The neuro-endocrine-immune relationship in pulmonary and pleural tuberculosis: a better local profile in pleural fluid.

BACKGROUND: Tuberculosis (TB) is a major health problem worldwide. In TB, the immune and central nervous systems modulate each other. The two main components of this network are the hypothalamic-pituitary-adrenal axis (HPA) and autonomic nervous system (ANS). OBJECTIVE: To elucidate neuro-endocrine-immune (NEI) interactions in pulmonary (PTB) or pleural (PLTB) TB, we analysed the relationship among compounds from these systems. METHODS: We quantified levels of catecholamines, hormones and cytokines in plasma from patients with PTB (n = 46) or PLTB (n = 12) and controls (n = 32), and in the pleural fluid from PLTB patients. Transcript expression for genes involved in glucocorticoid-related function (quantitative real-time polymerase chain reaction) was also analysed in mononuclear cells (MCs) from peripheral blood (PBMC) or pleural effusion (PEMC) compartments. RESULTS: Both patient groups had increased plasma levels of pro- and anti-inflammatory cytokines, cortisol, growth hormone (GH) and dopamine, whereas insulin-like growth factor 1 (IGF-1) and dehydroepiandrosterone levels were decreased. The pleural fluid contained increased levels of pro-inflammatory cytokines, GH and IGF-1 and reduced levels of steroid hormones compared with their plasma counterparts. PBMCs from PTB patients had increased expression of transcripts for 11ß-hydroxysteroid dehydrogenase (11ßHSD1) and a decreased glucocorticoid receptor (GR) ratio (GRα/GRß). In PLTB cases, expression of 11ßHSD1 and GRα transcripts was higher in PEMCs. CONCLUSION: PTB patients seem to display adverse NEI dysregulation. Changes in pleural fluid are compatible with a more effective NEI reaction.

Frecuencia alélica de apolipoproteina E en una población aborigen / Apolipoprotein E allelic frequency in a native population

El polimorfismo de apolipoproteína E (apoE) es originado por los alelos e2, e3 y e4. El origen étnico demostró ser un factor determinante del genotipo de apoE; existen pocos estudios acerca de su distribución. Realizamos un estudio explorativo para determinar la frecuencia alélica (FA) de apoE en una muestra de una población de origen aborigen (PA) nacidos en la provincia de Chaco (Rep. Argentina) y emigrados a Rosario y/o descendientes de los mismos nacidos en la ciudad, y compararla con la de una población caucásica argentina (PC), dato no reportado hasta el momento. Para comparar la FA en ambas poblaciones (PA n: 71,1 a 45 años y PC n: 56, 5 a 17 años), el tamaño muestral fue calculado para lograr una estimación representativa de la población total con una confianza del 95%. Las muestras fueron reclutadas en forma aleatoria de individuos que aceptaron participar previo consentimiento firmado. La caracterización molecular se realizó por ASA­PCR. Para comparar la FA de PA con PC, se realizó el ensayo de hipótesis de una proporción bajo teoría normal. Los resultados de FA fueron: PC: e3 0,786 (IC 95% 0,679­0,893), e4 0,178 (IC 95% 0,078­0,278), e2 0,036 (IC 95% 0,000­0,084), PA: e3 0,880 (IC 95% 0,804-0,956), e4 0,084 (IC 95% 0,021­0,147), e2 0,035 (IC 95% 0,000­0,075). Se encontró diferencia significativa en la FA de e3 y e4 entre las poblaciones estudiadas. El tamaño y esquema de muestreo, etnia, factores ambientales y protocolos utilizados, podrían contribuir a la diversidad de los resultados.

The polymorphism of apolipoprotein E (apoE) is originated by e2, e3 and e4 alleles. Ethnic origin has demonstrated to be a decisive factor for ApoE genotype. There are few studies about its distribution. We carried out this explorative study of the apoE genotype frequency (AF) in a native population (NP) born in the Chaco province and emigrated to Rosario (Argentina) and/or descendants in order to compare it with a Caucasian Argentinean population (CP), a fact that has not been reported yet. To compare the allelic frequency of both populations (NP n: 71. 1 to 45 yr and CP n: 56.5 to 17 yr), the sample size was calculated to achieve a representative estimation of total population with a confidence interval of 95%. Samples were randomly collected from individuals that accepted to participate and signed an informed consent. The molecular characterization was made by ASA­PCR. To compare the AF of both populations, the hypothesis assay of a proportion under a normal theory was carried out. The allelic frequencies (AF) in the PC were: e3 0.786 (IC 95% 0.679­0.893), e4 0.178 (IC 95% 0.078­0.278), e2 0.036 (IC 95% 0.000­0.084). While FA in PA were e3 0.880 (IC 95% 0.804­0.956), e4 0.084 (IC 95% 0.021­0.147) and e2 0.035 (IC 95% 0.000­0.075). Significant differences were observed in the AF of e3 and e4 among the different populations. The sample size and sampling procedure, ethnia, environmental factors, and lab protocols could have contributed to the diversity of the results.