Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria.

Aim: Globally, one of the leading causes of preventable blindness is primary open-angle glaucoma (POAG). The study assessed the clinical presentations of POAG patients attending an eye center in Abuja, Nigeria. Materials and methods: Records of 188 eyes, collected from 94 patients diagnosed with POAG for a period of 1 year at the eye center, were reviewed. Clinical records, including age, gender, visual acuity (VA), central cornea thickness (CCT), intraocular pressure (IOP), cup-to-disk ratios, and retinal nerve fiber layer (RNFL) thickness of the participants, were extracted and analyzed. Results: The majority of the participants were males (56.4%) and adults (57.4%), most of whom had normal VA (>70% in each eye). Our analysis revealed normal average estimates of RNFL thickness, IOP, and CCT among the participants. Females had thicker RNFL compared to males (p = 0.02). Although CCT decreased with age (r = -0.28, p = 0.005), there was no such link between IOP and CCT (r = 0.09, p = 0.38). Conclusion: Central cornea thickness (CCT), RNFL thickness, and IOP in isolation should not be used as early indicators for POAG; rather, a combination of these and other indices is recommended. Early detection through active screening and treatment in the community for at-risk groups is highly advised. How to cite this article: Ezinne NE, Kwarteng MA, Ekemiri KK, et al. Clinical Profile of Primary Open-angle Glaucoma Patients at an Eye Center in Nigeria. J Curr Glaucoma Pract 2023;17(3):113-117.

Profilaxis combinada con inmunoglobulina intravenosa y plasmaféresis en pacientes altamente sensibilizados, receptores de trasplante renal o combinado hígado-riñón: experiencia en un centro médico colombiano / Combined prophylaxis with intravenous immunoglobulin and plasmapheresis in highly sensitized patients, recipients of kidney or combined liver-kidney transplant: experience in a Colombian medical center

El trasplante renal constituye la mejor opción de tratamiento para los pacientes con enfermedad renal crónica terminal. La supervivencia del injerto es de gran importancia y puede ser afectada por factores inmunológicos o no inmunológicos; esto unido al número de pacientes en las listas de espera, hace necesario definir estrategias de manejo que permitan tener mejores resultados a largo plazo. Objetivo. Determinar las características clínicas y humorales, y los desenlaces en receptores de trasplante renal o combinado hígado-riñón, altamente sensibilizados, que recibieron profilaxis combinada con inmunoglobulina intravenosa y plasmaféresis en el Hospital San Vicente Fundación, en Colombia. Materiales y métodos. Se realizó un estudio retrospectivo, observacional, descriptivo, que incluyó los pacientes trasplantados entre el 4 de julio de 2010 y el 19 de abril de 2017. Como variables se incluyeron, entre otras, la etiología de la enfermedad renal crónica, el tipo de terapia recibida, y el tiempo en lista de espera en días. Como desenlace se evaluó la presencia de rechazo, el tipo de rechazo, la pérdida del injerto, las complicaciones y la muerte. Resultados. Del total de 25 pacientes, el 100% recibió inmunoglobulina intravenosa y el 84% plasmaféresis. El 12% presentó rechazo del injerto, todos de tipo humoral, y el 20% perdió el injerto. Discusión. A pesar de la gran variedad de protocolos propuestos en la literatura, en esta población especial no se ha establecido un protocolo óptimo de inmunosupresión. El protocolo en nuestra pequeña cohorte no tuvo un impacto negativo en el porcentaje de infecciones postrasplante ni en la pérdida del injerto renal, pero sí redujo el tiempo en las listas de espera; por lo tanto, se requieren estudios adicionales para confirmar los hallazgos encontrados en este estudio

