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1.
J. bras. econ. saúde (Impr.) ; 15(1): 12-23, Abril/2023.
Artigo em Inglês, Português | LILACS, ECOS | ID: biblio-1437861

RESUMO

Objetivo: Compreender o cenário da esclerose múltipla (EM) em relação aos aspectos epidemiológicos, diagnósticos, progressão, tratamento e comorbidades no sistema público brasileiro. Métodos: Trata-se de um estudo retrospectivo e observacional utilizando os sistemas de dados do Departamento de Informática do Sistema Único de Saúde (DataSUS). Os dados utilizados foram obtidos por meio da base de dados do Sistema Ambulatorial/Sistema de Procedimentos de Alta Complexidade (SIA/SUS). Nessa base, o vínculo de registros foi por meio do Cadastro Nacional de Saúde (CNS). Para a quantificação de dados epidemiológicos, foram coletados os dados do Código de Endereçamento Postal (CEP), sexo e data de nascimento, além das bases de geolocalização dos pacientes. Considerou-se como desfecho primário a descrição epidemiológica da população de pacientes em uso ou que usaram MMCD para o tratamento da EM. Como desfecho secundário, consideraram-se as características dos pacientes (gênero, idade, idade ao diagnóstico e comorbidades). Resultados: Foram incluídos na análise 45.011 pacientes. Identificou-se predominância de pacientes do gênero feminino (72,9%) e com idade entre 31 e 60 anos (61,23%) diagnosticados com CID G35 no primeiro registro. A taxa de incidência de pacientes com EM foi maior (2,7 pacientes/100 mil habitantes) na região Sudeste, seguida pela região Sul (2,2 pacientes/100 mil). A prevalência na região Sul teve a maior taxa (18 pacientes/100 mil), seguida pelo Sudeste (16,7 pacientes/100 mil). As betainterferonas e o acetato de glatirâmer foram os medicamentos mais utilizados no primeiro tratamento. O acetato de glatirâmer foi o mais utilizado para o segundo tratamento no período de 2011 até 2017. Em 2018, os MMCD mais utilizados como segundo tratamento foram fingolimode e natalizumabe. A partir de 2019, fingolimode, fumarato de dimetila e natalizumabe foram os medicamentos mais utilizados como segundo tratamento, permanecendo nessa ordem até 2021. Para o terceiro tratamento, o natalizumabe foi o medicamento mais utilizado até 2017. Após esse período, o fingolimode passou a ser mais usado. Desde 2019, com o acesso ao fumarato de dimetila, os medicamentos mais prescritos foram, em ordem decrescente, fingolimode, natalizumabe e fumarato de dimetila. Conclusão: Estabelecer uma análise epidemiológica dos pacientes que usam MMCD para o tratamento da EM no Brasil, além do padrão de tratamento, são dados essenciais para a promoção do tratamento da EM de forma adequada, bem como para a implementação de políticas públicas locais, regionais e nacionais.


