RESUMO
OBJECTIVE: To define the role of those drugs available for hepatitis B treatment and analyse current treatment guides prepared by the leading scientific societies in the field. METHODS: Bibliographic searches were carried out in the databases PubMed and EMBASE, using the search word <
Assuntos
Antivirais/uso terapêutico , Hepatite B/tratamento farmacológico , Adenina/análogos & derivados , Adenina/uso terapêutico , Guanina/análogos & derivados , Guanina/uso terapêutico , Humanos , Lamivudina/uso terapêutico , Organofosfonatos/uso terapêutico , Guias de Prática Clínica como Assunto , TenofovirRESUMO
The use of a single controlled bead milling step of the microalga Tetraselmis suecica resulted in a soluble fraction, rich in functional proteins. This was achieved by fine-tuning the processing time, thereby exploiting the difference in rates of protein and carbohydrate release during milling. Soluble proteins were extracted under mild conditions -room temperature, no addition of chemicals, pH 6.5-, with a yield of 22.5% and a specific energy consumption of 0.6â¯kWhâ¯kgDW-1, which is within the recommended minimum energy for an extraction step in a biorefinery process. The resulting protein extract contained 50.4% (DW) of proteins and 26.4% carbohydrates, showed light green color and displayed superior surface activity and gelation behavior compared to whey protein isolate. The proposed process is simple (only one bead milling step), scalable, and allows the mild extraction of functional proteins, making it interesting for industrial applications in the food industry.
Assuntos
Microalgas , Proteínas/isolamento & purificação , Metabolismo dos Carboidratos , Carboidratos , Clorófitas , Alimentos , Hexoses , Fenômenos FísicosRESUMO
The disintegration of three industry relevant algae (Chlorella vulgaris, Neochloris oleoabundans and Tetraselmis suecica) was studied in a lab scale bead mill at different bead sizes (0.3-1mm). Cell disintegration, proteins and carbohydrates released into the water phase followed a first order kinetics. The process is selective towards proteins over carbohydrates during early stages of milling. In general, smaller beads led to higher kinetic rates, with a minimum specific energy consumption of ⩽0.47kWhkgDW-1 for 0.3mm beads. After analysis of the stress parameters (stress number and stress intensity), it appears that optimal disintegration and energy usage for all strains occurs in the 0.3-0.4mm range. During the course of bead milling, the native structure of the marker protein Rubisco was retained, confirming the mildness of the disruption process.
Assuntos
Clorófitas/química , Microalgas/química , Proteínas de Algas/química , Clorófitas/crescimento & desenvolvimento , Clorófitas/ultraestrutura , Hexoses/metabolismo , Cinética , Microalgas/crescimento & desenvolvimento , Microalgas/ultraestrutura , Microscopia Eletroquímica de Varredura , Eletroforese em Gel de Poliacrilamida Nativa , Água/químicaRESUMO
Treatment of active chronic viral hepatitis type C with interferon alpha has proved effective and therefore its use is being extended to a large number of patients. Common side effects include respiratory manifestations. One side effect attributable to the immunomodulatory effect of interferon is the possible triggering or exacerbation of systemic or cutaneous sarcoidosis. We report a new case and offer an exhaustive review of the literature. A 49-year-old man with type C chronic, active hepatitis developed new respiratory symptoms and pulmonary infiltrates with hilar and mediastinal adenopathy after 4 months of treatment with pegylated interferon and ribavirin. The transbronchial biopsy showed multiple sarcoid granulomas. When the patient was diagnosed, he had already taken the total dose of interferon and no specific treatment was started. His hepatitis did not respond to therapy and his viral load and transaminase levels remained high.