Kidney transplantation is the best treatment option for patients with terminal chronic kidney disease, regardless of the etiology, making graft survival an important feature, which may be affected by immunological or non-immunological factors. This, added to the increasing number of patients on waiting lists, makes it necessary to define management strategies for these patients that allow better long-term results. Objectives. To determine the clinical, humoral and outcome characteristics in highly sensitized recipients of kidney and simultaneous kidneyliver transplant who received combined prophylaxis with intravenous immunoglobulin and plasmapheresis therapy in a Colombian medical center. Materials and methods. A retrospective, observational, descriptive study was carried out that included the transplanted patients between July 4, 2010 and April 19, 2017. Variables included the etiology of chronic kidney disease, the type of therapy received, and waiting time in days, among others. As outcomes, the presence of rejection, type of rejection, graft loss, complications and death were evaluated. Results. From a total of 25 patients, 100% received intravenous immunoglobulin and 84% plasmapheresis. Twelve percent presented graft rejection, all humoral, and 20% lost the graft. Discussion. Despite the great variety of protocols proposed in the literature, an optimal immunosuppression protocol has not been established for this particular population. The protocol in our small cohort did not have a negative impact on the percentage of post-transplant infections nor in the loss of the renal graft, but it did reduce waiting time; therefore, additional studies are required to confirm the findings in this study

Cutaneous phaeohyphomycosis.

BACKGROUND: Phaeohyphomycosis is an infrequent infection in human beings. However, in recent years, its prevalence has augmented in immunosuppressed patients (mostly in solid organ transplanted patients). Infection can be mucocutaneous or disseminated. In the former, the fungus inoculation occurs mainly through traumatism. Lesions may be polymorphic and asymptomatic, isolated or multiple, and are usually localized in exposed areas of the limbs and head. Treatment is not standardized. When possible, surgical resection of the lesion is combined with systemic antifungals. METHODS: We communicate three phaeohyphomycosis cases with cutaneous compromise. RESULTS: The cases we present show diverse clinical characteristics and varied severity and evolution. CONCLUSION: It is important for dermatologists to recognize this cutaneous fungus infection because the diagnosis using microscopic examination and mycological culture depends on the clinical suspicion.

Sequential treatment with immunotherapy and BRAF inhibitors in BRAF-mutant advanced melanoma.

PURPOSE: Immunotherapy (IT) agents and BRAF inhibitors (BRAFi) are effective treatments for patients with advanced BRAF-mutant melanoma although the optimal sequence remains to be elucidated. The aim of this study was to compare the outcomes of two different cohorts of patients treated with BRAFi first, then IT or the reverse sequence. PATIENTS AND METHODS: This is a retrospective study on two groups of patients: a cohort was treated first with BRAFi followed by immunotherapy (BRAFi-IT) and the other cohort with the reverse sequence (IT-BRAFi). Baseline characteristics and clinical outcomes were compared between the two cohorts. RESULTS: A total of 25 patients were included in the study. Sixteen patients were given BRAFi-IT sequence and nine received IT-BRAFi sequence. No differences were observed in the characteristics of patients prior to each treatment between cohorts. Objective response rate (ORR) achieved by BRAFi were not different among groups. ORR achieved by IT was higher when administered after BRAFi (43.8 vs 0 %). Survival rates at 1-2 years were similar in both cohorts and median overall survival was not different for BRAFi-IT and IT-BRAFi (log rank test p = 0.97). CONCLUSIONS: No differences were observed in OS between the two cohorts. These results support the indistinct use of IT or BRAFi as initial treatment in patients with metastatic BRAF-mutant melanoma, although higher rate of response to IT was observed when administered after BRAFi. Prospective randomized clinical trials are needed on this issue.