Objective: To understand the multiple sclerosis (MS) setting in relation to epidemiological aspects, diagnoses, progression, treatment and comorbidities in the Brazilian public system. Methods: This is a retrospective, observational study using the Unified Health System's Informatics Department [Departamento de Informática do Sistema Único de Saúde] data systems (DataSUS). The data used were obtained by means of the outpatient system/high-complexity procedure system (SIA/SUS) database. In this database, the association of entries was via the National Health Registration [Cadastro Nacional de Saúde] (CNS). For epidemiological data quantification, Zip Code, sex and date of birth information was collected, as well as data from patient geolocation databases. The epidemiological description of the patient population using or having used DMTs for MS treatment was considered as the primary endpoint. Patient characteristics (gender, age, age at diagnosis and comorbidities) were considered as the secondary endpoint. Results: 45,011 patients were included in the analysis. A predominance of female patients (72.9%) aged between 31 and 60 years (61.23%) and diagnosed with ICD code G35 in the first entry was identified. The incidence rate of patients with MS was higher (2.7 patients/100 thousand inhabitants) in the Southeast region, followed by the South region (2.2 patients/100 thousand). Prevalence in the South region had the highest rate (18 patients/100 thousand), followed by the Southeast region (16.7 patients/100 thousand). Interferons beta and glatiramer acetate were the most used drugs in the first treatment. Glatiramer acetate was the most used drug for the second treatment within the period from 2011 to 2017. In 2018, the most common DMTs used as second treatment were fingolimod and natalizumab. From 2019, fingolimod, dimethyl fumarate and natalizumab were the most used drugs as second treatment, remaining in this order until 2021. For the third treatment, natalizumab was the most used drug until 2017. After this period, fingolimod became more widely used. Since 2019, with access to dimethyl fumarate, the most prescribed drugs were, in decreasing order, fingolimod, natalizumab and dimethyl fumarate. Conclusion: Establishing an epidemiological analysis of patients using DMTs for MS treatment in Brazil, in addition to standard of care, results in critical data for adequately promoting MS treatment, as well as for implementing local, regional and national public policies.


Assuntos
Sistema Único de Saúde , Epidemiologia , Prevalência , Esclerose Múltipla
2.
Artigo em Português | LILACS, ECOS | ID: biblio-1411988

RESUMO

Objetivo: Os agentes biológicos representam um grande avanço no tratamento da psoríase em placas moderada a grave. No entanto, variações de eficácia, segurança e custos dos tratamentos podem dificultar a escolha do agente terapêutico. Este estudo teve como objetivo atualizar o custo por resposta dos agentes biológicos disponíveis para psoríase no ROL de Procedimentos e Eventos em Saúde (ROL) da Agência Nacional de Saúde Suplementar (ANS). Métodos: Uma análise de custo por resposta foi utilizada para avaliar a razão de custo pelo desfecho Índice de Gravidade e Área da Psoríase (PASI) 90. Os resultados foram apresentados para o primeiro ano (ano I), que compreende a fase de indução e a fase manutenção até completar 52 semanas e foi realizada uma análise da efetividade do tratamento num cenário de orçamento fixo. Os custos dos tratamentos foram calculados com base nos preços de fábrica (PF18%) da Tabela da Câmara de Regulação do Mercado de Medicamentos de junho de 2021. Resultados: Para o ano I, o guselcumabe apresentou melhor resultado para custo por resposta (R$ 130.467) PASI 90, seguido por ixequizumabe, ustequinumabe, secuquinumabe, adalimumabe, infliximabe e etanercepte. No cenário com orçamento fixo, o guselcumabe demonstrou ser o agente capaz de tratar com sucesso (PASI 90) o maior número de pacientes. Atualização do custo-efetividade por resposta para psoríase em placas moderada a grave. Conclusão: Sob a perspectiva do Sistema de Saúde Suplementar do Brasil, o guselcumabe apresentou o melhor custo por resposta PASI 90, sendo, assim, a terapia com melhor custo-efetividade no tratamento da psoríase em placas moderada a grave disponível no ROL.


Objective: Biological agents represent a major advance in the treatment of moderate-to-severe plaque psoriasis. However, variations of efficiency, safety and costs of treatments make it difficult to select the drug. This study aims to update the cost per response of biological agents available in the Health Procedures and Events Roll (ROL) of the National Supplementary Health Agency (ANS). Methods: A cost-per-response analysis was used to assess the cost per outcome of Psoriasis Area and Severity Index (PASI) 90. Results were presented for the first year (I), which comprises induction and maintenance for 52 weeks and a fixed budget scenario analysis. Treatment costs were calculated based on the prices of the 2021 Medicines Market Regulation Chamber Table. Results: Analysis of year I, guselkumab showed the best result for cost per cost (R$ 130,467) PASI 90, followed by ixekizumab, ustekinumab, secukinumab, adalimumab, infliximab, and etanercept. In the fixedbudget analysis, guselkumab is the therapy capable of successfully treating (PASI 90) the largest number of patients. Conclusion: From the perspective of the Supplementary Health System in Brazil, guselkumab showed the best cost per response PASI 90, thus being the most cost-effective therapy in the treatment of moderate to severe plaque psoriasis available in the Brazilian ROL.


