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1.
BMC Neurol ; 20(1): 1, 2020 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-31900128

RESUMO

OBJECTIVE: To investigate the clinical characteristics and prognosis of anti-gamma-aminobutyric acid-B (GABA-B) receptor encephalitis. METHODS: This retrospective study enrolled nineteen patients with anti-GABA-B receptor encephalitis. Clinical manifestations, radiological and electroencephalogram features, treatment and outcomes were collected and analyzed. The neurological function was evaluated according to the modified Rankin Scale (mRS). RESULTS: There were eleven patients in the favorable-prognosis group (mRS ≤ 2) and eight patients in the poor-prognosis group (mRS > 2). In the favorable-prognosis group, clinical symptoms included memory deterioration (n = 10; 90.9%), epileptic seizures (n = 9; 81.8%), psychiatric disorders (n = 9; 81.8%), and conscious disturbance (n = 5; 45.5%); magnetic resonance imaging (MRI) indicated an involvement of the limbic system in three (27.3%) cases in this group. Lung cancer was detected in one patient (9.1%). After an average follow-up period of 11.7 months, four (36.4%) patients were cured, and seven (63.6%) patients showed significant improvements. In the poor-prognosis group, all patients presented with memory deterioration, epileptic seizures, psychiatric disorders, and conscious disturbance; five (62.5%) patients had convulsive status epilepticus, and five (62.5%) patients developed respiratory failure; MRI indicated an involvement of the limbic system in seven (87.5%) cases. Malignant tumors were detected in five (62.5%) patients. After an average follow-up period of 14.8 months, seven (87.5%) patients died and one (12.5%) patient remained dependent in daily life. CONCLUSIONS: The clinical manifestations of anti-GABA-B receptor encephalitis include epileptic seizures, cognitive impairment and psychiatric disorders. Patients with convulsive status epilepticus or respiratory failure have poor outcomes. In anti-GABA-B receptor encephalitis, limbic system involvement is associated with a poor prognosis in and radiological examinations can reflect disease progression. Early diagnosis and appropriate treatment should be highlighted.


Assuntos
Doenças Autoimunes , Encefalite , Receptores de GABA-B/imunologia , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/fisiopatologia , China , Encefalite/complicações , Encefalite/diagnóstico , Encefalite/fisiopatologia , Humanos , Prognóstico , Estudos Retrospectivos , Convulsões/etiologia
2.
Autoimmun Rev ; 19(1): 102422, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31733369

RESUMO

Paraneoplastic autoimmune disorders (PAD) represent a group of autoimmune diseases associated with neoplasms. As a consequence of a remote autoimmunity-mediated effect, PAD are found in multiple organs or tissues, including the skin, blood and nervous system. Compared with non-paraneoplastic autoimmune diseases, PAD have different aetiologies, pathologies, disease symptoms and treatment responses. There are two main origins of autoimmunity in PAD: neoplasm-mediated dysregulated homeostasis in immune cells/organs and in autoantigens. Pathologically, PAD are mediated predominantly by either autoantibodies or autoreactive T-cells. In the past decade, significant progress has been achieved in increasing our understanding of the aetiology and pathology of PAD. In this review article, we aim to provide a comprehensive overview of the recent advances in this field.


Assuntos
Doenças Autoimunes/etiologia , Doenças Autoimunes/fisiopatologia , Neoplasias/fisiopatologia , Autoanticorpos , Autoantígenos , Humanos
3.
Nat Med ; 25(12): 1822-1832, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31806905

RESUMO

Although intermittent increases in inflammation are critical for survival during physical injury and infection, recent research has revealed that certain social, environmental and lifestyle factors can promote systemic chronic inflammation (SCI) that can, in turn, lead to several diseases that collectively represent the leading causes of disability and mortality worldwide, such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and autoimmune and neurodegenerative disorders. In the present Perspective we describe the multi-level mechanisms underlying SCI and several risk factors that promote this health-damaging phenotype, including infections, physical inactivity, poor diet, environmental and industrial toxicants and psychological stress. Furthermore, we suggest potential strategies for advancing the early diagnosis, prevention and treatment of SCI.