Cytotoxicity and in vitro activity of chard (Beta vulgaris L. var Cicla) extracts on porcine pancreatic islets / Citotoxicidad y actividad in vitro de extractos de acelga (Beta vulgaris L. var Cicla) en islotes pacreáticos porcinosa / Citotocidae e atividade in vitro de extratos de acelga (Beta vulgaris L. var Cicla) em ilhotas pancreáticas porcinas

Background: reports from traditional medicine suggest that chard (Beta vulgaris L. var Cicla) can have remarkable effects in diabetes therapy. Objective: to evaluate the cytotoxic activity of chard extracts in cell lines and determine the viability of cultured porcine pancreatic islets added with or without chard extracts. Methods: cytotoxic activity of chard extracts was assessed in non-tumor and tumor cell lines using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] technique, and the ability of extracts to maintain porcine pancreatic islets viability and regeneration in vitro was tested. Results: the 50% cytotoxic concentration (CC50) of extracts for non-tumor cell lines was above 1,000 μg/mL, while it was 825 μg/mL, 283 μg/mL, 136 μg/mL and 380 μg/mL, for hexane, ethyl acetate, ethanol and water extracts in the tumor cell line, respectively. The CC50 ratio between cell lines indicates that ethanol extract is 7.5 times more toxic to tumor than non-tumor cell lines. There was an increase in viability of porcine pancreatic islets cultured with aqueous, ethyl acetate, and ethanol extracts compared with standard media (CMRL1066) and Cyclosporine A (CsA) control groups. Furthermore, a greater than one regeneration index of islets cultured with ethanol extract at 1,000 μg/mL and 500 μg/mL concentrations during 15 days was observed, which remained constant and was significantly higher than CsA group. Conclusions: these results suggest that chard metabolites should be researched to develop antitumor therapies and human pancreatic islets recovery in diabetes treatment.

Antecedentes: reportes de medicina tradicional sugieren que la planta acelga (Beta vulgaris L. var Cicla) es importante en el tratamiento de enfermedades como la diabetes. Objetivo: evaluar la citotoxicidad de concentraciones de extractos de acelga en líneas celulares y determinar la viabilidad de islotes pancreáticos porcinos cultivados con y sin extracto de acelga. Método: se evaluó la actividad citotóxica en líneas celulares tumorales y no tumorales, con la técnica del MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide]. Específicamente se hicieron ensayos para comprobar si los extractos de acelga tienen la capacidad de mantener la viabilidad de islotes pancreáticos porcinos aislados e influir en su regeneración in vitro. Resultados: la concentración citotóxica al 50% (CC50) de los extractos en líneas no tumorales fue mayor de 1.000 μg/mL, mientras que para los extractos en hexano, acetato de etilo, etanol y agua fue de 825 μg/mL, 283 μg/mL, 136 μg/mL y 380 μg/mL, respectivamente, en líneas tumorales. La proporción CC50 encontrada indica que el extracto en etanol es 7,5 veces más tóxico para las líneas celulares tumorales que para las no tumorales. Igualmente encontramos un aumento en la viabilidad de los islotes pancreáticos porcinos cultivados con extracto acuoso, de acetato en etilo y etanol en comparación con el medio de cultivo estándar (CMRL1066) y un control inhibidor que contenía medio con Ciclosporina A (CsA). Además, se encontró que el índice de regeneración era mayor de uno en los islotes cultivados con el extracto en etanol a concentraciones de 1.000 μg/mL y 500 μg/mL durante 15 días, que se mantuvo constante y fue significativamente mayor en comparación con el grupo de CsA. Conclusión: estos resultados sugieren que los metabolitos de la acelga podrían ser utilizados en la investigación de nuevos fármacos para el desarrollo de terapias antitumorales y recuperación de islotes pancreáticos en el tratamiento de la diabetes.