Assuntos
Psoríase , Saúde Suplementar , Análise de Custo-Efetividade
3.
Materials (Basel) ; 14(3)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33530372

RESUMO

Hematopoietic stem cells (HSC) are responsible for the production of blood and immune cells during life. HSC fate decisions are dependent on signals from specialized microenvironments in the bone marrow, termed niches. The HSC niche is a tridimensional environment that comprises cellular, chemical, and physical elements. Introductorily, we will revise the current knowledge of some relevant elements of the niche. Despite the importance of the niche in HSC function, most experimental approaches to study human HSCs use bidimensional models. Probably, this contributes to the failure in translating many in vitro findings into a clinical setting. Recreating the complexity of the bone marrow microenvironment in vitro would provide a powerful tool to achieve in vitro production of HSCs for transplantation, develop more effective therapies for hematologic malignancies and provide deeper insight into the HSC niche. We previously demonstrated that an optimized decellularization method can preserve with striking detail the ECM architecture of the bone marrow niche and support HSC culture. We will discuss the potential of this decellularized scaffold as HSC niche model. Besides decellularized scaffolds, several other methods have been reported to mimic some characteristics of the HSC niche. In this review, we will examine these models and their applications, advantages, and limitations.

4.
J. bras. econ. saúde (Impr.) ; 11(2): 105-111, Agosto/2019.
Artigo em Inglês | ECOS, LILACS | ID: biblio-1021033

RESUMO

Objective: To perform a cost-minimization analysis comparing the cohort with the current average patient weight of 70 kg (MoH current assumption). Since most rheumatoid arthritis (RA) patients in Brazil are women (60 kg or less), we also aimed to define this percentage at Brazilian public healthcare system (SUS). Methods: Treatment-naïve RA patients using biologics from January 2008 to November 2018 were retrieved from Datasus as well as the number of patients ≤ 60 kg and their drug use distribution. Data on drug costs were assessed from the last payment reported by MoH and then recalculated using the weighted average of 60 kg and a 52-weeks a year to assess cost-minimization. Results: In the studied cohort, 33,646 patients (33.3%) were classified as ≤ 60 kg. Annual cost per patient, considering an average weight of 60 kg, ranged from 2,872,29 USD to 4,223.93 USD. Tocilizumab 80 mg was the only drug demonstrating a reduction in annual cost per patient (-526.79 USD). Conclusion: Cost-minimization analysis based on weight-dependent dosage showed that tocilizumab could reduce MoH costs with RA treatment in 14.28%. By adopting weight-dependent dose of 60 kg, the Brazilian government could save up to 916,651.31 USD per year using tocilizumab versus other biological disease-modifying antirheumatic drugs (DMARDs). In ten years, it represents an accumulative saving of 9,166,513.57 USD.


Objetivo: Realizar uma análise de custo-minimização comparando a coorte com o peso médio de pacientes de 70 kg (atual premissa do Ministério da Saúde ­ MS). Como a maioria dos pacientes são mulheres (≤ 60 kg), também se objetivou definir esse percentual no sistema público de saúde brasileiro (SUS). Métodos: Pacientes com artrite reumatoide (AR) virgens de tratamento utilizando biológicos de janeiro/2008 a novembro/2018 foram retirados do Datasus, assim como o número de pacientes com ≤ 60 kg e a distribuição de uso das drogas. Os custos dos medicamentos foram avaliados a partir do último pagamento relatado pelo MS e recalculados utilizando a média de 60 kg e um ano de 52 semanas para estimar a custo-minimização. Resultados: Na coorte estudada, 33.646 pacientes (33,3%) foram classificados com ≤ 60 kg. O custo anual por paciente, considerando o peso médio de 60 kg, variou de 2.872.29 a 4.223,93 USD. Tocilizumabe 80 mg foi o único que demonstrou redução no custo anual por paciente (-526,79 USD). Conclusão: A custo-minimização baseada em dose peso-dependente mostrou que o tocilizumabe poderia reduzir os custos do MS no tratamento de AR em 14,28%. Ao adotar o peso de 60 kg, o governo poderia economizar até 916.651,31 USD ao ano utilizando tocilizumabe vs. outros medicamentos modificadores do curso da doença biológicos (MMCDb). Em 10 anos, isso representa uma economia acumulada de 9.166.513,57 USD.


