Inflammation and kidney injury attenuated by prior intake of Brazil nuts in the process of ischemia and reperfusion / Inflamação e lesão renal atenuadas pela ingestão prévia de castanha-do-Brasil no processo de isquemia e reperfusão

ABSTRACT Introduction: Ischemia and reperfusion (IR) is a process inherent to the procedures involved in the transplantation of organs that causes inflammation, cell death and cell injury, and may lead to rejection of the graft. It is possible that the anti-inflammatory properties of the Brazil nuts (BN) can mitigate the renal injury caused by IR. Objective: To investigate whether the previous intake of BN reduces the expression of markers of inflammation, injury, and cell death after renal IR. Methods: Male Wistar rats were distributed into six groups (N = 6/group): SHAM (control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75 or 150 mg of BN. The IR procedure consisted of right nephrectomy and occlusion of the left renal artery with a non-traumatic vascular clamp for 30 min. BN was given daily from day 1 to 7 before surgery (SHAM or IR), and maintained until sacrifice (48 h after surgery). Inflammation was evaluated by renal expression of COX-2 and TGF-β, injury by the expression of vimentin, and cell death by apoptosis through caspase-3 expression (immunohistochemistry). Results: Pretreatment with 75 mg of BN reduced renal expression of the COX-2, TGF-β, vimentin, and caspase-3. The dose of 150 mg caused increased expression of COX-2. Conclusion: In experimental IR, the damage can be minimized with a prior low-dose intake of BN, improving inflammation, injury, and cell death.

RESUMO Introdução: Isquemia e reperfusão (IR) é um processo inerente aos procedimentos envolvidos no transplante de órgãos, que causa inflamação, morte celular e lesão, podendo levar à rejeição do enxerto. É possível que a castanha-do-brasil (CB), por suas propriedades anti-inflamatórias, possa atenuar a lesão renal causada pela IR. Objetivo: Investigar se a ingestão prévia de CB reduz a expressão de marcadores renais de inflamação, lesão e morte celular após a IR. Métodos: Ratos Wistar machos foram distribuídos em seis grupos (N = 6/grupo): SHAM (controle), SHAM tratado com 75 ou 150 mg de CB, IR, e IR tratado com 75 ou 150 mg de CB. O procedimento de IR consistiu na nefrectomia à direita e oclusão da artéria renal esquerda por 30 minutos. A castanha foi administrada diariamente por sete dias antes da cirurgia (SHAM ou IR), e mantida até o sacrifício (48 horas pós-cirurgia). A inflamação foi avaliada pela expressão renal de COX-2 e TGF-β; a lesão pela expressão de vimentina, e a morte celular por apoptose pela expressão de caspase-3, por imuno-histoquímica. Resultados: O pré-tratamento com 75 mg de CB reduziu a expressão renal de COX-2, de TGF-β, de vimentina e de caspase-3. A dose de 150 mg causou elevação da expressão de COX-2. Conclusão: No modelo experimental de IR renal, os danos podem ser minimizados com a ingestão prévia de baixas doses de CB, melhorando a inflamação, a lesão e a morte celular.

Inflammation and kidney injury attenuated by prior intake of Brazil nuts in the process of ischemia and reperfusion.

INTRODUCTION: Ischemia and reperfusion (IR) is a process inherent to the procedures involved in the transplantation of organs that causes inflammation, cell death and cell injury, and may lead to rejection of the graft. It is possible that the anti-inflammatory properties of the Brazil nuts (BN) can mitigate the renal injury caused by IR. OBJECTIVE: To investigate whether the previous intake of BN reduces the expression of markers of inflammation, injury, and cell death after renal IR. METHODS: Male Wistar rats were distributed into six groups (N = 6/group): SHAM (control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75 or 150 mg of BN. The IR procedure consisted of right nephrectomy and occlusion of the left renal artery with a non-traumatic vascular clamp for 30 min. BN was given daily from day 1 to 7 before surgery (SHAM or IR), and maintained until sacrifice (48 h after surgery). Inflammation was evaluated by renal expression of COX-2 and TGF-ß, injury by the expression of vimentin, and cell death by apoptosis through caspase-3 expression (immunohistochemistry). RESULTS: Pretreatment with 75 mg of BN reduced renal expression of the COX-2, TGF-ß, vimentin, and caspase-3. The dose of 150 mg caused increased expression of COX-2. CONCLUSION: In experimental IR, the damage can be minimized with a prior low-dose intake of BN, improving inflammation, injury, and cell death.

