RESUMO
Sjögren's syndrome (SS) is an autoimmune disorder affecting primarily the exocrine glands, leading to keratoconjunctivitis sicca (KCS) and xerostomia, but that can also include extraglandular features(1). Due the anatomical, physiological and pathological similarity between the pancreas and the salivary glands, it has been described that the pancreas it is not exempt from the damage produced by this syndrome. Some authors have assessed pancreatic involvement of SS by analyzing the histopathological changes, evaluating the pancreatic endocrine and exocrine function (serum pancreatic enzymes, elastase, lipase or trypsin determinations, N-benzoyl-L-tyrosyl-para-aminobenzoic acid excretion test, etc), searching specific pancreatic antibodies (antiductal) or performing endoscopic retrograde colangiopancreatography or noninvasive imaging studies such as computed tomography or ultrasound. Herein we review the literature regarding the prevalence and type of pancreatic involvement in the SS and we discuss the differential diagnosis with multiorganic Lymphoproliferative Syndrome.
Assuntos
Pâncreas Exócrino/fisiopatologia , Síndrome de Sjogren/fisiopatologia , Amilases/metabolismo , Animais , Especificidade de Anticorpos , Autoanticorpos/imunologia , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/patologia , Modelos Animais de Doenças , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/fisiopatologia , Fibrose , Humanos , Imunoglobulina G , Lipase/metabolismo , Linfócitos/patologia , Transtornos Linfoproliferativos/classificação , Transtornos Linfoproliferativos/diagnóstico , Camundongos , Camundongos Endogâmicos NOD , Doença de Mikulicz/classificação , Doença de Mikulicz/diagnóstico , Pâncreas Exócrino/imunologia , Pâncreas Exócrino/metabolismo , Pâncreas Exócrino/patologia , Ductos Pancreáticos/imunologia , Ductos Pancreáticos/patologia , Síndrome de Sjogren/classificação , Síndrome de Sjogren/complicações , Síndrome de Sjogren/patologia , Tripsina/metabolismoRESUMO
El síndrome de Sjögren (SS) es una enfermedad autoinmunitaria que afecta principalmente a las glándulas exocrinas, aunque puede ocasionar también manifestaciones extraglandulares. Dada la similitud anatómica, fisiológica y patológica del páncreas y las glándulas salivales, se ha descrito que el páncreas no está exento del daño producido por el síndrome de Sjögren. Por esta similitud, algunos autores han estudiado la influencia del SS en el páncreas analizando los cambios histopatológicos, evaluando la función pancreática endocrina y exocrina (medición de enzimas pancreáticas séricas, prueba de excreción de ácido N-benzoil-L-tirosil-para-aminobenzoico, medición de elastasa, lipasa o tripsina), por la detección de anticuerpos específicos para páncreas (Ac. anticonductos), o mediante la realización de colangiopancreatografía endoscópica retrógrada o estudios de imagen no invasivos (tomografía computarizada y ultrasonido). En el presente trabajo revisamos la literatura científica en relación con la prevalencia y el grado de afección pancreática en SS y discutimos sobre el diagnóstico diferencial con el síndrome linfoproliferativo multiorgánico(AU)
Sjögren's syndrome (SS) is an autoimmune disorder affecting primarily the exocrine glands, leading to keratoconjunctivitis sicca (KCS) and xerostomia, but that can also include extraglandular features1. Due the anatomical, physiological and pathological similarity between the pancreas and the salivary glands, it has been described that the pancreas it is not exempt from the damage produced by this syndrome. Some authors have assessed pancreatic involvement of SS by analyzing the histopathological changes, evaluating the pancreatic endocrine and exocrine function (serum pancreatic enzymes, elastase, lipase or trypsin determinations, N-benzoyl-L-tyrosyl-para-aminobenzoic acid excretion test, etc), searching specific pancreatic antibodies (antiductal) or performing endoscopic retrograde colangiopancreatography or noninvasive imaging studies such as computed tomography or ultrasound. Herein we review the literature regarding the prevalence and type of pancreatic involvement in the SS and we discuss the differential diagnosis with multiorganic Lymphoproliferative Syndrome(AU)
Assuntos
Humanos , Masculino , Feminino , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Síndrome de Sjogren/fisiopatologia , Insuficiência Pancreática Exócrina/complicações , Insuficiência Pancreática Exócrina/diagnóstico , Colangiopancreatografia por Ressonância Magnética , Doença de Mikulicz/complicações , Doença de Mikulicz/diagnóstico , Transtornos Linfoproliferativos/complicações , Transtornos Linfoproliferativos/diagnóstico , Síndrome de Sjogren/epidemiologia , Síndrome de Sjogren/terapia , Pâncreas Exócrino , Pâncreas Exócrino/patologia , Pâncreas Exócrino , Endoscopia/tendências , Endoscopia , /instrumentação , /métodosRESUMO
BACKGROUND: Matrix metalloproteinase-2 (MMP-2) is an enzyme with proteolytic activity on matrix proteins, particularly basement membrane constituents. A single nucleotide polymorphism C>T transition at -1306 displayed a strong association with several cancers. Our study investigated whether or not the MMP-2 -1306C>T polymorphism contributed to the development of breast cancer (BC) in a Mexican population. METHODS: 90 patients with BC and 96 control subjects were analyzed to detect MMP-2 -1306C>T polymorphism. RESULTS: The frequency of MMP-2 CC genotype was significantly higher in BC patients when compared with the control group (OR 2.15; 95% CI 1.1-4.1). MMP-2 CC genotype frequency was more pronounced in younger subjects (< or =50 years) at diagnosis (OR 2.66; 95% CI 1.04-6.96). CONCLUSION: The data suggest that MMP-2 -1306C>T polymorphism strongly contributes to the development of BC in the population studied, especially among women 50 years old and younger.
