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1.
J Med Vasc ; 46(1): 9-12, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33546823

RESUMO

Superior vena cava syndrome is the clinical expression of the obstruction of the superior vena cava reducing the blood flow. Malignant etiologies are the most common. Its management is multidisciplinary and despite the progress of endovascular procedures, conventional surgery retains its place in certain indications. Mediastinal fibrosis secondary to tuberculosis lymphadenopathy may be associated with superior vena cava syndrome. In the presence of symptomatic SVCS associated with extensive mediastinal fibrosis compressing the superior vena cava with sub occlusive thrombosis, conventional surgery remains a treatment option, with cavo-venous derivation by prosthetic bypass.


Assuntos
Mediastinite/etiologia , Esclerose/etiologia , Síndrome da Veia Cava Superior/etiologia , Tuberculose dos Linfonodos/complicações , Corticosteroides/uso terapêutico , Adulto , Antituberculosos/uso terapêutico , Implante de Prótese Vascular , Feminino , Humanos , Mediastinite/diagnóstico por imagem , Mediastinite/tratamento farmacológico , Esclerose/diagnóstico por imagem , Esclerose/tratamento farmacológico , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/cirurgia , Resultado do Tratamento , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/tratamento farmacológico
2.
J Comput Assist Tomogr ; 45(1): 157-165, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33475319

RESUMO

ABSTRACT: Mycobacterium infection remains a leading cause of morbidity and mortality worldwide. Although rare, thoracic cardiovascular complications are associated with devastating consequences if not promptly diagnosed using computed tomography. Intrapulmonary complications include tuberculous aortitis, Rasmussen aneurysms, involvement of bronchial and nonbronchial systemic arteries, and thromboembolic events. Extrapulmonary complications include pericarditis, myocarditis, endocarditis, involvement of coronary arteries, annular-subvalvular left ventricle aneurysms and mediastinal fibrosis. This article will review these complications and their computed tomography features.


Assuntos
Doenças Cardiovasculares/diagnóstico por imagem , Tuberculose Pulmonar/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Endocardite/diagnóstico por imagem , Aneurisma Cardíaco/diagnóstico por imagem , Humanos , Mediastinite/diagnóstico por imagem , Pericardite/diagnóstico por imagem , Esclerose/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Tuberculose Pulmonar/diagnóstico por imagem
3.
Am J Case Rep ; 22: e927556, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33431787

RESUMO

BACKGROUND Fibrosing mediastinitis is a rarely seen, progressive disease. It results from an excessive fibrotic reaction in the mediastinum. We describe a presentation of fibrosing mediastinitis that, to our knowledge, has never been seen before. CASE REPORT A 30-year-old female Colombian flight attendant presented with a right eyelid droop. Examination revealed partial right-sided ptosis and miosis but no anhidrosis. An ill-defined firm swelling was palpable at the root of the neck. Chest radiography revealed a widened mediastinum, and computerized tomography (CT) showed a right paratracheal mass without calcification extending to the thoracic inlet, encasing multiple blood vessels. All basic blood tests, magnetic resonance imaging of the head, and ultrasound Doppler of the neck vessels were normal. History and work up for infections including fungal diseases, granulomatous diseases, vasculitis, and autoimmune diseases were negative. Positron emission tomography (PET) showed significant FDG uptake in the mediastinum. Mediastinal biopsy was histologically consistent with fibrosing mediastinitis. All relevant immunohistochemistry and microbiological studies were negative. Subsequently, the patient developed signs of superior vena cava compression; this was managed by balloon angioplasty, which resulted in improvement of symptoms. However, over time, her symptoms worsened progressively, resulting in a left-sided ptosis and radiological progression of the mass on CT. She received treatment with rituximab and concomitant steroids, which yielded excellent results: the treatment led to both resolution of her symptoms and regression of the mass and its metabolic activity on PET scan. CONCLUSIONS Fibrosing mediastinitis can present with an incomplete Horner's syndrome. Treatment with rituximab and steroids shows promising results in select cases of metabolically active idiopathic fibrosing mediastinitis.


