Diss. (sammanfattning) Uppsala : Uppsala universitet, 2006. / Härtill 4 uppsatser.

Orientador: Sandra Helena Penha de Oliveira / Banca: Marília Afonso Rabelo Buzalaf / Banca: Carlos Ferreira dos Santos / Resumo: O declínio mundial da cárie dentária é atribuído ao uso abrangente do flúor. Embora esse elemento seja capaz de proteger os dentes, seu uso excessivo pode levar a uma ação citotóxica causando a inibição do crescimento celular, da síntese de proteínas e até mesmo a morte celular. O primeiro objetivo deste estudo foi investigar a concentração ideal do NaF (NaF) capaz de ativar os fibroblastos gengivais de camundongos sem induzir morte celular. Observou-se que, nesses fibroblastos, a concentração de 40 μg F/mL induziu morte celular de 62,6 %. Na concentração de 20 μg F/mL a morte celular foi de apenas 22,1%. Com base nesses resultados, optou-se por utilizar a concentração de 20 μg F/mL como dose máxima para investigar os mecanismos envolvidos na ativação dos fibroblastos gengivais. Dessa forma, avaliou-se a capacidade do NaF induzir a expressão de MMP-2 e MMP-9 pelos fibroblastos gengivais de camundongos na presença ou ausência de LPS, assim como a produção da quimiocina CCL-3/MIP-1α e óxido nítrico. Avaliou-se também a participação das vias de sinalização intracelular p44/42, p38, PI3K e NF-кB envolvidas durante essa ativação, por meio da utilização dos respectivos inibidores PD98059 (50 μM), SB202190 (10 μM), LY294002 (30 μM) e dexametasona (10 μM). Observou-se que o NaF foi capaz de estimular os fibroblastos gengivais a expressarem MMP-9, mas não MMP-2, na concentração de 20 μg F/mL com pico máximo 6 horas após, retornando aos níveis normais 24 horas após. A produção da quimiocina CCL3/MIP-1α pelos fibroblastos estimulados pelo NaF também foi observada com a concentração de 20 μg F/mL com pico máximo 6 horas após estímulo. Na presença de LPS, observou-se uma potenciação da expressão de MMP-9 e produção de CCL3/MIP-1α na concentração de 20 μg F/mL, 6 horas após. / Abstract: The worldwide decline of the dental caries is attributed to the widespread use of fluoride. Although this element is capable of protecting the teeth, its excessive use, can lead to a cytotoxic action, causing an inhibition of the cell growth, of the protein synthesis and even the cellular death. Based on these results, we have chosen to use a concentration of 20 μ g F/mL as maximum concentration to investigate the mechanisms involved in the activation of the gingival fibroblasts. It was observed that, on those fibroblasts, the concentration of 40 μg F/mL has resulted in a death cellular index of 62.6%. In the concentration of 20 μg F/mL the cellular death was of 22.1% only. Based on these results, the concentration of 20 μg F/mL has been chosen as maximum concentration to investigate the mechanisms involved in the activation of the gingival fibroblasts. Later, the ability of NaF to induce the expression of MMP-2 and MMP-9 in gingival fibroblasts of mice in the presence or absence of LPS has been assessed, as well as the production of chemokine CCL-3/MIP-1a and nitric oxide. It also evaluated the participation of intracellular signaling pathways p44/42, p38, PI3K e NF-kB involved in this activation, through inhibitors PD98059 (50 μM), SB202190 (10 μM), LY294002 (30 μM) e dexamethasone (10 μM). It was observed that the NaF was capable to stimulate the gingival fibroblasts to express MMP-9, at the concentration of 20 μgF/mL with maximum peak 6 hours after, returning to normal levels 24 hours after. The expression of MMP-2 was not observed. The production of chemokine CCL3/MIP-1α was also observed with the concentration of 20 μgF/mL with maximum peak 6 hours after the stimulation. In the presence of LPS, it was observed an intensification in the expression of MMP-9 and also in the production of CCL3/MIP-1α at the concentration of 20 μgF/mL, 6 hours later. / Mestre

