RESUMO
AIM: The soluble scavenger receptor differentiation antigen 163 (sCD163), a monocyte/macrophage activation marker, is related to cardiovascular mortality in the general population. This study aimed to evaluate their relationship between serum levels of sCD163 with cardiovascular risk indicators in rheumatoid arthritis (RA). METHODS: A cross-sectional study was performed on 80 women diagnosed with RA. The cardiovascular risks were determined using the lipid profile, metabolic syndrome, and QRISK3 calculator. For the assessment of RA activity, we evaluated the DAS28 with erythrocyte sedimentation rate (DAS28-ESR). The serum levels of sCD163 were determined by the ELISA method. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of sCD163 with cardiovascular risk in RA patients. RESULTS: Levels of sCD163 were significantly higher in RA patients with high sensitivity protein C-reactive to HDL-c ratio (CHR)≥0.121 (p=0.003), total cholesterol/HDL-c ratio>7% (p=0.004), LDL-c/HDL-c ratio>3% (p=0.035), atherogenic index of plasma>0.21 (p=0.004), cardiometabolic index (CMI)≥1.70 (p=0.005), and high DAS28-ESR (p=0.004). In multivariate analysis, levels of sCD163≥1107.3ng/mL were associated with CHR≥0.121 (OR=3.43, p=0.020), CMI≥1.70 (OR=4.25, p=0.005), total cholesterol/HDL-c ratio>7% (OR=6.63, p=0.044), as well as with DAS28-ESR>3.2 (OR=8.10, p=0.008). Moreover, levels of sCD163 predicted CHR≥0.121 (AUC=0.701), cholesterol total/HDL ratio>7% (AUC=0.764), and DAS28-ESR>3.2 (AUC=0.720). CONCLUSION: Serum levels of sCD163 could be considered a surrogate of cardiovascular risk and clinical activity in RA.
RESUMO
Escherichia coli is the main etiological agent of urinary tract infections. Its virulence factors are important during the initial interaction stage with the host as they enable colonization of urinary tract tissues. The genetic markers evidencing susceptibility to develop recurrent infections have been previously described. Toll-like receptors are critical sensors of microbial attacks, and they are also effectors of the individual's innate defense for elimination of pathogens. The aim of this study was to evaluate the association between functional polymorphisms (896 A>G, 1196 C>T, - 2570 A>G, - 2081 G>A) and susceptibility to develop urinary tract infections as well as E. coli virulence factors. This study includes 100 samples from patients diagnosed with UTI and 100 samples from uninfected subjects. A conventional urine culture was performed and the isolates were identified by using the Vitek automated system. TLR4 gene polymorphisms were identified by the PCR-RFLP technique. The hlyA, fimH, papC, iutA and cnf1 virulence factors as well as the E. coli phylogenetic group were assessed by PCR. In this study, it was observed that the presence of the - 2570 polymorphism represents a risk of UTI (p < 0.01), whereas - 2081 confers protection (p < 0.01). The 896A>G and 1196C>T polymorphisms were associated with the E. coli virulence factors fimH and hlyA, respectively (p < 0.05). The B2 group was the most frequent in clinical isolates (51%), and it displayed more virulence factors regarding other phylogenetic groups (p ≤ 0.05). An interesting finding was that strains considered as commensals, belonging to groups A and B1, can cause UTI and present virulence factors. Polymorphisms occurring in the TLR4 promoter region are correlated with susceptibility or risk of UTI, whereas structural polymorphisms are associated with the recognition of virulence factors displayed by E. coli.
Assuntos
Infecções por Escherichia coli/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Receptor 4 Toll-Like/genética , Infecções Urinárias/genética , Escherichia coli Uropatogênica/patogenicidade , Fatores de Virulência/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Técnicas Bacteriológicas , Criança , Pré-Escolar , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , Gravidez , Receptor 4 Toll-Like/metabolismo , Infecções Urinárias/microbiologia , Escherichia coli Uropatogênica/genética , Adulto JovemRESUMO
El éxito en el tratamiento de las infecciones necrotizantes de los tejidos blandos (INTB) depende de la precocidad diagnóstica y de la agresividad terapéutica, basada en el desbridamiento quirúrgico, la antibioticoterapia de amplio espectro y el soporte intensivo. Se presenta un caso de INTB secundaria a diverticulitis aguda perforada (Hinchey 4) con el fin de ilustrar las consideraciones particulares en el manejo de la INTB de localización en la pared abdominal, apoyadas en la evidencia disponible en la literatura científica. Se identifican como puntos clave la precocidad y la agresividad del desbridamiento quirúrgico, la antibioticoterapia dirigida por el cultivo y su suspensión guiada por la negativización microbiológica; y el empleo de técnicas combinadas de autoplastia y prótesis apoyadas en la terapia de presión negativa en la restauración de la pared abdominal, con lo que se ha obtenido un buen resultado.Successful treatment of necrotizing soft tissue infections (NSTI) depends on early diagnosis and therapeutical aggressiveness, based on surgical debridement, broad spectrum antibiotics and intensive support. A case of perforated diverticulitis (Hinchey 4)-secondary-NSTI is presented in order to illustrate the particular considerations in the management of abdominal wall located NSTI, supported on the evidence available in scientific literature. Several key points are identified, such as prompt and aggressive surgical debridement; culture-guided antibiotherapy and its suspension based on microbiological negativization; and the utilization of combined techniques of autoplastic repair and replacement, also supported on negative pressure therapy in the abdominal wall restoration, which have shown a good outcome.