Assuntos
Blefaroptose/etiologia , Mediastinite/complicações , Mediastinite/diagnóstico , Miose/etiologia , Esclerose/complicações , Esclerose/diagnóstico , Adulto , Feminino , Humanos , Mediastinite/terapia , Esclerose/terapia
4.
Angiol Sosud Khir ; 26(4): 17-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332302

RESUMO

The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.


Assuntos
Arteriosclerose , Calcinose , Diabetes Mellitus , Calcificação Vascular , Artérias/patologia , Calcinose/diagnóstico , Calcinose/etiologia , Humanos , Fatores de Risco , Esclerose/patologia , Calcificação Vascular/diagnóstico , Calcificação Vascular/etiologia , Calcificação Vascular/patologia
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47982

RESUMO

Os pacientes que sofrem de esclerose múltipla ganham mais um aliado no combate à doença. O Ministério da Saúde ampliou o uso do natalizumabe no tratamento da esclerose múltipla remitente-recorrente que representa 85% dos casos da doença.


Assuntos
Esclerose/prevenção & controle , Esclerose/tratamento farmacológico , Natalizumab/imunologia
6.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10): 108-117, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33244966

RESUMO

Amyotrophic lateral sclerosis (ALS) is an incurable neurodegenerative disease characterized by selective degeneration of motor neurons of the motor cortex, brain stem and brain stem. Mutations in genes coding for SOD1, C9ORF72, TDP-43, FUS and others are associated with ALS and result in abnormal processing and transport of RNA as well as changes in the dynamics of cytoskeleton. In addition, a sharp change in the metabolism of various lipid classes, including phospholipids, fatty acids, sphingolipids, etc., was detected. This review describes changes in lipid content and activity of enzymes involved in their metabolism in ALS animal models as well as in patients. Changes in the metabolism of fatty acids, phospholipids, cholesterol and its derivatives are reviewed in detail. The prospects of searching for new drugs among modulators of lipid metabolism enzymes are discussed.


Assuntos
Esclerose Amiotrófica Lateral , Doença dos Neurônios Motores , Doenças Neurodegenerativas , Esclerose Amiotrófica Lateral/genética , Animais , Proteína C9orf72 , Humanos , Lipídeos , Mutação , Proteína FUS de Ligação a RNA/genética , Esclerose
8.
Medicine (Baltimore) ; 99(42): e22783, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080749

RESUMO

RATIONALE: Anaplastic thyroid carcinoma (ATC) is a rare highly aggressive thyroid malignancy. Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia is also a rare low grade malignant thyroid neoplasm. To date, comorbidity of these 2 tumors in the thyroid gland has not been reported in the English literature. PATIENT CONCERNS: Here, we present a case of a 67-year-old women with a 6-month history of mass of left neck. She complained of a painless mass in the right neck. DIAGNOSES: Based on histopathological examination of H&E stained sections, immunohistochemical staining assay and molecular tests, the patient was diagnosed with ATC combined with sclerosing mucoepidermoid carcinoma with eosinophilia. INTERVENTIONS: The patient underwent radical surgery for thyroid cancer. OUTCOMES: No complications, local recurrence or metastases were observed during a 1 year and 3 months follow-up after surgery. LESSONS: To the best of our knowledge, this is the first case report on ATC combined with sclerosing mucoepidermoid carcinoma with eosinophilia in the English literature. This condition can be easily misdiagnosed during thyroid fine needle cytology. Clinicians should perform morphological examination, immunohistochemistry and molecular tests on resected specimen to make a definitive diagnosis.


Assuntos
Carcinoma Mucoepidermoide/patologia , Eosinofilia/diagnóstico , Neoplasias Primárias Múltiplas/patologia , Carcinoma Anaplásico da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Idoso , Carcinoma Mucoepidermoide/cirurgia , Feminino , Humanos , Neoplasias Primárias Múltiplas/cirurgia , Esclerose , Carcinoma Anaplásico da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
9.
Medicine (Baltimore) ; 99(42): e22813, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080758