Thesis (MSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The synthetic progestins, medroxyprogesterone acetate (MPA) and norethisterone (Net) and its derivatives (norethisterone enanthate (Net-EN) and norethisterone acetate (Net-A)), are widely used as contraceptives and in hormone replacement therapy (HRT). Several studies have indicated that synthetic progestins modulate immune function and increase the risk of sexually transmitted infections. However, little is known about the molecular mechanism of action of MPA and Net, in particular their regulation of gene expression in the female genital tract, as compared to progesterone (P4). In the first part of this thesis, the effect of P4, MPA and Net-A on the expression of the endogenous chemokine genes, macrophage inflammatory protein (MIP)-1α and MIP-1β, was investigated in a human vaginal epithelial cell line (Vk2/E6E7). Quantitative realtime PCR (QPCR) showed that both P4 and MPA upregulated the TNF-α-induced expression of MIP-1α and MIP-1β mRNA, while Net-A had no effect. Using siRNA technology, it was found that the responses to P4 and MPA on the MIP-1α gene, but not the MIP-1β gene, are mediated via the glucocorticoid receptor (GR). In the second part of the thesis, it was investigated whether the HIV-1 accessory protein, viral protein R (Vpr), could modulate the action of ligands on MIP-1α and MIP-1β gene expression. QPCR showed that Vpr abrogates the effects of P4 and MPA on the TNF-α induced expression of MIP-1α and MIP-1β. Silencing the GR with siRNA technology showed that the GR plays a role in the effect of Vpr on the P4 and MPA-induced expression of MIP-1α. Taken together, these results show that MPA and Net-A display differential effects on chemokine gene expression in a human vaginal epithelial cell line. Furthermore, this study shows that Vpr modulates the effects of MPA bound to the GR. Thus, the results of this thesis provide insight into the effect of synthetic progestins on the immune response in the vagina, and possibly how HIV-infection may alter these responses. / AFRIKAANSE OPSOMMING: Die sintetiese progestiene medroksieprogesteroon asetaat (MPA) en noretisteroon (Net) en derivate daarvan (noretisteroon enantaat (Net-EN) en noretisteroon asetaat (Net-A)), word op grootskaal gebruik as voorbehoedmiddels en in hormoonvervangingsterapie (HVT). Verskeie studies het al aangedui dat sintetiese progestiene immuunfunksie moduleer en die risiko vir seksuel oordraagbare infeksies verhoog. Daar is egter min bekend oor die molekulêre meganisme van aksie van MPA en Net, in die besonder die regulering van geenuitdrukking in die vroulike geslagskanaal in vergelyking met progesteroon (P4). In die eerste deel van hierdie tesis is die effek van P4, MPA en Net-A op die uitdrukking van endogene chemokiene gene, makrofaag inflammatoriese proteïen (MIP)-1α en MIP-1β, in 'n menslike vaginale epiteel sellyn (Vk2/E6E7) bestudeer. Kwantitatiewe intydse PKR (KPKR) het getoon dat beide P4 en MPA die TNF-α-geïnduseerde uitdrukking van beide die MIP-1α en MIP-1β mRNA uitdrukking op reguleer, terwyl Net-A geen effek getoon het nie. Met die gebruik van siRNA-tegnologie is daar bevind dat die effekte van P4 en MPA, bemiddel word deur die glukokortikoïd-reseptor (GR) op MIP-1α geen uitdrukking, maar nie op MIP-1β nie. In die tweede deel van die tesis, is ondersoek of die MIV-1-bykomstigheidsproteïen, virale proteïen R (Vpr), die aksie van die ligande op MIP 1α en MIP-1β geenuitdrukking kan moduleer. KPKR toon dat Vpr die uitwerking van P4 en MPA op die TNF-α-geïnduseerde uitdrukking van MIP 1α en MIP-1β kanselleer. Die verwydering van die GR met siRNA-tegnologie toon dat die GR 'n rol in die uitwerking van Vpr op die P4 en MPA-geïnduseerde uitdrukking van MIP-1α speel. Ter samevatting: hierdie resultate toon dat MPA en Net-A differensiële uitwerkings vertoon op chemokiene geenuitdrukking in 'n menslike vaginale epiteel sellyn, en dat Vpr hierdie uitwerkings moduleer van MPA gobonde aan die GR. Die resultate van hierdie tesis werp dus lig tot die uitwerking van sintetiese progestiene op die immuunreaksie in die vagina, sowel as hoe MIVinfeksie hierdie reaksies kan verander.

