RESUMO
To determine whether the plasma brain natriuretic peptide level increases differentially in muscular dystrophy and idiopathic dilated cardiomyopathy, we investigated the plasma brain natriuretic peptide level and echocardiographic parameters in patients with similarly low left ventricular ejection fraction. The plasma brain natriuretic peptide level was lower, and the left ventricular end-diastolic diameter was shorter in the patients with muscular dystrophy than in those with idiopathic dilated cardiomyopathy. The correlation between the plasma brain natriuretic peptide and left ventricular ejection fraction was shifted downward in the patients with muscular dystrophy compared with those with idiopathic dilated cardiomyopathy. Those between the brain natriuretic peptide and left ventricular end-diastolic diameter were superimposable, although the data from the muscular dystrophy patients were located at the shorter left ventricular end-diastolic diameter side. The plasma brain natriuretic peptide level may differentially increase in the two diseases with similar left ventricular systolic dysfunction. Differences in the left ventricular distension and in the physical activity might explain at least partially the different plasma brain natriuretic peptide levels.
Assuntos
Cardiomiopatia Dilatada/sangue , Atrofia Muscular/sangue , Peptídeo Natriurético Encefálico/sangue , Disfunção Ventricular Esquerda/sangue , Adulto , Cardiomiopatia Dilatada/complicações , Ecocardiografia/métodos , Feminino , Ventrículos do Coração/metabolismo , Ventrículos do Coração/patologia , Humanos , Ensaio Imunorradiométrico/métodos , Masculino , Atrofia Muscular/complicações , Estatísticas não Paramétricas , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/etiologiaRESUMO
We studied the immunological and virological effects of interferon-alpha (IFN-alpha) therapy in nine patients with HTLV-I-associated myelopathy (HAM/TSP). After therapy, the percentages of CCR5+ cells in CD4+ cells significantly decreased in the cerebrospinal fluid as well as blood. The therapy also significantly lowered the intracellular IFN-gamma+/interleukin-4+ T-cell ratio in blood. Those helper T-cell type 1 (Th1)-related responses tended to be higher and reduce more evidently following therapy in three patients who clinically improved. Also, all the three patients had one or more HTLV-I copies in five blood mononuclear cells. These results suggest that IFN-alpha suppresses Th1 responses in HAM/TSP and that the patients with higher Th1 immunity and proviral loads may be responders of the therapy. Larger-scale studies are needed to confirm the findings.
Assuntos
Antivirais/uso terapêutico , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Interferon-alfa/uso terapêutico , Paraparesia Espástica Tropical/imunologia , Provírus/imunologia , Linfócitos T Auxiliares-Indutores/efeitos dos fármacos , Idoso , Resistência a Medicamentos/imunologia , Feminino , Citometria de Fluxo , Humanos , Interferon gama/biossíntese , Interleucina-4/biossíntese , Líquido Intracelular/química , Masculino , Pessoa de Meia-Idade , Paraparesia Espástica Tropical/tratamento farmacológico , Reação em Cadeia da Polimerase , Receptores CCR3 , Receptores CCR5/metabolismo , Receptores CXCR3 , Receptores de Quimiocinas/metabolismo , Linfócitos T Auxiliares-Indutores/imunologia , Células Th1/efeitos dos fármacos , Células Th1/imunologia , Células Th2/efeitos dos fármacos , Células Th2/imunologia , Carga ViralRESUMO
We, for the first time, analyzed T cell and natural killer (NK) cell subsets in the cerebrospinal fluid (CSF) in nine patients with human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) treated with interferon-alpha (IFN-alpha). The CD4/CD8 ratio in CSF was significantly lower after the therapy, which is mainly attributable to the significant reduction in CD4+ cells, especially CD25+CD4 and CD45RO+CD4 cell subsets. Meanwhile, NK, natural T and NKT cell subsets in the CSF remained unchanged. There was no CSF lymphocyte subset significantly associated with the clinical efficacy of IFN-alpha in this small-scale study, and more patients should be analyzed to ascertain the link.