Assuntos
Doença Crônica/epidemiologia , Inflamação/fisiopatologia , Longevidade/genética , Doenças Autoimunes/etiologia , Doenças Autoimunes/fisiopatologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Diabetes Mellitus/etiologia , Diabetes Mellitus/fisiopatologia , Humanos , Inflamação/complicações , Inflamação/epidemiologia , Estilo de Vida , Longevidade/fisiologia , Neoplasias/etiologia , Neoplasias/fisiopatologia , Doenças Neurodegenerativas/etiologia , Doenças Neurodegenerativas/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/fisiopatologia , Fatores de Risco
4.
An Bras Dermatol ; 94(4): 399-404, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644610

RESUMO

BACKGROUND: The Autoimmune Bullous Disease Quality of Life (ABQOL) and the Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaires proved to be reliable tools that measure the disease and treatment burden. OBJECTIVES: We aimed to assess the ABQOL and TABQOL in the Arabic population. METHODS: The English questionnaires were translated into the Arabic language by a certified translation agency. Eighty autoimmune bullous disease (AIBD) patients were included in this study. Patients were asked to answer 2 questionnaires. After 1 week the same patients were asked to answer the same questionnaires again. RESULTS: The age of the patients ranged from 19 to 81 years (mean=46), 19 males, 61 females. The ABQOL ranged from 0-37 (mean=16.4±9.2). The TABQOL ranged from 2-43 (mean=21.5±9.4). Test-retest reliability was acceptable, Cronbach's alpha was 0.76 for ABQOL and 0.74 for TABQOL. There was no significant correlation between the age of the patients and ABQOL, r =-0.2, p value was 0.183. There was a significant negative correlation between the age of the patients and the TABQOL, r=-0.2, p value was 0.039. There was a significant negative correlation between the education of the patients and the TABQOL, r=-0.3, p value was 0.007. STUDY LIMITATIONS: Small sample size of some AIBDs and patients with severe disease. CONCLUSION: Objective and valuable measurements such as ABQOL and TABQOL are now available to help physicians understand their patient's distress and should be used in every patient with AIBD. Younger and less educated patients appear to have more effects on their QOL from the treatments.


Assuntos
Doenças Autoimunes/fisiopatologia , Doenças Autoimunes/terapia , Qualidade de Vida , Dermatopatias Vesiculobolhosas/fisiopatologia , Dermatopatias Vesiculobolhosas/terapia , Inquéritos e Questionários/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Egito , Feminino , Humanos , Linguagem , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Dermatopatias Vesiculobolhosas/imunologia , Fatores de Tempo , Resultado do Tratamento , Tunísia , Adulto Jovem
5.
C R Biol ; 342(5-6): 136-141, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31501012

RESUMO

The impact of stressful conditions on immunity seems mixed and at times counterbalanced. Such inconsistencies can often be attributed to the fact that the notion of stress has a very wide meaning and covers a large number of different situations. Research on liver X receptors using both natural and synthetic ligands may help to solve this conflict. When an infectious agent is present in a stressed body, LXR activation is likely to be a key element in the regulation of POMC, IFN-γ, and IL-18; moreover, it is a unique anti-inflammatory mode of action. They concurrently stimulate a non-specific immune reaction as they suppress inflammatory and autoimmune processes.


Assuntos
Síndrome de Adaptação Geral/imunologia , Síndrome de Adaptação Geral/fisiopatologia , Receptores X do Fígado/imunologia , Animais , Doenças Autoimunes/imunologia , Doenças Autoimunes/fisiopatologia , Humanos , Inflamação/imunologia , Inflamação/fisiopatologia
7.
BMJ Case Rep ; 12(9)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31494587

RESUMO

Interstitial pneumonia with autoimmune features (IPAF) is a recently proposed terminology for interstitial lung disease (ILD) with evidence of autoimmunity that does not meet the criteria for a defined connective tissue disease (CTD). Although ILD is well recognised in patients with established CTD, it is rarely the sole presenting feature of CTD. We report a case of 22-year-old male patient, who presented with progressive shortness of breath for 2 months and had features suggestive of platypnea-orthodeoxia syndrome (POS). Imaging revealed ILD with usual interstitial pneumonia pattern. Patient had features of autoimmune disorder but did not fulfil the criteria for any CTD and hence was labelled as IPAF. His POS was attributed predominantly to the lower lobe disease. The patient responded well to immunosuppressive treatment. A systematic review of literature of all cases with POS due to pulmonary parenchymal involvement has also been done.