published_or_final_version / abstract / Paediatrics and Adolescent Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / Microbiology / Doctoral / Doctor of Philosophy

Sterile inflammation is a key component of a variety of diseases including, gout, arthritis, type 1 diabetes, Alzheimer’s disease and multiple sclerosis (MS). Sterile inflammation induces the recruitment of immune cells via chemokines, such as CCL5 and CXCL10. Expression of these chemokines is dependent on IRF-1. Recently the FDA has approved the use of a pro-drug, FTY720 that after phosphorylation becomes a S1P mimetic for the treatment of MS. This report describes two novel and opposing mechanisms of S1P action in sterile inflammation. First, intracellular S1P acts as a cofactor of cIAP2 that inducesIL-1-dependent K63-polyubiquitination of IRF-1, which leads to the recruitment of immune cells to the site of inflammation. Conversely, extracellular S1P provides a feedback loop that inhibits CXCL10 and CCL5 expression through S1PR2 signaling. Accordingly, immune cell infiltration to sites of sterile inflammation is increased in S1PR2-/- production via calcium-dependent, but cAMP- and PKA-independent mechanisms that likely involve c-Fos expression and unconventional PKC activation. Elevated c-Fos could competitively inhibit CCL5 expression directly or indirectly via blocking IFN production. These two novel pathways highlight unexpected aspects of S1P signaling, and provide potential mechanisms that can be exploited for the improvement of therapeutics for the treatment of MS.

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. The 5-year survival rate when the cancer remains as a primary tumor is 81% but when it metastasizes to distant sites, defined as a metastatic cancer, it decreases dramatically to 26%. Approaches to prevent these cancers from undergoing these metastatic changes can greatly improve the survival and outcome of these cancer victims. This current study is examining the expression profiles of chemokines and VEGFs in HNSCC. By investigation the underlying pathways involved in the expressions of chemokines and VEGFS we hope to sort out the transcriptional regulation of these molecules. We used pharmological inhibitors of several important kinase pathways and the receptors involved in the transcription of chemokines and VEGFs. This study specifically looked at the proangiogenetic chemokines, CXCL5 and CXCL8, and their receptor CXCR2, and their possible impact on VEGFs, specifically VEGF-C and VEGF-A. From experimentation we concluded that HNSCC uses the MAPK pathway for regulation of the chemokines CXCL5 and CXCL8, but not for its downregulation. VEGF-A showed to be positively controlled by the MAPK pathway. The Akt pathway was found to downregulate VEGF-C, possibly from CXCR2. VEGF-C was not under control of the chemokines’ expression, VEGF-C and VEGF-A were also differentially regulated. The current study has begun to sort out the expression and regulation of chemokines and VEGFs in HNSCC. There are still many unanswered questions about the role these molecules play in HNSCC, but hopefully these conclusions will aid in finding improved treatments for patients diagnosed with head and neck cancer.