Prior intake of Brazil nuts attenuates renal injury induced by ischemia and reperfusion.

INTRODUCTION: Ischemia-reperfusion (IR) injury results from inflammation and oxidative stress, among other factors. Because of its anti-inflammatory and antioxidant properties, the Brazil nut (BN) might attenuate IR renal injury. OBJECTIVE: The aim of the present study was to investigate whether the intake of BN prevents or reduces IR kidney injury and inflammation, improving renal function and decreasing oxidative stress. METHODS: Male Wistar rats were distributed into six groups (N=6/group): SHAM (control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75 or 150 mg of BN. The IR procedure consisted of right nephrectomy and occlusion of the left renal artery with a non-traumatic vascular clamp for 30 min. BN was given daily and individually for 7 days before surgery (SHAM or IR) and maintained until animal sacrifice (48h after surgery). We evaluated the following parameters: plasma creatinine, urea, and phosphorus; proteinuria, urinary output, and creatinine clearance; plasmatic TBARS and TEAC; kidney expression of iNOS and nitrotyrosine, and macrophage influx. RESULTS: Pre-treatment with 75 mg of BN attenuated IR-induced renal changes, with elevation of creatinine clearance and urinary output, reducing proteinuria, urea, and plasmatic phosphorus as well as reducing kidney expression of iNOS, nitrotyrosine, and macrophage influx. CONCLUSION: Low intake of BN prior to IR-induced kidney injury improves renal function by inhibition of macrophage infiltration and oxidative stress.

Prior intake of Brazil nuts attenuates renal injury induced by ischemia and reperfusion / A ingestão prévia de castanha-do-brasil atenua a lesão renal induzida por isquemia e reperfusão

ABSTRACT Introduction: Ischemia-reperfusion (IR) injury results from inflammation and oxidative stress, among other factors. Because of its anti-inflammatory and antioxidant properties, the Brazil nut (BN) might attenuate IR renal injury. Objective: The aim of the present study was to investigate whether the intake of BN prevents or reduces IR kidney injury and inflammation, improving renal function and decreasing oxidative stress. Methods: Male Wistar rats were distributed into six groups (N=6/group): SHAM (control), SHAM treated with 75 or 150 mg of BN, IR, and IR treated with 75 or 150 mg of BN. The IR procedure consisted of right nephrectomy and occlusion of the left renal artery with a non-traumatic vascular clamp for 30 min. BN was given daily and individually for 7 days before surgery (SHAM or IR) and maintained until animal sacrifice (48h after surgery). We evaluated the following parameters: plasma creatinine, urea, and phosphorus; proteinuria, urinary output, and creatinine clearance; plasmatic TBARS and TEAC; kidney expression of iNOS and nitrotyrosine, and macrophage influx. Results: Pre-treatment with 75 mg of BN attenuated IR-induced renal changes, with elevation of creatinine clearance and urinary output, reducing proteinuria, urea, and plasmatic phosphorus as well as reducing kidney expression of iNOS, nitrotyrosine, and macrophage influx. Conclusion: Low intake of BN prior to IR-induced kidney injury improves renal function by inhibition of macrophage infiltration and oxidative stress.