Assuntos
Doenças Autoimunes/diagnóstico , Fibrose Pulmonar Idiopática/diagnóstico , Imunossupressores/uso terapêutico , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/imunologia , Doenças Autoimunes/fisiopatologia , Dispneia/imunologia , Humanos , Fibrose Pulmonar Idiopática/tratamento farmacológico , Fibrose Pulmonar Idiopática/imunologia , Fibrose Pulmonar Idiopática/fisiopatologia , Masculino , Síndrome , Resultado do Tratamento , Adulto Jovem
8.
Nutrients ; 11(8)2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31394758

RESUMO

Diet and microbiota each have a direct impact on many chronic, inflammatory, and metabolic diseases. As the field develops, a new perspective is emerging. The effects of diet may depend on the microbiota composition of the intestine. A diet that is rich in choline, red meat, dairy, or egg may promote the growth, or change the composition, of microbial species. The microbiota, in turn, may produce metabolites that increase the risk of cardiovascular disease. This article reviews our current understanding of the effects of the molecule trimethylamine-N-oxide (TMAO) obtained from food or produced by the microbiota. We review the mechanisms of actions of TMAO, and studies that associate it with cardiovascular and chronic kidney diseases. We introduce a novel concept: TMAO is one among a group of selective uremic toxins that may rise to high levels in the circulation or accumulate in various organs. Based on this information, we evaluate how TMAO may harm, by exacerbating inflammation, or may protect, by attenuating amyloid formation, in autoimmune diseases such as rheumatoid arthritis.


Assuntos
Artrite Reumatoide/fisiopatologia , Doenças Autoimunes/fisiopatologia , Dieta , Metilaminas/farmacologia , Microbiota/fisiologia , Amiloide/metabolismo , Animais , Doenças Cardiovasculares/etiologia , Disbiose/fisiopatologia , Intolerância à Glucose , Humanos , Inflamação/etiologia , Metilaminas/metabolismo , Insuficiência Renal Crônica , Fatores de Risco
9.
An. bras. dermatol ; 94(4): 399-404, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1038298

RESUMO

Abstract: Background: The Autoimmune Bullous Disease Quality of Life (ABQOL) and the Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaires proved to be reliable tools that measure the disease and treatment burden. Objectives: We aimed to assess the ABQOL and TABQOL in the Arabic population. Methods: The English questionnaires were translated into the Arabic language by a certified translation agency. Eighty autoimmune bullous disease (AIBD) patients were included in this study. Patients were asked to answer 2 questionnaires. After 1 week the same patients were asked to answer the same questionnaires again. Results: The age of the patients ranged from 19 to 81 years (mean=46), 19 males, 61 females. The ABQOL ranged from 0-37 (mean=16.4±9.2). The TABQOL ranged from 2-43 (mean=21.5±9.4). Test-retest reliability was acceptable, Cronbach's alpha was 0.76 for ABQOL and 0.74 for TABQOL. There was no significant correlation between the age of the patients and ABQOL, r =-0.2, p value was 0.183. There was a significant negative correlation between the age of the patients and the TABQOL, r=-0.2, p value was 0.039. There was a significant negative correlation between the education of the patients and the TABQOL, r=-0.3, p value was 0.007. Study limitations: Small sample size of some AIBDs and patients with severe disease. Conclusion: Objective and valuable measurements such as ABQOL and TABQOL are now available to help physicians understand their patient's distress and should be used in every patient with AIBD. Younger and less educated patients appear to have more effects on their QOL from the treatments.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Qualidade de Vida , Doenças Autoimunes/fisiopatologia , Doenças Autoimunes/terapia , Inquéritos e Questionários/normas , Dermatopatias Vesiculobolhosas/fisiopatologia , Dermatopatias Vesiculobolhosas/terapia , Fatores de Tempo , Tunísia , Índice de Gravidade de Doença , Estudos Transversais , Análise Multivariada , Reprodutibilidade dos Testes , Dermatopatias Vesiculobolhosas/imunologia , Resultado do Tratamento , Egito , Linguagem
10.
Nursing ; 49(8): 46-49, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31343533

RESUMO

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) describes a disorder that develops in children who abruptly develop neurologic abnormalities following a streptococcal infection. The authors discuss what is known about this poorly understood disorder and how nurses can educate and support patients and their families.