O desenvolvimento da doença periodontal (DP) é influenciado pela resposta imunológica do hospedeiro frente ao desafio bacteriano. Apesar da função protetora de tal resposta frente à infecção, a mesma leva à destruição dos tecidos periodontais. Neste estudo, analisamos o papel de MIP-1 na imunomodulação da DP experimental em camundongos. Camundongos C57Bl/6 (WT) infectados com A. actinomycetemcomitans desenvolveram uma intensa reação inflamatória e severa reabsorção óssea alveolar, associada a uma alta expressão de MIP-1 e uma intensa migração de células CCR5+ e CCR1+ para os tecidos periodontais. Além disso, verificamos que uma intensa expressão de citocinas inflamatórias (TNF-) e do tipo Th1 (IFN-), RANKL e MMPs estava associada à progressão da doença. Entretanto, camundongos geneticamente modificados para não expressar MIP-1 (MIP-1KO), quando infectados com A. actinomycetemcomitans, apresentaram um padrão de resposta muito semelhante aos animais WT. De fato, a ausência de MIP-1 não interferiu na migração de células inflamatórias para os tecidos periodontais e na reabsorção óssea alveolar nos camundongos infectados. Semelhantemente, a expressão de citocinas (TNF-, IFN- e IL-10), dos fatores osteoclastogênicos (RANKL e OPG) e das MMPs e seus inibidores (MMP-1, MMP-2, MMP-3, TIMP-1 e TIMP-3) foram similares entre os camundogos das linhagens WT e MIP-1KO. Além disso, a ausência de MIP-1 não interferiu no controle da infecção por A. actinomycetemcomitans como demonstrado pela similaridade na quantidade de carga bacteriana presente nos tecidos e nos níveis de MPO e iNOS. Os resultados obtidos podem ser explicados pela relativa redundância no sistema quimiocinas/receptores de quimiocinas, onde mais de uma quimiocina pode ligar-se ao mesmo receptor. De fato quimiocinas como MIP-1 e RANTES, que utilizam os mesmos receptores de MIP-1 (CCR5 e CCR1), apresentaram-se intensamente expressas nos tecidos periodontais dos camundongos infectados com A. actinomycetemcomitans, independentemente da ausência de MIP-1. De fato, camundongos tratados com Met-RANTES, um antagonista específico dos CCR5 e CCR1, resultou em uma redução significativa no influxo de células inflamatórias e perda óssea alveolar quando comparados com os camundongos não tratados. Nossos resultados demonstraram que a ausência de MIP-1 não afeta o desenvolvimento da doença periodontal experimental em camundongos, provavelmente pela presença de quimiocinas homólogas que suprem sua ausência. / Periodontal disease (PD) development is highly influenced by the host immune response to the bacterial challenge. Despite the protective role of this response against infectious agents it leads to periodontal tissues destruction. In this study, we analyzed the role of chemokine MIP-1 on the immunomodulation of experimental PD in mice. C57Bl/6 (WT) mice infected with A. actinomycetemcomitans developed an intense inflammatory reaction and severe alveolar bone resorption, associated with a high expression of MIP-1 and the migration of CCR5+ and CCR1+ cells to the periodontal tissues. In addition, an intense expression of Th1 (IFN-) and inflammatory (TNF-) cytokines, RANKL and MMPs are associated with the disease progression. However, mice genetically deficient of MIP-1 (MIP-1KO), when infected with A. actinomycetemcomitans, developed a very similar response pattern to that observed for WT strain. Indeed, the absence of MIP-1 does not interfere in inflammatory cells migration to periodontal tissues and alveolar bone resorption in response to A. actinomycetemcomitans infection. Similarly, the expression of cytokines (TNF-, IFN- and IL-10), osteoclastogenic factors (RANKL and OPG) and MMPs and its inhibitors (MMP-1, MMP-2, MMP-3, TIMP-1 and TIMP-3) was similar between WT and MIP-1KO strains. Furthermore, the lack of MIP-1 does not interfere in the control of A. actinomycetemcomitans infection as demonstrated by the similar bacterial load, and similar levels of the antimicrobial MPO and iNOS. Such results can be explained by the relative redundancy of chemokine system, where more than one chemokine can bind to the same receptor. Indeed, chemokines, such as MIP-1 and RANTES, which use the same receptors used by MIP-1 (CCR1 and CCR5), are intensely expressed in periodontal tissues of mice infected with A. actinomycetemcomitans, regardless of the absence of MIP-1. In accordance, the treatment of mice with Met-RANTES, a specific antagonist of the receptors CCR5 and CCR1, resulted in a significant reduction in the influx of inflammatory cells and alveolar bone loss when compared with untreated mice. Our results demonstrate that the absence of MIP-1 does not affect the development of experimental periodontitis in mice, probably due to the presence of homologous chemokines that overcome the absence of this chemokine.