Assuntos
Humanos , Artrite Reumatoide , Sistema Único de Saúde , Custos e Análise de Custo
5.
Biomater Sci ; 7(4): 1516-1528, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-30681075

RESUMO

Due to the increasing demand for a bone marrow study model, we developed a natural scaffold from decellularized bovine bone marrow (DeBM). The obtained bioscaffold was analyzed after the decellularization process; histological staining, scanning and transmission electron microscopy confirmed the preservation of its native 3D-architecture; including blood vessels and cell niches as well as the integrity of important components of the extracellular matrix; Collagen III, IV and fibronectin. In addition to biochemical composition, physical properties of the bone marrow were also conserved. We evaluated the suitability of this bio-scaffold as a tridimensional culture platform. Seeding experiments with umbilical cord-derived hematopoietic stem cells and human bone marrow stromal cell line HS5 demonstrated that this scaffold is capable of supporting hematopoietic and stromal cell adhesion and proliferation without the need of exogenous factors. DeBM provided an inductive environment for the repopulation of the bone marrow inducing the expression of SDF-1, HGF and SCF by seeded stromal cells. The presence of these potent hematopoietic chemoattractants would be crucial for ex vivo long-term culture of HSCs, and for recreating the natural microenvironment of the bone marrow for bioengineering applications. We conclude that the decellularization process succeeded in preserving the 3D structure and mechanical properties of the bone marrow. The resulting scaffold is suitable for cell culture, representing an advantageous bone marrow experimental model, and potentially an effective platform for CD34+ HSC expansion and differentiation for clinical applications.


Assuntos
Medula Óssea , Células-Tronco Hematopoéticas/citologia , Animais , Bovinos , Células Cultivadas , Técnicas de Cocultura , Humanos , Células-Tronco Mesenquimais/citologia , Tamanho da Partícula
6.
Braz. j. infect. dis ; 20(6): 546-555, Nov.-Dec. 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-828157

RESUMO

ABSTRACT Plesiomonas shigelloides isolated from water in Brazil was previously described as a hemorrhagic heat-labile cytotoxic-enterotoxin producer. We purified this toxin from culture supernatants using ion metallic affinity chromatography (IMAC) followed by molecular exclusion chromatography. The pure toxin presented molecular mass of 50 kDa and isoelectric point (pI) around 6.9 by 2D electrophoresis. When injected intravenously, the purified cytotoxic-enterotoxin induced also severe spasms followed by sudden death of mice. Hence, we entitled it as lethal cytotoxic-enterotoxin (LCE). The presence of membrane vesicles (MVs) on cell surfaces of P. shigelloides was observed by scan electron microscopy (SEM). From these MVs the LCE toxin was extracted and confirmed by biological and serological assays. These data suggest that P. shigelloides also exports this cytotoxic-enterotoxin by membrane vesicles, a different mechanism of delivering extra cellular virulence factors, so far not described in this bacterium.