Antecedentes: relatos encontrados em medicina sugerem que a planta acelga (Beta vulgaris L. var Cicla) tem un papel importante no tratamento das doenças como a diabetes. Objetivo: avaliar a citotoxicidade de concentrações de extratos em linhagens celulares e determinar a viabilidade de ilhotas pancreáticas de porcos cultivadas com e sem extrato de acelga. Métodos: neste trabalho foi avaliada a atividade citotóxica dos extratos da acelga em linhagens celulares tumorais e não tumorais, usando a técnica do MTT [3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide]; além disso, foram feitos ensaios para verificar a capacidade que têm os extratos para manter a viabilidade das ilhotas pancreáticas isoladas de porcos e a influência em sua regeneração in vitro. Resultados: a concentração citotóxica ao 50% (CC50) dos extratos em linhagens não tumorais está acima de 1000 μg/mL, enquanto para os extratos de hexano, acetato de etilo, etanol y água é de 825 μg/mL, 283 μg/mL, 136 μg/mL y 380 μg/mL, respectivamente, em linhagens tumorais. A proporção CC50 entre a célula indica que o extrato de etanol é 7,5 vezes mais tóxico para as linhas celulares tumorais que para as linhas não tumorais. Houve um aumento na viabilidade dos isolados pancreáticos de porcos cultivados com extrato aquoso, de acetato de etilo y etanol, em comparação com o meio de cultura padrão (CMRL 1066) e um controle inibitório contendo meio com Ciclosporina A (CsA). Encontrou-se também uma taxa de regeneração maior do que um em ilhotas cultivadas com concentrações de 1000 μg/mL e 500 μg/mL durante 15 días, que se manteve constante e foi significativamente mais elevada em comparação com a CsA. Conclusões: estes resultados sugerem que os metabolitos da acelga poderiam ser usados para a pesquisa de novas drogas para o desenvolvimento de terapias antitumorais e recuperação de ilhotas pancreáticas para o tratamento da diabetes.

Lingual ulceration associated with retinoic acid syndrome during treatment of acute promyelocytic leukemia.

BACKGROUND: All-trans retinoic acid (ATRA) is routinely associated with chemotherapy for the treatment of acute promyelocytic leukemia (APL). Several reports of scrotal ulceration induced by this agent have been made in the recent years. AIMS: The aim of this article was to report the first case of a lingual ulceration associated with retinoic acid syndrome (RAS). MATHERIALS AND METHODS: We presented a 32-year-old man with a diagnosis of acute promyelocytic leukemia who received treatment with ATRA. He presented with febrile neutropenia and a lingual ulcer that did not respond to antibiotic and antifungal regimens. He developed weight gain, lower limb edema, polyserositis, and acute renal failure. Retinoic acid syndrome syndrome was diagnosed. RESULTS: An exhaustive attempt to exclude infectious causes was made performing repeated cultures, histologic examinations, and direct immunofluorescence for HSV. No causative agent was identified. Re-epithelialization of the ulcer was achieved with ATRA cessation and treatment with systemic steroids. DISCUSSION: As far as we are concerned, we report the first case of a lingual ulceration associated with RAS. CONCLUSION: It is important for dermatologists to recognize this cutaneous complication of ATRA as it poses many differential diagnoses in neutropenic patients.

The computational influence of neurogenesis in the processing of spatial information in the dentate gyrus.

This study was designed to analyze the effect of hippocampal neurogenesis on the spatial maps of granule cells. Accordingly, we developed and improved an artificial neural network that was originally proposed by Aimone. Many biological processes were included in this revised model to improve the biological relevance of the results. We proposed a novel learning-testing protocol to analyze the activation of encoding place cells across contexts and over time in the dentate gyrus. We observed that, regardless of the presence of neurogenesis, the quantity and morphology of the place fields were represented in the same manner by granule cells. Additionally, we observed that neurogenesis was an effective mechanism for reducing the degree of rate remapping that occurred in the place fields of the granule cells.

Neurogenesis interferes with the retrieval of remote memories: forgetting in neurocomputational terms.

In contrast to models and theories that relate adult neurogenesis with the processes of learning and memory, almost no solid hypotheses have been formulated that involve a possible neurocomputational influence of adult neurogenesis on forgetting. Based on data from a previous study that implemented a simple but complete model of the main hippocampal circuitry (Weisz & Argibay, 2009), we now test this model under different situations to better study the case of remote memories. The results of this work show that following neurogenesis, the new, ongoing memories in the hippocampus are better retained than when no neurogenesis occurs at all, while the older memories are affected (to a lesser extent) by a special type of interference that is different from interference that occurs with an increasing number of memories per se. This work adds a new point of analysis in support of the interference view that might lead to the forgetting of memories in the hippocampus as they are transferred to neocortex for long-term storage, consistent with the Complementary Learning Systems models of system-level consolidation. Attention should be directed to the specific causes of interference; the results of this work signal a type of distortion of remote memories that is produced by the birth and the growth of new processing units, which results in a subtly impoverished retrieval as new neurons become active. The proposals of this model fit well with some empirical findings that are related to the issue. In the future, as new evidence emerges, we believe that this biological process, which is largely related to learning and memory, will also help to shape our ideas about normal forgetting and its possible contributions to system consolidation.

