RESUMO
A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.
Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Hanseníase , Neurite (Inflamação) , Adulto , Citocinas , Feminino , Humanos , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Neurite (Inflamação)/tratamento farmacológico , Neurite (Inflamação)/etiologia , Células Th1 , Células Th17RESUMO
OBJECTIVES: For the first time in the history of periodontics, the production of lipid bodies by monocytes was assessed from blood of patients with periodontitis in comparison to systemically healthy individuals. The purpose of this study was to compare the lipid body frequency within monocytes between healthy patients and those with periodontal disease. MATERIALS AND METHODS: A total of 30 participants (11 males and 19 females), were divided between orally healthy control subjects (C, n = 16) and periodontitis subjects (P, n = 14), in a cross-sectional study. Both groups were systemically healthy. The following clinical periodontal parameters were assessed: probing depth, clinical attachment level, visible plaque index and gingival bleeding on probing index. Blood samples were collected to obtain monocytes containing lipid bodies, which were analyzed by light microscopy. RESULTS: The periodontitis group demonstrated a higher corpuscular index than the control group (nonopsonized p = .0296 or opsonized p = .0459; Mann-Whitney). The frequency of monocyte cells containing lipid bodies (basal p = .0147, opsonized p = .0084 or nonopsonized, p = .026; Mann-Whitney) was also higher compared to those observed in healthy individuals. CONCLUSIONS: The data suggest that periodontitis may contribute to a higher production of lipid bodies. It was also hypothesized that a major production of lipid bodies by monocytes in severe periodontitis, compared to orally healthy subjects, could interfere with the innate immune response or represents a higher reservoir of cholesterol esters within macrophages and a major risk to systemic implications, such as atherosclerosis.
Assuntos
Monócitos , Periodontite , Estudos Transversais , Feminino , Humanos , Gotículas Lipídicas , Masculino , Índice PeriodontalRESUMO
Abstract A 39-year-old woman was diagnosed with relapsed multibacillary leprosy and refractory neuritis. Here, we describe an evident loss of therapeutic effectiveness after the third pulse of corticosteroids, which may be attributed to tachyphylaxis and the posterior modulation of interferon- γ (IFN-γ), tumor necrosis factor- α (TNF-α,) interleukin-17A (IL-17A), and IL-12/23p40 after the induction phase of secukinumab. In this case, plasma cytokine analysis showed that secukinumab induced a reduction in IL-17 concomitant with impressive clinical improvements in the patient's neural function. Interestingly, secukinumab induced reductions in cytokines related to Th1 responses and earlier stages of the Th17 response, including IL-23/12.