Assuntos
Doenças Autoimunes/enfermagem , Transtorno Obsessivo-Compulsivo/enfermagem , Infecções Estreptocócicas/enfermagem , Doenças Autoimunes/fisiopatologia , Criança , Humanos , Relações Enfermeiro-Paciente , Diagnóstico de Enfermagem , Transtorno Obsessivo-Compulsivo/fisiopatologia , Educação de Pacientes como Assunto , Relações Profissional-Família , Apoio Social , Infecções Estreptocócicas/fisiopatologia
11.
J Clin Lab Anal ; 33(7): e22929, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31350776

RESUMO

BACKGROUND: Autoimmune thyroid disease (AITD) is a common organ-specific autoimmune disorder, and genetic, environmental, and endogenous factors are responsible for initiation of thyroid autoimmunity. Some AITD patients suffer from a certain degree of glucose-lipid metabolism disorder. This study aims to explore the changes in glucose-lipid metabolism, insulin resistance, and inflammatory factors in patients with AITD. METHODS: A total of 91 patients with Hashimoto's thyroiditis were retrospectively analyzed and divided into hypothyroidism group (n = 42) and normal thyroid group (n = 49), while 50 healthy people were selected as control group. The changes in glucose-lipid metabolism, insulin resistance, and inflammatory factors in each group were compared, and their correlations with the thyroid function were analyzed. RESULTS: The levels of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), IL-12, IL-10, (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) were gradually declined in sequence of hypothyroidism group, normal thyroid group, and control group (P < 0.05). In hypothyroidism group, the levels of serum-free triiodothyronine (FT3), free thyroxine (FT4), (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly lower than those in normal thyroid group (P < 0.05), while the level of serum thyroid stimulating hormone (TSH) was significantly higher than that in normal thyroid group (P < 0.05). However, the fasting blood glucose and 2-hour postprandial blood glucose levels had no statistically significant differences among the three groups (P > 0.05). CONCLUSION: Autoimmune thyroid disease patients are prone to fat metabolism disorder, and the serum thyroid hormone level has a close correlation with blood lipid metabolism, insulin metabolism, and inflammatory factors.


Assuntos
Doenças Autoimunes/metabolismo , Glucose/metabolismo , Mediadores da Inflamação/metabolismo , Resistência à Insulina , Metabolismo dos Lipídeos , Doenças da Glândula Tireoide/metabolismo , Adolescente , Adulto , Idoso , Doenças Autoimunes/sangue , Doenças Autoimunes/fisiopatologia , Glicemia/análise , Criança , Citocinas/sangue , Jejum/sangue , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/fisiopatologia , Glândula Tireoide/patologia , Glândula Tireoide/fisiopatologia , Adulto Jovem
12.
Rev Med Chil ; 147(3): 334-341, 2019 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-31344171

RESUMO

Acquired hemophilia A (AHA) is a rare and life-threatening autoimmune hemorrhagic disorder where autoantibodies are developed against factor VIII. An early diagnosis is challenging and mandatory: an immediate hemostatic control is required to reduce morbidity and mortality. Laboratory features of AHA are: presence of autoantibodies against factor VIII, prolonged activated partial thromboplastin time (with normal prothrombin time and thrombin time) and decreased factor VIII levels. In some cases, the results of laboratory tests may be incorrect due to errors in analysis, blood extraction or manipulation of samples; also worth of consideration are limitations in the measurement range and low sensitivity of the tests. This review highlights the importance of adequate screening in patients with suspected AHA to make an adequate diagnosis and reduce overall fatal outcomes.