Reactivation of Chagas' disease: cutaneous manifestations in two immunosuppressed patients.

BACKGROUND: Chagas' disease is a zoonosis caused by a protozoan agent, Trypanosoma cruzi. Patients undergoing immunosuppressive treatment due to organ transplant, malignancies, infections, or chemotherapy may reactivate a preexisting chronic or indeterminate Trypanosoma cruzi infection. METHODS: We present two transplant patients who underwent reactivation of Chagas' disease with cutaneous manifestations after an augmentation in their immunosuppressive therapy. A 38-year-old man was hospitalized on day 69 after receiving an allogeneic bone marrow transplant; he developed multiple painful erythematous plaques with diffuse borders, confined to the right cheek, trunk, thigh, elbows, and feet. A 59-year-old woman with a 14-year history of Chagasic cardiomyopathy presented one month after heart transplantation with a painful infiltrated purpuric plaque on the back of her right leg. RESULTS: In both cases, histologic examination of skin biopsies showed dermal infiltration with intrahistiocytic amastigotes. In one of the reported cases, the Strout method detected parasitemia. Treatments with nifurtimox (600 mg/d) in case 1 and benznidazole (400 mg/d) in case 2 were started. Fever and cutaneous lesions resolved immediately after seven days of treatment. CONCLUSIONS: Reactivation of Chagas' disease is a serious complication that usually occurs in immunocompromised patients. Clinical manifestations include febrile illness occasionally associated with painful skin lesions. Early diagnosis and proper treatment can significantly improve these patients' outcome.

Episodic-like memory: new perspectives from a behavioral test in rats.

In order to have a tool to empirically test the ideas derived from a theoretical model, we extended a protocol for evaluation of episodic-like memory in rats, based on the triad "what, where, context" for definition of memories. As with the computational model, our intention was for the animal being tested to store a specific number of object-place-context configurations as different memories, which would then be retrievable from cues. The aim of this work was to evaluate the influence of the number of configurations to be memorized on the performance of the task. Sixty-five Wistar male rats were evaluated. In accordance with previous work, for two configurations, the recognition index was indicative of recognition of the element mismatching the original memory (mean = 0.28; SEM = 0.12). The recognition index for three configurations was lower (mean = 0.15; SEM = 0.10), evidencing less recall with increasing requirements. The results also showed a trend toward recognition of novelty for the first and the last memory when evaluating three configurations (a "U" shape in the exploratory preference's curve), showing the primacy and recency effects typical of memory both in humans and animals. Nonetheless, the data presented a high inter-subject variability which makes the test non-robust for small groups. However, if used before and after a treatment for a same subject, we suggest that the protocol presented in this work can be a useful behavioral test for the evaluation of episodic-like memory in rats in terms of a variable task demand.

Fetal endothelium dysfunction is associated with circulating maternal levels of sE-selectin, sVCAM1, and sFlt-1 during pre-eclampsia.