RESUMO

RATIONALE: Idiopathic mesenteric phlebosclerosis (IMP) is a rare form of ischemic colitis. It is more common in the Asian population people with Asian ancestry. Disease pathogenesis and etiology are not fully elucidated but may be associated with the long-term intake of toxins and other substances, including Chinese herbs. The disease has typical radiological and endoscopic features. Radiologic examination combined with endoscopy can lead to a conclusive diagnosis. PATIENT CONCERNS: We present 2 cases of IMP: in male patients aged 66 and 79 years. The first patient presented with diarrhea and abdominal pain, and the second patient presented with numbness of limbs and abdominal discomfort. These patients had a history of long-term use of Chinese herbal medicine (CHM). DIAGNOSIS: Both patients were diagnosed with IMP by endoscopy and radiology, and the diagnosis confirmed by biopsy in the first patient. INTERVENTIONS: The first patient was advised to stop using CHM. Both patients were given conservative treatment and were followed up regularly. OUTCOMES: Symptoms improved after conservative treatment. The patients had no obvious discomfort during the follow-up period. CONCLUSION: We suspect that the disease is induced by the long-term use of CHM, and dosage and duration of use may determine disease severity.


Assuntos
Colite Isquêmica/induzido quimicamente , Medicamentos de Ervas Chinesas/efeitos adversos , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/patologia , Calcificação Vascular/induzido quimicamente , Idoso , Colite Isquêmica/diagnóstico por imagem , Colite Isquêmica/patologia , Humanos , Mucosa Intestinal/patologia , Masculino , Esclerose , Tomografia Computadorizada por Raios X , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/patologia
10.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 5781-5784, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019288

RESUMO

Chronic Kidney Disease has become a worldwide public health problem which demands careful assessments by pathologists. In this paper, we propose a novel architecture for fine-grained classification of glomerular lesions in renal pathology images sampling from patients with IgA nephropathy. The adversarial correlation loss is innovatively presented to guide a parallel convolutional neural network. In this well- designed loss function, bias between the prediction and the label was take into account while the relationship among different categories is well-aligned. Glomerular lesions in this study are divided into five subcategories, Neg (Negative samples such as tubule and artery), SS (sclerosis involving a portion of the glomerular tuft), GS (sclerosis involving 100% of the tuft), C (build-up of more than two layers of cells within Bowman's space, often with fibrin and collagen deposition) and NOA (none of above). Our model with 93.0% accuracy and 92.9% Fl-score for these five categories has proved superior to other models through experimental results.


Assuntos
Glomerulonefrite por IGA , Insuficiência Renal Crônica , Glomerulonefrite por IGA/patologia , Humanos , Rim/patologia , Glomérulos Renais/patologia , Insuficiência Renal Crônica/patologia , Esclerose/patologia
11.
Arch. argent. pediatr ; 118(5): e463-e467, oct 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1122520

RESUMO

El síndrome de la piel indurada es un trastorno esclerosante crónico, infrecuente, que se presenta en la infancia, caracterizado por la induración progresiva de la piel. Esta afección puede provocar restricciones torácicas y dificultad respiratoria, limitaciones en la movilidad articular y trastornos en la marcha, con importante deterioro de la calidad de vida. Debido a que sus opciones terapéuticas son escasas y poco eficaces, es fundamental que el paciente inicie precozmente una terapia física para prevenir estas complicaciones y que se continúe estudiando esta enfermedad a fin de poder ofrecer a los pacientes más y mejores tratamientos. Se presenta el caso de una paciente de 9 años con síndrome de la piel indurada y su desafío terapéutico.


Stiff skin syndrome is a chronic, rare sclerosing disorder that occurs in childhood, characterized by progressive induration of the skin that can cause thoracic restrictions and respiratory distress, limitations in joint mobility and gait difficulties, with significant deterioration of the quality of life. Because their therapeutic options are scarce and ineffective it is essential to start an early physical therapy to prevent these complications and to continue studying this condition to be able to offer patients more and better treatments. We present the case of a 9-year-old patient with indurated skin syndrome and its therapeutic challenge.