Assuntos
Hemofilia A/diagnóstico , Autoanticorpos/sangue , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/fisiopatologia , Testes de Coagulação Sanguínea , Diagnóstico Precoce , Fator VIII , Hemofilia A/fisiopatologia , Humanos , Tempo de Tromboplastina Parcial
13.
Medicina (Kaunas) ; 55(7)2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31311172

RESUMO

Background and objectives: Myasthenia gravis (MG) and Guillain-Barré Syndrome (GBS) are autoimmune neuromuscular disorders that may present as neuromuscular emergencies requiring mechanical ventilation and critical care. Comparative outcomes of these disease processes, once severe enough to require mechanical ventilation, are not known. In this study, we compared the patients requiring mechanical ventilation in terms of in-hospital complications, length of stay, disability, and mortality between these two disease entities at a national level. Materials and Methods: Mechanically ventilated patients with primary diagnosis of MG (n = 6684) and GBS (n = 5834) were identified through retrospective analysis of Nationwide Inpatient Sample (NIS) database for the years 2006 to 2014. Results: Even though mechanically ventilated MG patients were older (61.0 ± 19.1 versus 54.9 ± 20.1 years) and presented with more medical comorbidities, they had lower disease severity on admission, as well as lower in-hospital complications sepsis, pneumonia, and urinary tract infections as compared with GBS patients. In the multivariate analysis, after adjusting for confounders including treatment, GBS patients had significantly higher disability (odds ratio (OR) 15.6, 95% confidence interval (CI) 10.9-22.2) and a longer length of stay (OR 3.48, 95% CI 2.22-5.48). There was no significant difference in mortality between the groups (8.45% MG vs. 10.0% GBS, p = 0.16). Conclusion: Mechanically ventilated GBS patients have higher disease severity at admission along with more in-hospital complications, length of stay, and disability compared with MG patients. Potential explanations for these findings include delay in the diagnosis, poor response to immunotherapy particularly in patients with axonal GBS variant, or longer recovery time after nerve damage.


Assuntos
Síndrome de Guillain-Barré/complicações , Miastenia Gravis/complicações , Insuficiência Respiratória/etiologia , Adulto , Idoso , Doenças Autoimunes/complicações , Doenças Autoimunes/fisiopatologia , Feminino , Síndrome de Guillain-Barré/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/fisiopatologia , Doenças Neuromusculares/complicações , Doenças Neuromusculares/fisiopatologia , Razão de Chances , Respiração Artificial/métodos , Respiração Artificial/estatística & dados numéricos , Estudos Retrospectivos
14.
Expert Opin Drug Saf ; 18(9): 841-852, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31238745

RESUMO

Introduction: Systemic Autoimmune Diseases (SADs) include systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, systemic sclerosis, Sjogren's syndrome, mixed connective tissue disease, idiopathic inflammatory myopathies and vasculitis. SADs often occur in women of childbearing age and can affect fertility. Both infertility treatments and fertility preservation techniques are thus often indicated. Areas covered: The literature regarding the safety of fertility-related drugs for both fertility preservation and infertility treatment in patients affected by SADs was reviewed. Based on current knowledge, all the options for fertility preservation should be contemplated in patients with SADs who are at risk for fertility loss, including GnRH analogue administration, oocyte/embryo vitrification and ovarian tissue cryopreservation. Similarly, if pregnancy is not contraindicated in a patient with a SAD, neither should be any fertility treatment. Expert opinion: Women with SADs should postpone conception until a stable disease has been achieved for at least 6 months. When infertility treatments are needed, women with antiphospholipid antibodies should receive concomitant anticoagulation. If in vitro fertilization/intra-cytoplasmic sperm injection and embryo transfer is required, ovarian hyperstimulation and the inherent risk of thrombosis should be eliminated by GnRH-agonist trigger and cycle segmentation. Counselling about adherence to anti-rheumatic therapy to prevent disease exacerbations is also critical.