Assuntos
Antivirais/efeitos adversos , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/efeitos adversos , Ribavirina/efeitos adversos , Sarcoidose Pulmonar/induzido quimicamente , Biópsia por Agulha , Hepatite C Crônica/diagnóstico , Humanos , Interferon alfa-2 , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/patologia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: There is scarce information about the influence of pregnancy in patients with chronic hepatitis C virus infection is little know. PATIENTS AND METHODS: 6,556 pregnant women were screened for anti-HCV (ELISA II). We determine ALT, HCV-RNA by PCR (Amplicor Roche) and HCV viraemia (Amplicor-HCV-Monitor Roche) in the third trimester of pregnancy and after 6 months of delivery. HBsAg, anti-HIV and HCV serotype (Murex 1-3) were also determined. STATISTICAL ANALYSIS: Fisher test, paired-t and U Mann Whitney. RESULTS: Anti-HCV was positive in 59 out of 6,556 (0.9%). Mean (SD) age: 27 (9) years (range, 18-40). Drug users: 34 (57%), post-transfusion: 10 (18%) and unknown: 15 (25%). HIV positive 11 (19%). Serotype 1, 30 (51%), setotype 3, 7 (20%), and nontypeable, 22 (37%). We studied HCV-RNA before and after delivery in 35 women, 8 out of 35 (23%) had HCV-RNA negative in both analysis. ALT was normal in 88% of women during pregnancy and in 42% after delivery. ALT levels in pregnancy were 32.6 (39.5) and in postpartum 64.5 (53.4) U/l (p < 0.005). 6 women were RNA-VHC negative during pregnancy and positive in postpartum. HCV viraemia during pregnancy and postpartum was 503 (1,203) and 1,014 (1,907) thousand copies/ml (p < 0.05). No relation was found among ALT or HCV viraemia with risk factors, serotype or coinfection with HIV. CONCLUSIONS: The prevalence of anti-HCV in pregnant women is 0.9%. ALT is usually normal in pregnancy. A quarter of women were HCV-RNA negative in pregnancy and positive after delivery. The viraemia was lower in pregnancy than after delivery, which is consistent with the fact of the low mother-to-infant HCV transmission rate.
Assuntos
Hepatite C Crônica/sangue , Complicações Infecciosas na Gravidez/sangue , Adolescente , Adulto , Alanina Transaminase/sangue , Feminino , Anticorpos Anti-Hepatite C/sangue , Humanos , GravidezRESUMO
BACKGROUND: To know the prevalence of antiphospholipid antibodies in chronic hepatitis C and their relationship with disease progression. METHODS: One hundred and twenty-eight patients with chronic hepatitis C and 93 healthy controls were enrolled up. We determined platelets, ALT, gamma GT, RNAHCV in serum and liver and non-organ specific antibodies, grade and stage in liver biopsy, risk factors, duration of disease and alcohol intake were also included. Portal hypertension and liver function parameters were studied. Antiphospholipid antibodies (APA): lupus anticoagulant (LA) and anticardiolipin antibodies (ACA) (IgG and IgM) were measured by EIA. Anti-beta 2 glycoprotein I antibodies were also detected by EIA in ACA positive patients. RESULTS: Thirty one out of 128 (25%; 95% CI: 17.8%-33.4%) showed positive antiphospholipid antibodies. Positive ACA-IgG was higher in patients than controls (22% vs 3.2%; p < 0.05), whereas, ACA-IgM was similar (5% vs 3.2%; p = NS), and LA was absent in both groups. ALT levels, viraemia, viral load in liver, platelets, or ANA titre were similar in patients with and without positive ACA-IgG. Risk factors, duration of disease or alcohol intake were not related yet. Patients with staging F1 showed positive ACA-IgG 4 of 44 (9%; 95% CI: 2.5%-21.7%), in staging F2 7 of 39 (18%; 95% CI: 7.5%-33.5%) and in staging F4 17 of 45 (38%; 95% CI: 23.8%-53.5%; p < 0.005). ACA-IgG was significantly related to portal hypertension, Child-Pugh stage and presence of cirrhosis complications. Anti-beta 2 glycoprotein I antibodies were detected in ten (43.5%; CI 95%: 23.2%-65.5%) out of 23 ACA positive patients. CONCLUSIONS: ACA-IgG seems to be associated with chronic hepatitis C, and could play a potential role in fibrosis progression and liver disease in these patients.