Assuntos
Humanos , Feminino , Criança , Dermatopatias Genéticas , Esclerose , Amplitude de Movimento Articular , Losartan/uso terapêutico , Diagnóstico Diferencial
12.
J Vis Exp ; (162)2020 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-32894262

RESUMO

Parietal epithelial cell (PEC) activation is one of the key factors involved in the development and progression of glomerulosclerosis. Inhibition of pathways involved in parietal epithelial cell activation could therefore be a tool to attenuate the progression of glomerular diseases. This article describes a method to culture and analyze parietal epithelial cell outgrowth of encapsulated glomeruli isolated from mouse kidney. After dissecting isolated mouse kidneys, the tissue is minced, and glomeruli are isolated by sieving. Encapsulated glomeruli are collected, and single glomeruli are cultured for 6 days to obtain glomerular outgrowth of parietal epithelial cells. During this period, parietal epithelial cell proliferation and migration can be analyzed by determining the cell number or the surface area of outgrowing cells. This assay can therefore be used as a tool to study the effects of an altered gene expression in transgenic- or knockout-mice or the effects of culture conditions on parietal epithelial cell growth characteristics and signaling. Using this method, important pathways involved in the process of parietal epithelial cell activation and consequently in glomerulosclerosis can be studied.


Assuntos
Células Epiteliais/citologia , Células Epiteliais/metabolismo , Glomérulos Renais/citologia , Animais , Movimento Celular , Proliferação de Células , Separação Celular , Células Cultivadas , Glomerulonefrite/patologia , Camundongos , Esclerose
14.
Braz J Med Biol Res ; 53(9): e9000, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32696820

RESUMO

This study aimed to investigate the effect of a caregiver intensive education program (CIEP) on anxiety, depression, and quality of life (QOL) in patients with drug-resistant temporal lobe epilepsy and mesial temporal sclerosis (TLE-MTS) who underwent cortico-amygdalohippocampectomy (CAH). Ninety patients with drug-resistant TLE-MTS who underwent CAH and their caregivers were recruited and randomly allocated to the CIEP group or control group as 1:1 ratio. Caregivers received the CIEP program or routine guidance/education (control group). Anxiety/depression and QOL in patients at month (M)0, M1, M3, and M6 were assessed by the Hospital Anxiety and Depression Scale (HADS) scale and the QOL in Epilepsy Inventory-31 (QOLIE-31), respectively. Treatment efficacy at M6 was assessed by Engel classification. The HADS-anxiety score at M3 (P=0.049) and M6 (P=0.028), HADS-anxiety score change (M6-M0) (P=0.001), percentage of anxiety patients at M6 (P=0.025), and anxiety severity at M6 (P=0.011) were all decreased in the CIEP group compared with the control group. The HADS-depression score at M6 (P=0.033) and HADS-depression score change (M6-M0) (P=0.022) were reduced, while percentage of depression patients at M6 (P=0.099) and depression severity at M6 (P=0.553) showed no difference in the CIEP group compared with the control group. The QOLIE-31 score at M6 (P=0.043) and QOLIE-31 score change (M6-M0) (P=0.010) were both elevated in the CIEP group compared with the control group. In conclusion, CIEP for caregivers contributed to the recovery of anxiety and depression as well as the improvement of QOL in patients with drug-resistant TLE-MTS who underwent CAH.


Assuntos
Cuidadores/educação , Epilepsia do Lobo Temporal , Qualidade de Vida , Ansiedade , Depressão , Humanos , Esclerose
15.
Am J Pathol ; 190(10): 2136-2145, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32650001

RESUMO

Secondary mitochondrial damage in skeletal muscles is a common feature of different neuromuscular disorders, which fall outside the mitochondrial cytopathies. The common cause of mitochondrial dysfunction and structural changes in skeletal muscle tissue remains to be discovered. Although they are associated with different clinical, genetic, and pathologic backgrounds, the pathomechanisms underlying neuromuscular disorders might be attributed to the complex interaction and cross talk between mitochondria and the associated miRNAs. This study aimed to identify the common miRNA signatures that are associated with mitochondrial damage in different muscular dystrophies (MDs; Duchenne muscular dystrophy, megaconial congenital muscular dystrophy, Ullrich congenital muscular dystrophy, and α-dystroglycanopathy). The miRNome profiles of skeletal muscle biopsies acquired from four different MD groups and control individuals were analyzed by miRNA microarray. We identified 17 common up-regulated miRNAs in all of the tested MD groups. A specific bioinformatics approach identified 10 of these miRNAs to be specifically related to the mitochondrial pathways. Six miRNAs, miR-134-5p, miR-199a-5p, miR-382-5p, miR-409-3p, miR-497-5p, and miR-708-5p, were associated with the top four mitochondrial pathways and were thus selected as priority candidates for further validation by quantitative real-time PCR analysis. We demonstrate, for the first time, common up-regulated miRNAs that are associated with mitochondrial damage in different MD groups, therefore contributing to the pathophysiology. Our findings may open a new gate toward therapeutics.