Assuntos
Animais , Masculino , Ratos , Sobrevivência Celular/efeitos dos fármacos , Plesiomonas/metabolismo , Vesículas Citoplasmáticas , Fatores de Virulência , Rios/microbiologia , Enterotoxinas/farmacologia , Células Vero , Testes de Neutralização , Microscopia Eletrônica de Varredura , Chlorocebus aethiops , Plesiomonas/patogenicidade , Plesiomonas/ultraestrutura , Dose Letal Mediana
7.
Braz J Infect Dis ; 20(6): 546-555, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27770615

RESUMO

Plesiomonas shigelloides isolated from water in Brazil was previously described as a hemorrhagic heat-labile cytotoxic-enterotoxin producer. We purified this toxin from culture supernatants using ion metallic affinity chromatography (IMAC) followed by molecular exclusion chromatography. The pure toxin presented molecular mass of 50kDa and isoelectric point (pI) around 6.9 by 2D electrophoresis. When injected intravenously, the purified cytotoxic-enterotoxin induced also severe spasms followed by sudden death of mice. Hence, we entitled it as lethal cytotoxic-enterotoxin (LCE). The presence of membrane vesicles (MVs) on cell surfaces of P. shigelloides was observed by scan electron microscopy (SEM). From these MVs the LCE toxin was extracted and confirmed by biological and serological assays. These data suggest that P. shigelloides also exports this cytotoxic-enterotoxin by membrane vesicles, a different mechanism of delivering extra cellular virulence factors, so far not described in this bacterium.


Assuntos
Sobrevivência Celular/efeitos dos fármacos , Vesículas Citoplasmáticas , Enterotoxinas/farmacologia , Plesiomonas/metabolismo , Rios/microbiologia , Fatores de Virulência , Animais , Chlorocebus aethiops , Dose Letal Mediana , Masculino , Microscopia Eletrônica de Varredura , Testes de Neutralização , Plesiomonas/patogenicidade , Plesiomonas/ultraestrutura , Coelhos , Células Vero
8.
PLoS One ; 9(8): e105170, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25126941

RESUMO

The reconstruction of the external ear to correct congenital deformities or repair following trauma remains a significant challenge in reconstructive surgery. Previously, we have developed a novel approach to create scaffold-free, tissue engineering elastic cartilage constructs directly from a small population of donor cells. Although the developed constructs appeared to adopt the structural appearance of native auricular cartilage, the constructs displayed limited expression and poor localization of elastin. In the present study, the effect of growth factor supplementation (insulin, IGF-1, or TGF-ß1) was investigated to stimulate elastogenesis as well as to improve overall tissue formation. Using rabbit auricular chondrocytes, bioreactor-cultivated constructs supplemented with either insulin or IGF-1 displayed increased deposition of cartilaginous ECM, improved mechanical properties, and thicknesses comparable to native auricular cartilage after 4 weeks of growth. Similarly, growth factor supplementation resulted in increased expression and improved localization of elastin, primarily restricted within the cartilaginous region of the tissue construct. Additional studies were conducted to determine whether scaffold-free engineered auricular cartilage constructs could be developed in the 3D shape of the external ear. Isolated auricular chondrocytes were grown in rapid-prototyped tissue culture molds with additional insulin or IGF-1 supplementation during bioreactor cultivation. Using this approach, the developed tissue constructs were flexible and had a 3D shape in very good agreement to the culture mold (average error <400 µm). While scaffold-free, engineered auricular cartilage constructs can be created with both the appropriate tissue structure and 3D shape of the external ear, future studies will be aimed assessing potential changes in construct shape and properties after subcutaneous implantation.


Assuntos
Condrócitos/fisiologia , Fator de Crescimento Insulin-Like I/fisiologia , Animais , Fenômenos Biomecânicos , Células Cultivadas , Colágeno/metabolismo , Cartilagem da Orelha/citologia , Elastina/metabolismo , Feminino , Insulina/fisiologia , Coelhos , Engenharia Tecidual , Tecidos Suporte
9.
Biomaterials ; 34(13): 3290-302, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23384795