Assuntos
Anticorpos Antifosfolipídeos/sangue , Hepatite C Crônica/sangue , Progressão da Doença , Feminino , Humanos , Masculino , Prevalência , Prognóstico , Estudos SoroepidemiológicosRESUMO
We describe 2 women with features of autoimmune cholangitis. Serum biochemical studies showed cholestasis and increased immunoglobulin M with negative antimitochondrial antibodies. Markers of hepatitis B and C viruses were absent. Both had positive antinuclear antibodies. One had a speckled pattern (multiple nuclear dots) and the other a perinuclear pattern (pore nuclear). In the first case anti-Sp100 was positive by EIA and in the second anti-Gp210 was detected by immunoblot. Diagnosis of primary biliary cirrhosis was made and the patients were treated with UDCA. Current knowledge indicates that determination of anti-Sp100 and anti-Gp210 substantially improves diagnosis of primary biliary cirrhosis as these ANA are highly specific for this disease. These autoantibodies may lead to the classification of different groups of patient included in autoimmune cholangitis. All patients with autoimmune cholangitis should be tested for anti-Sp100 and anti-Gp210.
Assuntos
Anticorpos Antinucleares/sangue , Antígenos Nucleares , Autoantígenos/imunologia , Doenças Autoimunes/diagnóstico , Colangite/diagnóstico , Cirrose Hepática Biliar/diagnóstico , Glicoproteínas de Membrana/imunologia , Proteínas Nucleares/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Immunoblotting , Pessoa de Meia-Idade , Mitocôndrias/imunologia , Peso Molecular , Complexo de Proteínas Formadoras de Poros NuclearesRESUMO
Two cases of peritoneal mesothelioma (PM), with ultrastructural study, of females who lived in a rural area without asbestos exposition history are described and the Spanish literature reviewed. We highlight the association with severe autoimmune hemolytic anemia, due to the presence of cold agglutinins, in one patient without relationship to drugs or concomitant diseases. We focus on the need for thorough and multiple biopsies through laparoscopy to avoid false negative. We believe that there are no totally specific morphological data on mesothelioma, which means that the initial study is based on optical microscopy performed with hematoxylin-eosin and PAS-diastase stain using the electronic microscopy to confirm the diagnosis.
Assuntos
Mesotelioma/ultraestrutura , Neoplasias Peritoneais/ultraestrutura , Idoso , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/etiologia , Anemia Hemolítica Autoimune/patologia , Biópsia , Feminino , Humanos , Mesotelioma/complicações , Mesotelioma/diagnóstico , Pessoa de Meia-Idade , Neoplasias Peritoneais/complicações , Neoplasias Peritoneais/diagnóstico , Peritônio/patologiaAssuntos
2-Aminopurina/análogos & derivados , Adenina/análogos & derivados , Antivirais/uso terapêutico , Hepatite B/tratamento farmacológico , Interferon-alfa/uso terapêutico , Lamivudina/uso terapêutico , Organofosfonatos , Inibidores da Transcriptase Reversa/uso terapêutico , 2-Aminopurina/uso terapêutico , Adenina/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Replicação do DNA/fisiologia , Famciclovir , Previsões , Hepatite B/imunologia , Hepatite B/patologia , Antígenos E da Hepatite B/imunologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/imunologia , Hepatite B Crônica/patologia , Humanos , Prednisona/uso terapêutico , Prognóstico , Fatores de Tempo , Replicação Viral/fisiologiaRESUMO
We report a patient in whom sarcoidosis coexisted with sclerosing cholangitis and chronic atrophic autoimmune gastritis. There are some autoimmune diseases associated with primary sclerosing cholangitis; the difference between sarcoidosis and all other autoimmune diseases associated with primary sclerosing cholangitis is the ability of the former to damage the biliary tree. Moreover, when sarcoidosis behaves like cholestasis it can damage the biliary tree, mimicking primary sclerosing cholangitis, with high immunoglobulin M but without inflammatory bowel disease and p-ANCAs negative. We believe that it should be regarded as a single disease "infiltrative sclerosing cholangitis" because this is not a primary disease and sarcoidosis would be responsible for a beaded biliary tree.