Fibroblastos são as células mais numerosas encontradas nos tecidos orais como gengiva, ligamento periodontal e polpa dental. Além de exercerem função estrutural, estas células também desempenham papel importante na resposta imune destes tecidos através do reconhecimento de antígenos e produção de mediadores inflamatórios e citocinas. Evidências apontam ainda para o fato de que fibroblastos não constituem um grupo único de células. Sendo assim, os objetivos deste estudo foram: (I) avaliar a produção diferencial de fibroblastos de gengiva, ligamento periodontal e polpa dental de dentes permanentes e decíduos quanto à produção das quimiocinas CCL3 e CXCL12; (II) avaliar a produção de pró-colágeno I pelas células de polpa e (III) avaliar a expressão diferencial dos fibroblastos quanto a microRNAs. Dentes recentemente extraídos (terceiros molares hígidos) e fragmentos de gengivas saudáveis de três pacientes adultos foram obtidos no Laboratório de Farmacologia e Fisiologia Clínica da Faculdade de Odontologia de Bauru. Caninos decíduos de dois pacientes com indicação para extração por motivos ortodônticos foram obtidos na Clínica de Odontopediatria da mesma unidade. Culturas primárias de fibroblastos de gengiva (n=3), ligamento periodontal (n=3) e polpa de dente permanente (n=3) e polpa dental de dente decíduo (n=2) foram estabelecidas a partir de tecidos humanos por meio de técnica de explant. Após a quarta passagem, a produção de CCL3 e de CXCL12 foi avaliada após estímulo com concentrações crescentes (0 10 µg/mL) de ácido lipoteicóico de Enterococcus faecalis (EfLTA), lipopolissacarídeo de Porphyromonas gingivalis (PgLPS) ou LPS de Escherichia coli (EcLPS) por ELISA após 1, 6 e 24 h. O RNAm para as quimiocinas no grupo estimulado com EcLPS por 24 h foi avaliado por transcrição reversa seguida de reação em cadeia da polimerase quantitativa. A produção de pró-colágeno I por células de polpa estimuladas com EfLTA e PgLPS foi avaliada por imunofluorescência. O perfil de expressão de microRNAs foi investigado por ensaio de microarranjo. A produção de CCL3 foi aumentada (p< 0,05) pelos antígenos empregados, porém de maneira mais evidente para EcLPS em células de gengiva. A quimiocina CXCL12 foi detectada em níveis basais em todos os grupos de células, porém em maiores quantidades em fibroblastos de gengiva seguidos pelos de ligamento periodontal. A adição dos antígenos diminuiu a produção de CXCL12 de maneira distinta entre células e entre antígenos (p< 0,05). Fibroblastos de polpa decídua não apresentaram qualquer alteração na produção desta quimiocina pelos antígenos (p> 0,05). No período experimental de 24 h, a expressão do RNAm para CXCL12 não foi alterada enquanto a de CCL3 não foi detectada. A produção de pró-colágeno I se mostrou aumentada (p< 0,05) na presença do desafio antigênico em células de polpa com exceção para fibroblastos de polpa permanente que apresentaram diminuição na produção desta proteína quando estimulados com EfLTA. Em condições basais, fibroblastos do mesmo doador apresentaram perfil distinto de expressão de microRNAs envolvidos com a produção das proteínas-alvo deste estudo. A expressão de imunomiRs por EcLPS também se mostrou modificada de maneira distinta entre os fibroblastos, em especial os de ligamento periodontal. Com base nestes resultados, pode-se concluir que fibroblastos de diferentes