Assuntos
Doenças Autoimunes/complicações , Preservação da Fertilidade/métodos , Infertilidade Feminina/terapia , Anticorpos Antifosfolipídeos/imunologia , Doenças Autoimunes/fisiopatologia , Criopreservação/métodos , Feminino , Fertilização In Vitro/métodos , Humanos , Infertilidade Feminina/etiologia , Gravidez , Técnicas de Reprodução Assistida
15.
Med Hypotheses ; 128: 69-75, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31203913

RESUMO

Vitiligo (VL) is a chronic autoimmune pigmentation disorder characterized by destruction of melanocytes. The condition is associated with several other autoimmune diseases, but autoimmune thyroid diseases, especially Hashimoto's thyroiditis (HT), is the most prevalent organ-specific autoimmune disease with a co-morbidity up to 34%. Among the many hypotheses that have been proposed for the pathogenesis of both diseases, autoimmunity and oxidative stress-mediated toxicity in melanocytes or thyrocytes, respectively, have been the most widely accepted - with autoimmunity being the presumed consequence of oxidative stress-mediated toxicity. However, the predominant etiologic basis for impairment of redox balance has rarely been studied. The two autoimmune diseases are not only linked by a concordance of clinical presentations and an autoimmune/oxidative stress-mediated toxicity pathogenesis but also by an apparent biochemical commonality. The target molecules produced in the thyroid and skin, i.e., thyroxine and melanin, respectively, are derived from the same primordial parent molecule, tyrosine. On the basis of these similarities between Hashimoto's thyroiditis and vitiligo, specifically with respect to the activation of oxidative stress, we propose a novel hypothesis accounting for the destruction of melanocytes or thyrocytes in VL and AT. We suggest a new therapeutic regimen of quinone derivatives to combat ROS-induced autoimmunity resulting from this common biochemical etiologic error.


Assuntos
Doenças Autoimunes/fisiopatologia , Doença de Hashimoto/fisiopatologia , Estresse Oxidativo , Vitiligo/fisiopatologia , Animais , Doenças Autoimunes/complicações , Autoimunidade , Benzoquinonas/química , Modelos Animais de Doenças , Doença de Hashimoto/complicações , Humanos , Peróxido de Hidrogênio/química , Hidroquinonas/química , Melaninas/química , Melanócitos/citologia , Melanócitos/metabolismo , Modelos Teóricos , Oxidantes/química , Oxirredução , Oxigênio/química , Espécies Reativas de Oxigênio/metabolismo , Superóxidos/química , Células Epiteliais da Tireoide/metabolismo , Glândula Tireoide/metabolismo , Tiroxina , Vitiligo/complicações
17.
Crit Rev Microbiol ; 45(4): 394-412, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31145640

RESUMO

The exact aetiology of most autoimmune diseases remains unknown, nonetheless, several factors contributing to the induction or exacerbation of autoimmune reactions have been suggested. These include the genetic profile and lifestyle of the affected individual in addition to environmental triggers such as bacterial, parasitic, fungal and viral infections. Infections caused by viruses usually trigger a potent immune response that is necessary for the containment of the infection; however, in some cases, a failure in the regulation of this immune response may lead to harmful immune reactions directed against the host's antigens. The autoimmune attack can be carried out by different arms and components of the immune system and through different possible mechanisms including molecular mimicry, bystander activation, and epitope spreading among others. In this review, we examine the data available for the involvement of viral infections in triggering or exacerbating autoimmune diseases in addition to discussing the mechanisms by which these viral infections and the immune pathways they trigger possibly contribute to the development of autoimmunity.


Assuntos
Doenças Autoimunes/etiologia , Doenças Autoimunes/fisiopatologia , Interações Hospedeiro-Patógeno , Viroses/complicações , Viroses/patologia , Animais , Modelos Animais de Doenças , Humanos
18.
Eur J Clin Invest ; 49(8): e13132, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31125424