Assuntos
Doenças Autoimunes/complicações , Colangite Esclerosante/complicações , Gastrite Atrófica/complicações , Sarcoidose/complicações , Adulto , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/imunologia , Colangite Esclerosante/diagnóstico por imagem , Colangite Esclerosante/imunologia , Diagnóstico Diferencial , Gastrite Atrófica/diagnóstico por imagem , Gastrite Atrófica/imunologia , Ducto Hepático Comum/diagnóstico por imagem , Humanos , Imunoglobulina M/sangue , Cirrose Hepática Biliar/complicações , Cirrose Hepática Biliar/diagnóstico por imagem , Cirrose Hepática Biliar/imunologia , Masculino , Radiografia , Sarcoidose/diagnóstico por imagem , Sarcoidose/imunologia , Sarcoidose Pulmonar/complicações , Sarcoidose Pulmonar/diagnóstico por imagem , Sarcoidose Pulmonar/imunologiaRESUMO
Cultured Caco-2 cells were stimulated with Lens culinaris, Phaseolus vulgarisandVicia fabalectins. The production of IL-1, IL-6, IL-8 and MCP-1 was measured by ELISA and RT-PCR. IL-8 production appeared to be specifically triggered upon stimulation with all three lectins used, since none of the other cytokines tested were produced. The IL-8 secreted may induce the extravasation of activated neutrophils and generate tissue damage. A similar mechanism may be implicated in the lesions observed after infection by some enteric pathogens, with lectin-like domains on their membrane. Finally, this model may be suitable one to study the regulation of IL-8 production.
Assuntos
Colo/efeitos dos fármacos , Interleucina-8/biossíntese , Lectinas/farmacologia , Fito-Hemaglutininas/farmacologia , Lectinas de Plantas , Células CACO-2 , Quimiocina CCL2/metabolismo , Colo/metabolismo , Enterócitos/efeitos dos fármacos , Enterócitos/metabolismo , Humanos , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Interleucina-8/metabolismo , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
We have prospectively studied the clinical data, prognostic factors and chronic liver sequelae in 68 patients who developed posttransfusion non-A, non-B hepatitis. The mean incubation period was 5.9 weeks with a range from 2.1 to 12 weeks; 63.5% of the patients were asymptomatic and 60.6% anicteric. The chronicity rate (elevated ALT values for a period of more than 6 months) was 67.6%. The chronicity rate of symptomatic hepatitis (95.5%) was significantly higher than that of asymptomatic hepatitis (54.5%) (P less than 0.01). Monophasic hepatitis, characterized by a rapid elevation in serum ALT followed by a rapid decline with no further fluctuations, had a chronicity rate (42.5%) significantly lower than polyphasic hepatitis (86.6%) (P less than 0.05) and plateau type hepatitis (94.4%) (P less than 0.01). Results of 35 liver biopsies carried out among 46 patients with elevated ALT after 6 months were as follows: chronic active hepatitis, 15 cases; prolonged acute hepatitis, 12 cases; chronic persistent hepatitis, 6 cases; posthepatitis liver changes, 1 case; and secondary hemosiderosis, 1 case.
Assuntos
Hepatite C/etiologia , Hepatite Viral Humana/etiologia , Reação Transfusional , Doença Aguda , Adulto , Alanina Transaminase/sangue , Doença Crônica , Feminino , Hepatite C/classificação , Hepatite C/enzimologia , Hepatite C/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos ProspectivosRESUMO
The pathogenesis of portal vein thrombosis (PVT) in cirrhotic liver patients is not known. PVT has been related to liver dysfunction, neoplasm, hemodynamic factors, and hypercoagulability states. PVT has been reported in patients with antiphospholipid syndrome without liver cirrhosis. Our aim was to find the role of antiphospholipid antibodies (APAs) and coagulation inhibitors in PVT in patients with liver cirrhosis. We present a case-controlled study, matched by age, liver function, and etiology, to discover the role of APAs and anticoagulant protein activity in PVT in cirrhotic patients. We studied 30 cirrhotic patients: 6 of 10 (60%) patients with PVT were APA-positive, whereas only 2 of 20 (10%) in the cirrhotic control group were APA-positive (p < 0.005). Low serum levels of protein C, protein S antithrombin III, and plasminogen were found in cirrhotic patients; and, no differences were found between patients with and without PVT. Significantly lower protein S and antithrombin III levels were found in patients with Child-Pugh class C. Therefore, APAs were related to PVT in cirrhotic patients; but, a lower concentration of coagulation inhibitors was associated with liver dysfunction alone.