RESUMO Introdução: a lesão por isquemia-reperfusão (IR) resulta, entre outros fatores, de inflamação e estresse oxidativo. Devido às suas propriedades anti-inflamatórias e antioxidantes, a castanha-do-brasil (BN) pode atenuar a lesão renal causada por IR. Objetivo: O objetivo foi investigar se a ingestão prévia de BN reduz a lesão e a inflamação renal causadas por IR, melhorando a função renal e o estresse oxidativo. Métodos: Ratos Wistar machos foram distribuídos em seis grupos (N=6/grupo): SHAM (controle), SHAM tratado com 75 ou 150 mg de BN, IR, e IR tratado com 75 ou 150 mg de BN. O procedimento de IR consistiu na nefrectomia à direita e oclusão da artéria renal esquerda por 30 minutos. A castanha foi administrada diariamente e individualmente por sete dias antes da cirurgia (SHAM ou IR), e mantida até o sacrifício (48h pós-cirurgia). Os seguintes parâmetros foram avaliados: creatinina, ureia e fósforo plasmáticos; proteinúria, volume urinário e depuração de creatinina; TBARS e TEAC (capacidade antioxidante) plasmáticos; expressão renal de iNOS e nitrotirosina, e influxo de macrófagos. Resultados: O pré-tratamento com 75 mg de BN atenuou os parâmetros de função renal alterados pela IR, com elevação da depuração de creatinina e o volume urinário, redução da proteinúria, ureia e fósforo plasmáticos, e diminuição da expressão de iNOS, nitrotirosina e da infiltração de macrófagos. Conclusão: A ingestão de baixa quantidade de BN, previamente ao processo de IR, melhora a função renal pela inibição da infiltração de macrófagos e do estresse oxidativo.

AIDS depois dos 50 anos: incidência de 2003 a 2013 em São José do Rio Preto, SP, e a percepção dos idosos de uma Unidade Básica de Saúde sobre a doença / AIDS after the age of 50: incidence from 2003 to 2013 in the city of São José do Rio Preto, São Paulo, and the perception on the disease of the elderly of a Basic Health Care Unit

Os avanços da medicina e da tecnologia favorecem o envelhecimento, prolongando a sexualidade. Concomitantemente, crescem os casos de AIDS nesta população desassistida sobre o assunto. Objetivo: Calcular a incidência de AIDS em pessoas com 50 anos ou mais em São José do Rio Preto - SP e verificar o conhecimento dessas pessoas sobre a doença em uma Unidade Básica de Saúde. Métodos: Estudo retrospectivo da incidência de AIDS a partir dos casos notificados no sistema eletrônico da Secretaria de Saúde do Estado de São Paulo entre 2003 e 2013. A percepção dos idosos sobre a doença foi avaliada mediante a aplicação de questionários, antes e após intervenção educativa (panfleto). Os dados foram comparados utilizando-se o teste Qui-quadrado de McNemar. Resultados: De 2003 a 2013, foram notificados 224 casos novos de AIDS na população estudada, com predomínio do sexo masculino. Embora tenha ocorrido certa oscilação na incidência, ao se comparar o início e o final do período estudado observou-se decréscimo de 68% na notificação destes novos casos. Responderam aos questionários 34 homens e 66 mulheres entre 50 e 88 anos. A maioria (59%) referiu ter parceiro fixo e negou a utilização de preservativos (87%). Após a atividade educativa, apenas 5% continuaram com dúvidas e 68% demonstraram interesse em obter informações sobre DTS na UBS. Conclusão: Nota-se instabilidade na incidência de AIDS no município; contudo, no período estudado ocorreu diminuição significativa dos casos. A maioria dos entrevistados não possuía conhecimentos sobre a AIDS, mas os panfletos se mostraram uma ferramenta simples e eficaz.

The advances in medicine and technology favor aging, thus prolonging sexuality. Concomitantly, AIDS cases present growth on such an unassisted population. Objective: To estimate the incidence of AIDS in people aged 50 years of more in the city of São José do Rio Preto, São Paulo, and to verify their knowledge about the disease in a Basic Health Care Unit (Unidade Básica de Saúde). Methods: A retrospective study of AIDS incidence based on cases reported in the electronic system of the São Paulo State Health Department between 2003 and 2013. The elderly perception on the disease was evaluated through questionnaires, before and after the educational intervention (leaflets). Data were compared using the McNemar Chi-square test. Results: From 2003 to 2013, 224 new cases of AIDS were reported in the studied population, with a predominance of males. Although there was some oscillation in the incidence, a comparison between the beginning and the end of the studied period revealed a 68% decrease in new notified cases. Questionnaires were answered by 34 men and 66 women ranging 50 to 88 years of age. Most of them (59%) reported having a steady partner and denied the use of condom (87%). After the educational activity, only 5% remained in doubt and 68% showed interest in obtaining information about STDs at the Basic Health Care Unit. Conclusion: An instability in the incidence of AIDS was observed within the city; however, during the studied period there was a significant reduction in cases. Most of the interviewees did not know about AIDS, and the leaflets proved to be a simple and effective tool.