RESUMO

BACKGROUND: Experimental autoimmune myocarditis (EAM) is a common animal model for the investigation of the pathophysiology of myocarditis. Because of diverging findings from previous studies, we performed serial echocardiographic examinations throughout the course of the disease and investigated the dimensions of the murine heart and left ventricular (LV) systolic function. MATERIALS AND METHODS: Experimental autoimmune myocarditis was induced in male Balb/c mice by subcutaneous injection of a fragment of the α-myosin heavy chain (MyHC-α 614-629: Ac-SLKLMATLFSTYASAD). Transthoracic echocardiography was performed on days 0, 7 and 21 in healthy animals and mice with EAM. RESULTS: Experimental autoimmune myocarditis was associated with a reduction in LV systolic function and an increase in LV internal diameter in diastole (LVIDd) and systole (LVIDs) 7 days postimmunization. After 21 days, EAM led to a significant increase in LV-thickness (1.3-fold increase in LV anterior wall diameter in diastole [LVAWDd]), but there was no difference in LV systolic function between immunized animals and healthy controls. LV-thickness correlated well with the severity of myocarditis in the histopathological examination (LVAWDd: rs = 0.603, P = 0.003, LV anterior wall diameter in systole (LVAWDs): rs = 0.718, P < 0.0001). CONCLUSION: Our results indicate that EAM leads to an initial dilatation of the LV that is followed by ventricular "hypertrophy." On day 21, there was no significant difference in LV systolic function between immunized animals and controls. Furthermore, the ageing of the animals had a major impact on the echocardiographic parameters; therefore, the use of healthy age-matched controls seems warranted when echocardiography is performed in rodents.


Assuntos
Doenças Autoimunes/fisiopatologia , Miocardite/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Animais , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/patologia , Diástole , Modelos Animais de Doenças , Ecocardiografia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Miocardite/diagnóstico por imagem , Miocardite/imunologia , Miocardite/patologia , Miocárdio/patologia , Sístole , Função Ventricular Esquerda
19.
Intern Med ; 58(8): 1167-1172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30982805

RESUMO

Hashimoto's encephalopathy (HE) is a steroid-responsive autoimmune encephalopathy associated with Hashimoto thyroiditis. We herein report a case of HE manifesting "smoldering" limbic encephalitis with persisting symptoms and abnormalities on examinations. Although our patient experienced partial clinical remission after treatment, hippocampal hypermetabolism on [18F] fluorodeoxyglucose positron emission tomography (FDG-PET) and subclinical seizures on video electroencephalography persisted. Hypermetabolism on FDG-PET was improved by additional prednisolone therapy. Thus, as with other autoimmune limbic encephalitis cases, HE can take a course of "smoldering" encephalitis. FDG-PET and electroencephalogram findings can reflect the disease activity degree in such patients, although with certain neurophysiological and biochemical distinctions.


Assuntos
Doenças Autoimunes/fisiopatologia , Encefalite/fisiopatologia , Doença de Hashimoto/fisiopatologia , Encefalite Límbica/fisiopatologia , Idoso , Doenças Autoimunes/diagnóstico , Biomarcadores/análise , Eletroencefalografia/métodos , Encefalite/diagnóstico , Feminino , Doença de Hashimoto/diagnóstico , Humanos , Encefalite Límbica/complicações , Encefalite Límbica/diagnóstico , Tomografia por Emissão de Pósitrons/métodos
20.
Intern Med ; 58(14): 2067-2072, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-30996157

RESUMO

We herein report a case of autoimmune pulmonary alveolar proteinosis (PAP) diagnosed after one-time exposure to silica powder. Owing to the misuse of a silica-containing fire extinguisher and the inhalation of large amounts of its powder, the patient experienced prolonged cough and visited our hospital. The findings of chest computed tomography and surgical lung biopsy specimens led to the diagnosis of PAP. Interestingly, the presence of anti-GM-CSF antibody was detected; therefore, both autoimmune characteristics and exposure to large amounts of silica may have caused the development of PAP in this patient. This case provides important insight into the mechanisms leading to the onset of PAP.


Assuntos
Doenças Autoimunes/fisiopatologia , Exposição Ambiental/efeitos adversos , Material Particulado/efeitos adversos , Proteinose Alveolar Pulmonar/induzido quimicamente , Proteinose Alveolar Pulmonar/diagnóstico , Dióxido de Silício/efeitos adversos , Administração por Inalação , Idoso , Doenças Autoimunes/induzido quimicamente , Doenças Autoimunes/diagnóstico , Feminino , Sistemas de Combate a Incêndio , Humanos , Proteinose Alveolar Pulmonar/fisiopatologia
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