tecidos orais apresentam comportamento diferencial frente a antígenos bacterianos comumente relacionados a patologias que afetam a cavidade oral. / Fibroblasts are the dominant cells within oral tissues such as gingiva, periodontal ligament and dental pulp. Besides the architectural maintenance of the connective tissues, fibroblasts are also involved in connective tissue immune response through antigen recognition and production of inflammatory mediators and cytokines. Recent studies also demonstrated that fibroblasts do not constitute a unique group of cells. Taken this togeter, the objectives of the present study were: (I) to evaluate the production of the chemokines CCL3 and CXCL12 by human gingival, periodontal ligament as well as permanent and deciduous dental pulp fibroblasts; (II) to evaluate the production of procollagen I by dental pulp fibroblasts and (III) to evaluate the differential pattern of expression of microRNAs by the oral fibroblasts. Recently extracted teeth (non-carious third molars) and fragments of healthy gingiva from three adults were obtained at the Laboratory for Clinical Pharmacology and Physiology at Dental School of Bauru. Deciduous canines from two patients with orthodontic indication for extraction were obtained at Pediatrics Clinics of Dental School of Bauru. Primary cultures of fibroblasts from gingiva (n=3), periodontal ligament (n=3) as well as permanent pulp (n=3) and deciduous pulp (n=2) were established through an explant technique. After the fourth passage, fibroblasts were challenged with increasing concentrations (0 10 µg/mL) of Enterococcus faecalis lipoteichoic acid (EfLTA), Porphyromonas gingivalis lipopolysaccharide (PgLPS) or Escherichia coli LPS (EcLPS) for 1, 6 and 24 h. The chemokines were assessed through ELISA while the mRNA for CCL3 and CXCL12 (EcLPS at 24 h) were assessed through reverse transcription followed by quantitative polymerase chain reaction. The expression of microRNAs was screened through a microarray assay. The production of CCL3 on cell supernatants was detected in all cellular groups, with higher amounts at gingival fibroblasts. EcLPS induced more important chemokine differences compared to the other antigens. CXCL12 basal levels were higher for gingival fibroblasts followed by periodontal ligament ones, but also detected in dental pulp fibroblasts. The production of this chemokine was decreased by stimulation in a different fashion for each antigen and cell type. Deciduous pulp fibroblasts did not display any differences in CXCL12 synthesis even in the presence of the microbial challenge. No differences were detected at mRNA level for CXCL12, while no expression for CCL3 could be detected at 24 h. Increased production of procollagen type I was observed for dental pulp cells in general, with the only exception for permanent pulp cells which displayed decreased production of the protein with EfLTA. Microarray analysis showed differential expression pattern of microRNAs comparing unstimulated cells from the same donnor. EcLPS was able to alter immunomiRs expression in some of the cellular groups, in particular periodontal ligament fibroblasts. In conclusion, our results showed that fibroblasts from distinct oral tissues display differential behavior against bacterial antigens commonly related to the diseases that affect the oral cavity.