RESUMO

To design tissue-specific bioscaffolds with well-defined properties and 3-D architecture, methods were developed for preparing porous foams from enzyme-solubilized human decellularized adipose tissue (DAT). Additionally, a technique was established for fabricating "bead foams" comprised of interconnected networks of porous DAT beads fused through a controlled freeze-thawing and lyophilization procedure. In characterization studies, the foams were stable without the need for chemical crosslinking, with properties that could be tuned by controlling the protein concentration and freezing rate during synthesis. Adipogenic differentiation studies with human adipose-derived stem cells (ASCs) suggested that stiffness influenced ASC adipogenesis on the foams. In support of our previous work with DAT scaffolds and microcarriers, the DAT foams and bead foams strongly supported adipogenesis and were also adipo-inductive, as demonstrated by glycerol-3-phosphate dehydrogenase (GPDH) enzyme activity, endpoint RT-PCR analysis of adipogenic gene expression, and intracellular lipid accumulation. Adipogenic differentiation was enhanced on the microporous DAT foams, potentially due to increased cell-cell interactions in this group. In vivo assessment in a subcutaneous Wistar rat model demonstrated that the DAT bioscaffolds were well tolerated and integrated into the host tissues, supporting angiogenesis and adipogenesis. The DAT-based foams induced a strong angiogenic response, promoted inflammatory cell migration and gradually resorbed over the course of 12 weeks, demonstrating potential as scaffolds for wound healing and soft tissue regeneration.


Assuntos
Tecido Adiposo/citologia , Tecido Adiposo/fisiologia , Regeneração/fisiologia , Engenharia Tecidual/métodos , Tecidos Suporte/química , Adipogenia/efeitos dos fármacos , Adipogenia/genética , Tecido Adiposo/efeitos dos fármacos , Animais , Materiais Biocompatíveis/farmacologia , Módulo de Elasticidade/efeitos dos fármacos , Feminino , Liofilização , Regulação da Expressão Gênica/efeitos dos fármacos , Glicerolfosfato Desidrogenase/metabolismo , Humanos , Espaço Intracelular/efeitos dos fármacos , Espaço Intracelular/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Metabolismo dos Lipídeos/genética , Fenômenos Mecânicos , Microscopia Eletrônica de Varredura , Microesferas , Modelos Animais , Porosidade , Ratos , Ratos Wistar , Regeneração/efeitos dos fármacos , Tela Subcutânea/efeitos dos fármacos
10.
Biomacromolecules ; 13(7): 2211-7, 2012 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-22712428

RESUMO

Low molecular weight poly(5-ethylene ketal ε-caprolactone-co-D,L-lactide) (PEKCDLLA) is being considered as a viscous liquid, injectable depot for localized drug delivery. This polymer degrades in vitro via surface erosion, which is potentially advantageous for the proposed application. However, the in vivo degradation rate and mechanism, and tissue response, to polymers based on 5-ethylene ketal ε-caprolactone have not yet been reported. The purpose of this study was to measure the in vivo weight loss and change in polymer properties and assess the tissue response to PEKCDLLA after subcutaneous injection in rats. The tissue response was assessed histologically using Masson's trichrome staining and immunohistochemically by staining for CD68 positive cells. The polymer lost weight with time in a nearly linear fashion but did not exhibit significant changes in number average molecular weight, polydispersity index, and glass transition temperature or monomer ratio, consistent with a surface erosion process. The tissue response to the polymer was moderate and comparable to that reported in the literature for other degradable polymers used in clinical applications. These findings indicate that PEKCDLLA is a promising candidate for injectable drug delivery.