OBJECTIVES: To evaluate the association between endothelial activation markers in the maternal circulation with nitric oxide (NO) synthesis in human umbilical endothelial cells. STUDY DESIGN: This is a case-control study of normal and pre-eclamptic pregnancies. The levels of sE-selectin, soluble vascular cell adhesion molecule 1 (sVCAM-1), and soluble fms-like tyrosine kinase 1 (sFlt-1) were measured by enzyme-linked immunosorbent assay, and histamine-induced NO synthesis was detected by fluorometric examination of the human umbilical vein endothelial cells (HUVECs) isolated from normal and pathological pregnancies. RESULTS: Mothers with severe pre-eclamptic pregnancies have premature and smaller babies than mothers with normal pregnancies (P < 0.05); they also have high maternal plasma levels of sVCAM-1 (∼2-fold), sFlt-1 (∼2.5-fold), and lower (∼70%) histamine-stimulated NO synthesis in HUVECs. A positive relationship between systolic blood pressure (SBP) and plasma levels of sE-selectin, sVCAM-1, and sFlt-1 was demonstrated. Moreover, levels of sE-selectin, sVCAM-1, and sFlt-1 were negatively associated with newborn weight (NBW), gestational age at delivery, and NO synthesis. Women with high E-selectin (>63 ng/ml), VCAM-1 (>752 ng/ml), and sFlt-1 (>15204 pg/ml) showed high risk (∼2-fold) for preterm delivery and very preterm delivery, or fetal weight <1500 g (∼1.5-fold) compared with women with low levels. CONCLUSIONS: High circulating levels of maternal endothelial dysfunction markers present in pre-eclampsia are associated with decreased NO synthesis in fetal endothelium.

Pediatric hospitalizations associated with 2009 pandemic influenza A (H1N1) in Argentina.

BACKGROUND: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. METHODS: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. RESULTS: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). CONCLUSIONS: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years.

A putative role for neurogenesis in neuro-computational terms: inferences from a hippocampal model.

New neurons are generated daily in the hippocampus during adult life. They are integrated into the existing neuronal circuits according to several factors such as age, physical exercise and hormonal status. At present, the role of these new neurons is debated. Computational simulations of hippocampal function allow the effects of neurogenesis to be explored, at least from a computational perspective. The present work implements a model of neurogenesis in the hippocampus with artificial neural networks, based on a standard theoretical model of biologically plausible hippocampal circuits. The performance of the model in retrieval of a variable number of patterns or memories was evaluated (episodic memory evaluation). The model increased, in a phase subsequent to initial learning, the number of granular cells by 30% relative to their initial number. In contrast to a model without neurogenesis, the retrieval of recent memories was very significantly improved, although remote memories were only slightly affected by neurogenesis. This increase in the quality of retrieval of new memories represents a clear advantage that we attribute to the neurogenesis process. This advantage becomes more significant for higher storage loads. The model presented here suggests an important functional role of neurogenesis on learning and memory.

Ribonucleases in HIV type 1 inhibition: effect of recombinant RNases on infection of primary T cells and immune activation-induced RNase gene and protein expression.

Ribonucleases (RNases) have therapeutic potential against cancer and viral diseases and have been reported to inhibit replication of the human immunodeficiency virus type 1 (HIV-1) in chronically infected cell lines. The ribonuclease eosinophil-derived neurotoxin (EDN) is responsible for the anti-HIV-1 activity of a soluble factor produced in response to human alloantigens (ASF). Four recombinant RNases (EDN; a four amino acid extension of the N-terminus EDN, -4EDN; RNase A; and angiogenin) were tested for inhibition of HIV-1 replication in PHA blasts. All RNases showed anti-HIV-1 activity, irrespective of whether the RNases were added before, during, or 2 h after infection. Polyclonal antibodies against the four RNases blocked the antiviral activity. ASF inhibited HIV-1 replication in vitro if added up to 4 h after infection. We demonstrated that allostimulation induced EDN, RNase A, and angiogenin mRNA expression in peripheral blood mononuclear cells (PBMCs), although only EDN protein was detected. We identified monocytes and dendritic cells, but not macrophages or T cells, as EDN-producing cells. These findings raise the possibilities that multiple naturally occurring RNases may contribute to protection against HIV-1 infection and could be considered for utilization in HIV-1 therapy.