Assuntos
Mitocôndrias/metabolismo , Músculo Esquelético/patologia , Distrofias Musculares/genética , Distrofia Muscular de Duchenne/genética , Esclerose/genética , Adolescente , Criança , Pré-Escolar , Biologia Computacional/métodos , Feminino , Perfilação da Expressão Gênica/métodos , Humanos , Lactente , Masculino , MicroRNAs/genética
17.
Neurology ; 95(9): e1236-e1243, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32611640

RESUMO

OBJECTIVE: To assess the prevalence of brain MRI abnormalities in people with epilepsy in rural China and to compare it with that of individuals in the United Kingdom. METHODS: Brain MRI scans were obtained in people with epilepsy who participated in a rural community-based program in China between July 2010 and December 2012. Individual epileptogenic lesion types were reviewed and their associations with seizure control examined. The MRI findings were compared with 2 previous similar studies in the United Kingdom. RESULTS: Among the 597 individuals (58% male, median age 38 years) with MRI scans analyzed, 488 (82%) had active epilepsy. The MRI was abnormal in 389 individuals (65%), with potentially epileptogenic lesion in 224 (38%) and nonspecific abnormalities in 165 (28%), and 108 (18%) were potentially resectable. The potentially epileptogenic lesions were less frequently detected in children (<18 years old, 12 of 68, 18%) than in adults (212 of 529, 40%; p < 0.001). In people with potentially epileptogenic lesions, 67% (150 of 224) had failed ≥2 antiseizure medications. They had higher risk of uncontrolled epilepsy than those with normal MRI (risk ratio [RR] 1.25; p < 0.001) and those with nonspecific abnormality (RR 1.15; p = 0.002) after adjustment for age and sex. The diagnostic yield of MRI was similar to that reported in community- and hospital-based studies in the United Kingdom. CONCLUSIONS: More than one-third of people with chronic epilepsy in rural China have potentially epileptogenic lesions identifiable on brain MRI, with two-thirds fulfilling the definition of pharmacoresistance. These findings highlight the magnitude of the unmet needs for epilepsy surgery in China.


Assuntos
Encefalomalacia/epidemiologia , Epilepsia/epidemiologia , Gliose/epidemiologia , Malformações do Sistema Nervoso/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/epidemiologia , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/epidemiologia , Criança , Pré-Escolar , China/epidemiologia , Epilepsia Resistente a Medicamentos , Encefalomalacia/diagnóstico por imagem , Epilepsia/diagnóstico por imagem , Feminino , Gliose/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Malformações do Sistema Nervoso/diagnóstico por imagem , Prevalência , População Rural , Esclerose , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia , Reino Unido/epidemiologia , Adulto Jovem
18.
BMC Neurol ; 20(1): 235, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32513122