Assuntos
Implantes Absorvíveis , Portadores de Fármacos/farmacocinética , Poliésteres/farmacocinética , Animais , Antígenos CD/metabolismo , Antígenos de Diferenciação Mielomonocítica/metabolismo , Portadores de Fármacos/toxicidade , Fibroblastos/metabolismo , Células Gigantes de Corpo Estranho/metabolismo , Células Gigantes de Corpo Estranho/patologia , Inflamação/induzido quimicamente , Inflamação/patologia , Macrófagos/metabolismo , Macrófagos/patologia , Masculino , Poliésteres/toxicidade , Ratos , Ratos Wistar , Tela Subcutânea/efeitos dos fármacos , Tela Subcutânea/patologia , Temperatura de Transição
11.
Biomaterials ; 33(18): 4490-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22456084

RESUMO

With the aim of developing a clinically-translatable cell expansion and delivery vehicle for adipose tissue engineering, the adipogenic differentiation of human adipose-derived stem cells (ASCs) was investigated on microcarriers fabricated from human decellularized adipose tissue (DAT). ASCs seeded on the DAT microcarriers and cultured in adipogenic differentiation medium within a low-shear spinner culture system demonstrated high levels of adipogenic differentiation, as measured by the expression of adipogenic genes, glycerol-3-phosphate dehydrogenase (GPDH) enzyme activity, and intracellular lipid accumulation. In contrast, gelatin microcarrier controls did not demonstrate significant adipogenesis, emphasizing the role of the native matrix in mediating ASC differentiation. Interestingly, ASCs cultured on the DAT microcarriers in proliferation medium expressed elevated levels of the adipogenic markers, suggesting that the DAT provided an adipo-inductive substrate for the human ASCs. In vivo testing of the DAT and gelatin microcarriers in a subcutaneous Wistar rat model confirmed injectability and demonstrated stable volume retention over 28 days. Under histological analysis, the DAT microcarriers demonstrated no evidence of immunogenicity or cytotoxicity, with the DAT supporting cellular infiltration and tissue remodeling. Pre-seeding the DAT microcarriers with allogenic rat ASCs enhanced cellularity and angiogenesis within the implant region.


Assuntos
Adipócitos/citologia , Tecido Adiposo/citologia , Células-Tronco/citologia , Técnicas de Cultura de Células/métodos , Diferenciação Celular/fisiologia , Células Cultivadas , Humanos , Engenharia Tecidual/métodos
12.
Pregnancy Hypertens ; 1(1): 87-94, 2011 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-22279618

RESUMO

Pre-eclampsia, an acute complication of human pregnancy, is associated within complete physiological modification of decidual spiral arteries. This is thought to promote oxidative stress from perfusion/reperfusion of the placenta and to restrict placental and fetal growth. Alymphoid (genotype Rag2(-/-)/Il2rg(-/-)) mice, sufficient in dendritic and myeloid cell functions, lack spiral arterial modification with individual spiral arteries having ~1.7x the vascular resistance and 0.66x the blood velocity of +/+ mice. Their placentae are measurably hypoxic yet neither placental growth nor fetal survival is impaired and gestational hypertension is not seen. Thus, lymphocytes rather than vascular adaptations appear to be the pivotal contributors to the clinical complications of pre-eclampsia.

13.
Am J Reprod Immunol ; 63(6): 472-81, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20175772

RESUMO

Reproductive success in mammals involves coordinated changes in the immune and cardiovascular as well as in the neuroendocrine and reproductive systems. This review addresses studies that identify potential links for NK cells and T cells with the local and systemic cardiovascular adaptations of pregnancy. The studies reviewed have utilized immunohistochemisty and in vivo analyses of vascular parameters by ultrasound, chronic monitoring of hemodynamics via radiotelemetric recording and intravital microscopy. At the uterine level, functional subsets of uterine natural killer cells were identified. These included subsets expressing molecules important for vasoregulation, in addition to those previously identified for angiogenesis. Spiral arteries showed conducted responses that could account for conceptus control of vasoactivity and mouse gestational blood pressure 5-phase pattern. Vascular immunology is an emerging transdisciplinary field, critical for both reproductive immunology and cardiovascular disease.