Inmunologia del virus de la inmunodeficiencia humana / Immunology of the human immunodeficiency virus

Propósito: realizar una revisión de la literatura sobre las características de los mecanismos de respuesta inmune que se activan en cada una de las etapas de la infección por el virus de inmunodeficiencia humana (VIH), los tipos de respuesta observada entre diferentes subgrupos de individuos infectados y los factores genéticos, ambientales y virológicos que influyen o determinan la velocidad de progresión de la infección. Fuentes de los datos: se hizo una búsqueda sistemática de artículos originales en las bases de datos de PubMed y Medline publicados desde 1988 hasta abril de 2002, se revisaron los artículos identificados y las revisiones publicadas por expertos. Selección de los estudios: se encontraron 329 artículos. Se seleccionaron estudios clínicos y experimentales controlados o con grupos comparativos prospectivos y retrospectivos con datos suficientes sobre marcadores inmunológicos, virológicos y genéticos relacionados con la historia natural de la infección del VIH y la progresión de la enfermedad que permitieran calcular la razón de disparidad, Extracción de los datos: los artículos se clasificaron y analizaron de acuerdo a si se referían a marcadores inmunológicos, virológicos, genéticos de infección por VIH-1 y/o progresión a síndrome de inmunodeficiencia adquirida (SIDA) y si eran artículos originales o revisiones. En el caso de marcadores inmunológicos se clasificaron de acuerdo a si estudiaban la inmunidad humoral o celular. Resultados y síntesis de los datos: el sistema inmune es incapaz de asumir el control de la infección por el VIH-1 porque las células CD4+ son blanco del virus, se infectan en forma productiva y mueren rápidamente por diferentes mecanismos. Los linfocitos T CD8+ o células citotóxicas son importantes en la respuesta inmune anti-VIH-1, con una gran correlación entre una respuesta vigorosa y el control inicial de la replicación del VIH-1 durante la infección primaria...

Frecuencia de mutaciones en el correceptor CCR5 del virus de la inmunodeficiencia humana (VIH) en diferentes grupos en Medellín, Colombia / Mutation frequency in CCR5 HIV virus Co-receptor, in different groups in Medellín

Introducción: la exposición repetida al virus de la inmunodeficiencia humana (VIH) no siempre llevan la infección, multiples factores de resistencia han sido propuestos, pero sólo una mutación, la delección de 32 pares de base (delta 32)en el gen que codifica por la molécula CCR5, confiere un alto grado de protección; esta molécula es el principal correceptor del virus: Objetivos: determinar la frecuencia de delta 32 en Medellín, Colombia y buscar otros polimorfismos en el gen ccr5 en individuos expuestos al VIH y seronegativos (ESNs). Materiales y métodos: la mutación delta 32 se determinó por la técnica de reacción en cadena de la polimerasa en 218 individuos: 29 seropositivos (SP), 39 ESN y 150 individuos de la población general (PG). Por medio de la técnica de polimorfismos conformacionales de cadena simple (SSCP) se buscaron otras mutaciones en el gen ccr5 en la población de ESNs. Resultados: la frecuencia del alelo delta 32 fué de 3.8 por ciento para ESN, 2.7 por ciento para PG y 1.7 por ciento para SP. Entre los ESNs se encontró el único genotipo homocigótico mutado (ccr5/ delta 32/delta 32), se encontro en el 5.3 por ciento de la PG y en 2.6 por ciento de SP y de ESNs. Las diferencias en las frecuencias alélicas y genotipicas entre los grupos no fueron estadísticamente significativas. La comparación entre las frecuencias genotípicas esperadas y observadas mostró que estas frecuencias eran significativamente diferentes en el grupo de ESNs. Lo que sugirió en forma indirecta, un efecto protector del geneotipo gemocigótico mutado en delta 32/delta 32. No se encontró ninguna otra mutación en el gen ccr5. Conclusión: la baja frecuencia del genotipo homocigótico mutado delta 32/delta 32y la ausencia de otras mutaciones en ccr5 en los ESNs sugierén la presencia de otros mecanismos de resitencia a la infección por VIH en nuestra población