RESUMO

BACKGROUND: Mesial temporal lobe epilepsy (MTLE) is the most common form of focal epilepsy, which is frequently characterized by hippocampal sclerosis (HS). Accumulating studies have suggested widespread cortico-cortical connections related to MTLE. The role of subcortical structures involved in general epilepsy has been extensively investigated, but it is still limited in MTLE. Our purpose was to determine the specific morphological correlation between sclerotic hippocampal and thalamic sub-regions, using quantitative analysis, in MTLE. METHODS: In this study, 23 MTLE patients with unilateral hippocampal sclerosis and 24 healthy controls were examined with three-dimensional T1 MRI. Volume quantitative analysis in the hippocampus and thalamus was conducted and group-related volumetric difference was assessed. Moreover, vertex analysis was further performed using automated software to delineate detailed morphological patterns of the hippocampus and thalamus. The correlation was used to examine whether there is a relationship between volume changes of two subcortical structures and clinical characteristics. RESULTS: The patients had a significant volume decrease in the sclerotic hippocampus (p < 0.001). Compared to controls, obvious atrophic patterns were observed in the bilateral hippocampus in MTLE (p < 0.05). Only small patches of shrinkage were noted in the bilateral thalamus (p < 0.05). Moreover, the volume change of the hippocampus had a significant positive correlation with that of the thalamus (P < 0.001). Intriguingly, volume changes of the hippocampus and thalamus were correlated with the duration of epilepsy (hippocampus: P = 0.024; thalamus: P = 0.022). However, only volume changes of thalamus possibly differentiated between two prognostic groups in patients (P = 0.026). CONCLUSIONS: We demonstrated the morphological characteristics of the hippocampus and thalamus in MTLE, providing new insights into the interrelated mechanisms between the hippocampus and thalamus, which have potential clinical significance for refining neuromodulated targets.


Assuntos
Epilepsia do Lobo Temporal , Hipocampo , Tálamo , Adolescente , Adulto , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/patologia , Feminino , Hipocampo/diagnóstico por imagem , Hipocampo/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Esclerose , Tálamo/diagnóstico por imagem , Tálamo/patologia , Adulto Jovem
20.
BMC Neurol ; 20(1): 241, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32532251

RESUMO

BACKGROUND: Increasing evidence supports the role of soluble inflammatory mediators in the pathogenesis of refractory temporal lobe epilepsy (TLE). Hippocampal sclerosis (HS) is a well-described pathohistological abnormality in TLE. The association of proinflammatory cytokines with epileptic disease profiles is well established; however, the potential significance of circulating interleukin 10 (IL-10), particularly in TLE-associated HS, is still poorly understood. Therefore, taking into consideration the neuroprotective and anticonvulsive effects of IL-10, we performed this study to examine the role of the plasma levels of IL-10 in patients with TLE with HS (TLE + HS), TLE without HS (TLE-HS) and with other types of epilepsy. METHODS: This study included 270 patients with refractory epilepsy who were classified into four groups: i) 34 patients with TLE + HS, ii) 105 patients with TLE-HS, iii) 95 patients with extra-TLE (XLE) and iv) 36 patients with idiopathic generalized epilepsy (IGE). The plasma IL-10 levels were quantified using a commercially available enzyme-linked immunosorbent assay (ELISA). RESULTS: IL-10 levels were significantly lower in TLE + HS than in TLE-HS (p = 0.013). In a subgroup of TLE-HS patients who had seizures 1 month before sampling, patients with seizures had significantly higher IL-10 levels than patients who were seizure-free (p = 0.039). Among a small group (n = 15) of non-refractory TLE-HS patients, IL-10 levels showed a moderate negative correlation with the duration of epilepsy (r = - 0.585, p = 0.023). CONCLUSIONS: This study demonstrated that chronically reduced levels of plasma IL-10 were associated with HS in TLE patients, suggesting that there was an inadequate systemic anti-inflammatory immune response. These results could provide new biological insights into the pathophysiology of HS in TLE. We also found that the production of IL-10 could be affected by the seizure frequency and declined concomitantly with increased disease durations. Therefore, the measurement of plasma IL-10 may have diagnostic value as a biomarker for stratifying TLE + HS from other epilepsy types or as a marker of disease progression towards a progressive form of epilepsy.


Assuntos
Epilepsia do Lobo Temporal/sangue , Epilepsia do Lobo Temporal/patologia , Hipocampo/patologia , Interleucina-10/sangue , Adulto , Epilepsia Resistente a Medicamentos/sangue , Epilepsia Resistente a Medicamentos/imunologia , Epilepsia Resistente a Medicamentos/patologia , Epilepsia do Lobo Temporal/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose/sangue , Esclerose/complicações , Esclerose/patologia
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