Assuntos
Artérias/fisiologia , Pressão Sanguínea/fisiologia , Células Matadoras Naturais/fisiologia , Prenhez/fisiologia , Útero/citologia , Animais , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Neovascularização Fisiológica , Gravidez , Prenhez/imunologia , Útero/irrigação sanguínea , Útero/imunologia
14.
Hypertension ; 55(3): 729-37, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20100997

RESUMO

Maternal cardiovascular adaptations occur in normal pregnancy, systemically, and within the uterus. In humans, gestational control of blood pressure is clinically important. Transient structural remodeling of endometrial spiral arteries normally occurs in human and mouse pregnancies. In mice, this depends on uterine natural killer cell function. Using normal and immune-deficient mice, we asked whether spiral artery remodeling critically regulates gestational mean arterial pressure and/or placental growth. Radiotelemetric transmitters were implanted in females and hemodynamic profiles to a dietary salt challenge and to pregnancy were assessed. Implantation sites from noninstrumented females were used for histological morphometry. Both normal and immune-deficient mice had normal sensitivity to salt and showed similar 5-phase gestational patterns of mean arterial pressure correlating with stages of placental development, regardless of spiral artery modification. After implantation, mean arterial pressure declined during the preplacental phase to reach a midgestation nadir. With gestation day 9 opening of placental circulation, pressure rose, reaching baseline before parturition, whereas heart rate dropped. Heart rate stabilized before parturition. Placental sizes deviated during late gestation when growth stopped in normal mice but continued in immune-deficient mice. As an indication of the potential for abnormal hemodynamics, 2 pregnant females delivering dead offspring developed late gestational hypertension. This study characterizes a dynamic pattern of blood pressure over mouse pregnancy that parallels human gestation. Unexpectedly, these data reveal that spiral artery remodeling is not required for normal gestational control of blood pressure or for normal placental growth.


Assuntos
Adaptação Fisiológica/fisiologia , Artérias/fisiologia , Pressão Sanguínea/fisiologia , Doenças do Sistema Imunitário/fisiopatologia , Prenhez/fisiologia , Animais , Monitores de Pressão Arterial , Proteínas de Ligação a DNA/genética , Feminino , Doenças do Sistema Imunitário/genética , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Mutantes , Placenta/fisiologia , Gravidez , Resultado da Gravidez , Cloreto de Sódio na Dieta/farmacologia , Telemetria
15.
Microsc Res Tech ; 72(4): 310-6, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19009596

RESUMO

On the basis of transmission electron microscopy observations in tumor cell lines, oncologists have made innumerous diagnostic and therapeutical progresses. Following this path, the UNICAMP immunopathologies laboratory established the NG97 cell line derived from a human astrocytoma grade III, which when injected to the athymic nude mouse flank developed a grade IV astrocytoma. In this study, we focused on ultrastructural characterization of the NG97 cells after being recovered from xenotransplant (NG97ht). These cells in culture were assayed by two different electron microscopy procedures to characterize ultrastructures related to grade IV astrocytomas and to observe their structures through cell subcultivation. Additionally, comparative morphological descriptions of different cell passages in these technical procedures could be a useful tool for improving electron microscopy cell lineage protocols. Results from many cell passage observations showed ultrastructural similarities, which suggest malignant and glioblastoma phenotypes. In the first procedure, NG97ht cells were harvested and then incorporated into agarose before subjecting them to electron microscopy protocols, whereas in the second one, monolayer cells grew first on cover slides. Comparison among protocols revealed that organelles, cytoplasmatic extensions, spatial conformation of filopodia, and cell attachment to substrate were more preserved in the second procedure. Furthermore, in this latter procedure, a unique ellipsoidal structure was observed, which was already described when dealing with gliosarcoma cell line elsewhere. Therefore, these analyses demonstrated a morphological characterization of a new NG97ht cell line using electron transmission microscopy. Moreover, it has been shown that the second procedure provides more detailed information compared with the first.


Assuntos
Astrocitoma/ultraestrutura , Microscopia Eletrônica de Transmissão/métodos , Animais , Astrocitoma/patologia , Técnicas de Cultura de Células/métodos , Linhagem Celular Tumoral , Humanos , Camundongos , Transplante de Neoplasias , Transplante Heterólogo
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