níveis intracelulares de Zn sugerem que o influxo de Zn, sob a forma de ZnCl2, ocorre em cinética de ordem zero em leucócitos humanos.


Assuntos
Antígenos HLA , Zinco/toxicidade
16.
Rio de Janeiro; s.n; 2015. xv,108 p. ilus, tab, graf, mapas.
Tese em Português | LILACS | ID: lil-774228

RESUMO

Embora complexa e multifatorial, a aquisição da imunidade clínica à malária é dependente da resposta mediada por anticorpos. No entanto, variações na resposta de anticorpos determinadas por características epidemiológicas ou polimorfismos genéticos dos genes HLA de classe II podem influenciar diretamente esse processo. Nesse sentido, estudos com foco na influência dos alelos de classe II na resposta imune em populações naturalmente expostas são extremamente necessários no desenvolvimento de vacinas contra o Plasmodium vivax. Portanto, neste estudo nós avaliamos as possíveis associações entre os grupos alélicos HLA-DRB1* e HLA-DQB1* detectados por PCR-SSO (Luminex) e resposta humoral mediada por anticorpos IgG e subclasses (ELISA) contra três proteínas recombinantes:PvMSP1 19, PvRBP123-751 e PvAMA-1 em 565 indivíduos da Amazônia brasileira. Nossos resultados demonstram que as proteínas PvMSP1 19, PvRBP123-751 e PvAMA-1 foram altamente imunogênicas sendo reconhecidas respectivamente por 75,8 por cento, 73,5 por cento e 60,7 por cento da população estudada e as subclasses de anticorpos citofílicos IgG1 e/ou IgG3 foram predominantes na resposta contra todas as proteínas. Em relação aos dados epidemiológicos observamos que os níveis de IgG contra as três proteínas foram associados com o número de infecções maláricas anteriores e com o tempo de exposição em área endêmica, relacionando a estas proteínas um efeito cumulativo na resposta humoral. No entanto, este efeito parece ser dependente de infecções constantes uma vez que o tempo desde a última malária teve correlação inversa e significativa com o índice de reatividade de anticorpos IgG anti-MSP1 19, anti-AMA-1 e anti-RBP-123-751...


Although complex and multifactorial,the acquisition of clinical immunity to malaria is dependent of antibody-mediated immuneresponse. However, variations in antibody response could be determined by epidemiologicalcharacteristics or genetic polymorphisms in HLA class II genes. In this scenario, studiesaiming the evaluation of HLA class II alleles and its influence in the specific immuneresponse of naturally exposed populations are necessary in the development of vaccinesagainst P. vivax. Therefore, we evaluated the possible association between allelic groupsHLA-DRB1* and HLA-DQB1* detected by PCR-SSO (Luminex) and humoral responsemediated by IgG and subclass (ELISA) against three recombinant proteins: PvMSP1-19,PvRBP123-751 and PvAMA-1 in 565 individuals in the Brazilian Amazon. Our resultsdemonstrate that PvMSP1-19, PvRBP123-751 and PvAMA-1 were highly immunogenic andrecognized by respectively 75.8 percent, 73.5 percent and 60.7 percent of studied population and subclasses ofcytophilic antibodies IgG1 and/or IgG3 were predominant in response against all proteins.Concerning the epidemiological data we observed that IgG levels against the three proteinswere associated with the number of previous malaria infections and time of exposure inendemic area, relating to these proteins a cumulative effect on the humoral response.However, this effect appears to be dependent of constant infections since the time since thelast malaria has an inverse correlation with the IR of anti-MSP1 19 IgG antibodies, anti-AMA-1 and anti-RBP-123- 751. Lastly, we evaluated the frequency of IgG antibody response byallelic groups of HLA class II...


Assuntos
Humanos , Antimaláricos , Antígenos HLA , Proteínas de Membrana , Malária Vivax/imunologia , Ensaio de Imunoadsorção Enzimática
17.
Medicina (B.Aires) ; 74(5): 400-403, oct. 2014. tab
Artigo em Espanhol | LILACS | ID: lil-734408

