Manifestaciones gastrointestinales de la nfermedad de Behçet / Gastrointestinal manifestations of Behçet´s disease

Resumen La Enfermedad de Behçet (EB), es una entidad poco común, idiopática, de naturaleza crónica y recurrente con afectación multisistémica. Entre ellos, el tracto gastrointestinal ha suscitado especial interés, al asociarse a mayor morbimortalidad y dado sus presentaciones heterogéneas puede simular otras enfermedades gastrointestinales y ser un gran reto diagnóstico para el gastroenterólogo. Por lo tanto, presentamos una revisión narrativa donde se pretenderá describir las manifestaciones gastrointestinales de la EB y sus diagnósticos diferenciales.

Abstract Behçet's Disease (BD) is a rare, idiopathic, chronic and relapsing entity; characterized by multisystem involvement. The gastrointestinal tract has aroused special interest, as it is associated with higher morbidity and mortality and given its heterogeneous presentations, being able to simulate other gastrointestinal pathologies, becoming a great diagnostic challenge for gastroenterologists. Therefore, we present a narrative review, where we intend to describe the possible gastrointestinal manifestations of BD and its differentials.

Recomendaciones para reumatólogos sobre el manejo farmacológico durante la emergencia sanitaria por COVID-19: opinión de un grupo de expertos / Recommendations for rheumatologists on pharmacological management during the COVID-19 health emergency: Expert group opinion

RESUMEN La enfermedad por Coronavirus 2019 (COVID-19) es una pandemia inesperada que ha pro vocado un estado de emergencia y que ha generado cambios drásticos en los protocolos de atención clínica. Para su tratamiento se ha descrito el papel de algunos medicamen tos usados habitualmente en artritis reumatoide, lupus eritematoso sistémico y otras enfermedades autoinmunitarias sistémicas. Debido a ello, existe un inminente riesgo de desabastecimiento, por lo cual el objetivo de esta revisión narrativa y opinión de expertos es formular recomendaciones generales clínicas y administrativas sobre el manejo de pacien tes ambulatorios con enfermedad autoinmunitaria o inflamatoria sistémica en el contexto de la pandemia por COVID-19.

ABSTRACT Coronavirus 2019 (COVID-19) is an unexpected pandemic that has caused a state of emergency, as well as generating drastic changes in clinical care protocols. Some drugs commonly used in rheumatoid arthritis, systemic lupus erythematosus, and other systemic autoimmune diseases have been described for its treatment. Therefore, there is an imminent risk of shortages. The aim of this narrative review and expert opinion is to present general recommendations on the clinical and administrative management of outpatients with autoimmune or systemic inflammatory disease, in the context of the COVID-19 pandemic.

IL-9: Function, Sources, and Detection.

IL-9 is a pleiotropic cytokine produced in different amounts by a wide variety of cells including mast cells, NKT cells, Th2, Th17, Treg, ILC2, and Th9 cells. Th9 cells are considered to be the main CD4+ T cells that produce IL-9. IL-9 exerts its effects on multiple types of cells and different tissues. To date, its main role has been found in the immune responses against parasites and pathogenesis of allergic diseases such as asthma and bronchial hyperreactivity. Additionally, it induces the proliferation of hematologic neoplasias, including Hodgkin's lymphoma in humans. However, IL-9 also has antitumor properties in solid tumors such as melanoma. The objective of this review is to describe IL-9, its function, sources, and methods of detection.

Th9 lymphocytes: A recent history from IL-9 to its potential role in rheumatic diseases.

Various subtypes of effector T cells have been described up to date, and each one has its specific immunological function and a defined cytokine secretion profile. Th9 lymphocytes, recently described, are characterized by a high IL-9 expression. Their differentiation requires the integration of IL-4 and TGF-ß signaling pathways and the coordinated participation of multiple transcription factors. Their role has been mainly found in immunity against parasites and in allergic inflammatory processes. Nevertheless, they have been implicated in processes as autoimmunity, cancer and recently in rheumatic diseases. The objective of this review is to describe the discovery of this cellular subtype, its differentiation, expression regulation and its potential role in rheumatic diseases.