RESUMO

En trasplante renal, los anticuerpos donante-específicos por ensayos de fase sólida predicen el rechazo temprano mediado por anticuerpos, incluso con resultados negativos de citometría de flujo o citotoxicidad dependiente del complemento. Aquí se describen los protocolos de inmunosupresión y los resultados a diez meses de cuatro pacientes en los que se detectó anticuerpos donante-específicos anti-antígenos leucocitarios humanos (HLA) por Luminex®, pero no detectados por el método de citotoxicidad dependiente de complemento (CDC) ni por citometría de flujo. Los cuatro pacientes recibieron tratamiento de inducción con 5 dosis de timoglobulina de 1.25 mg/kg y 5 dosis de inmunoglobulina intravenosa (IVIG) de 400 mg/kg. Además, uno recibió 20 mg de basiliximab el mismo día del trasplante y el día 4 postrasplante; otro recibió 3 sesiones de plasmaféresis en los días -5, -3, y -1 y eculizumab en dosis de 1200 mg antes del trasplante, 900 mg el día 1, and 600 mg por semana durante un mes. En todos los casos, la inmunosupresión de mantenimiento consistió en tacrolimus, micofenolato y deltisona. Todos presentaron buenos resultados en el corto plazo. Nuestra experiencia sugiere que los pacientes con anticuerpos donante-específicos anti-HLA detectados solo por Luminex® deben recibir un seguimiento estricto y que en esta población se pueden obtener buenos resultados a partir del uso de terapia de inducción con timoglobulina e IVIG.


In renal transplantation, donor specific antibodies (DSAs) detected by sensitive solid-phase assay foresee early antibody-mediated rejections, even with negative complement-dependent cytotoxicity or flow cytometry results. We describe the immunosuppression protocols and outcomes at 10 months of four renal transplant patients in whom anti-HLA DSAs were detected by Luminex® but not by CDC and flow cytometry. The four patients underwent induction treatment with five doses of thymoglobulin at 1.25 mg/kg and 5 doses of intravenous immunoglobulin (IVIG) at 400 mg/kg. In addition, one patient received 20 mg basiliximab on the day of transplant and on post-operative day 4; another patient underwent three sessions of plasmapheresis on days -5, -3, and -1 and also received 1200 mg eculizumab prior to transplant, 900 mg on day 1, and 600 mg each week during one month. In all of them, the maintenance immunosuppressive regimen consisted of tacrolimus, mycophenolate acid and deltisone. All patients had good short-term outcomes. Our findings suggest that patients with anti-HLA DSAs detected only by Luminex® should be monitored closely and can be treated successfully with induction therapy based on thymoglobulin and IVIG.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anticorpos/imunologia , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/prevenção & controle , Antígenos HLA/imunologia , Imunossupressão/métodos , Transplante de Rim , Anticorpos Monoclonais Humanizados/administração & dosagem , Imunoglobulinas Intravenosas/administração & dosagem , Imunossupressores/administração & dosagem , Transplante de Rim/métodos , Ácido Micofenólico/administração & dosagem , Doadores de Tecidos , Resultado do Tratamento
18.
Bogotá; IETS; oct. 2014.
Não convencional em Espanhol | LILACS, BRISA/RedTESA | ID: biblio-875826

RESUMO

INTRODUCCIÓN: La enfermedad de Behcet (EB) es una vasculitis sistémica de etiología desconocida, caracterizada por ulceraciones orales y genitales recurrentes asociadas y compromiso ocular. En la actualidad, el diagnóstico se realiza por medio de grupos de criterios diagnósticos. Aunque existe una asociación entre HLA-B51 y EB, no se ha considerado aún el uso de los HLA como prueba diagnóstica. OBJETIVO: Evaluar si existe un papel para los antígenos leucocitarios humanos, en particular los denominados HLA 15, 108, 105, 109 y 119, en el diagnóstico de pacientes con EB. MÉTODOS: Se realizó una búsqueda de revisiones sistemáticas de estudios de validez diagnóstica publicadas en los últimos cinco años en Cochrane Database of Systematic Reviews, DARE y MEDLINE, así como una búsqueda de estudios primarios sobre validez diagnóstica en MEDLINE (1966 a la fecha), EMBASE (1982 a la fecha), LILACS (1982 a la fecha), de referencias entre los estudios encontrados y consulta a expertos temáticos, productores y comercializadores de la tecnología; la tecnología de interés fue el uso de HLA para el diagnóstico de EB; como estándar de referencia se consideraron diferentes criterios clínicos (International Study Group (ISG), International Criteria For Behcet Disease (ICBD), entre otros). Dos evaluadores de manera independiente, tamizaron las referencias obtenidas, resolviendo las discrepancias por medio de un tercer autor. RESULTADOS: No es posible establecer conclusiones acerca del papel de los antígenos leucocitarios humanos en el diagnóstico de EB dado que, hasta la fecha, no se han publicado estudios sobre sus características operativas. En Colombia se requieren estimaciones de la frecuencia de alelos HLA y su asociación con EB que puedan sugerir su posible valor diagnóstico.(AU)


Assuntos
Humanos , Síndrome de Behçet/diagnóstico , Antígenos HLA/análise , Vasculite Sistêmica/etiologia , Avaliação da Tecnologia Biomédica , Colômbia
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