A nefropatia diabética é uma doença crônica caracterizada por falência renal, que torna necessária a hemodiálise. A diálise peritoneal é uma alternativa para a hemodiálise, porém causa peritonite e morte, principalmente devido à infecção com Staphylococcus aureus, especialmente em pacientes imunodeprimidos, como pacientes diabéticos. Nossa hipótese é que a insulina possa modular a peritonite causada por S. aureus. Para tanto, investigamos sua intervenção, após a indução de diabetes mellitus, na infecção peritoneal por cepas diferentes de S. aureus, analisando os mecanismos moleculares (produção/liberação de citocinas, expressão de moléculas de adesão) e a atividade microbicida dos macrófagos peritoneais envolvidos. Ratos Wistar, machos, diabéticos (aloxana, 42 mg/kg, i.v., 10 dias) e respectivos controles (salina, i.v.) foram submetidos à injeção intraperitoneal de uma suspensão de S. aureus (5x109 CFU/mL) ou volume equivalente de PBS estéril. Os animais foram submetidos a dois tratamentos com insulina NPH: 1) dose única (1UI e 4UI respectivamente, controle e diabético), administrada por via subcutânea; ou, 2) com 4 doses sendo a primeira administrada 2 horas antes da infecção, seguida de metade desta dose às 17 horas e no mesmo horário pelos próximos 2 dias (dose inicial 4UI e 1UI, grupo diabético e grupo controle, respectivamente), passadas 16 horas da última dose de insulina, a glicemia foi determinada e, em seguida, foi realizada eutanásia e coleta de amostras. Avaliamos: a) número de células no lavado peritoneal (LPe), leucograma e glicemia (monitor de glicose); b) níveis séricos de corticosterona e insulina (ELISA); c) concentrações de citocinas (IL-1&#946;, TNF-&#945;, IL-6, IFN-&#947;, IL-4, IL-10, IL-12) e quimiocinas (CINC-1, CINC-2, CINC-3) no sobrenadante do LPe (ELISA); d) expressão de moléculas de adesão (P-selectina, PECAM-1, ICAM-1) no endotélio vascular (imunoistoquímica); e) atividade microbicida. Após a infecção com a cepa ATCC 25923, comparados aos não infectados, ratos diabéticos apresentaram aumento no número de leucócitos (350%) e nas concentrações de CINC-1 (1900%), IL-1&#946; (1300%), IFN-&#947; (280%), IL-4 (800%). O tratamento destes animais com dose única de insulina diminuiu as concentrações de CINC-1 (17%) e IFN-&#947; (30%) e o leucócitos (55%); e aumentou a concentração de IL-4 (260%); enquanto o tratamento com 4 doses diminuiu o número de leucócitos (82%) e as concentrações de CINC-1 (96%) e CINC-2 (45%); e, aumentou as concentrações de TNF-&#945; (270%), IFN-&#947; (220%), IL-1&#946; (42%), IL-6 (760%) e a expressão de ICAM-1 (1360%); enquanto as concentrações de CINC-3, IL-10 e IL-12 não foram alteradas pelos tratamentos com insulina. Após a infecção com a cepa N315 HLA+, comparados aos não infectados, ratos diabéticos apresentaram aumento do número de leucócitos (200%), nas concentrações de CINC-1 (1000%), IL-4 (860%), IFN-&#947; (200%) e na expressão de PECAM-1 (800%) e diminuição de CINC-2 (92%). O tratamento destes animais com dose única de insulina diminuiu a concentração de CINC-1 (85%); e aumentou a concentração de CINC-2 (2030%), IL-1&#946; (370%) e IL-4 (250%); enquanto o tratamento com 4 doses diminuiu a concentração de CINC-1 (92%); e, aumentou número de leucócitos (66%), as concentrações de CINC-2 (100%), IL-1&#946; (490%), IL-6 (1870%) e IFN-&#947; (330%), e os outros parâmetros não foram modificados pelos diferentes tratamentos com insulina. Estes dados sugerem que a insulina possa modular a peritonite induzida por cepas diferentes de S. aureus, controlando pelo menos em parte, o infiltrado inflamatório, a produção das citocinas CINC-1, CINC-2, IL-4, IL-6, IFN-&#947;, TNF-&#945; e IL-1&#946;; e, consequentemente a expressão P-selectina e PECAM-1 no endotélio vascular do mesentério. / Diabetic nephropathy is a chronic disease characterized by kidney failure, so hemodialysis is necessary. Peritoneal dialysis is an alternative to hemodialysis, but causes peritonitis and death primarily due to infection by Staphylococcus aureus, especially in immunocompromised patients, such as diabetics. Our hypothesis is that insulin can modulate peritonitis caused by S. aureus, therefore, we investigated its action, after diabetes induction, in peritoneal infection with different S. aureus strains, analyzing the molecular mechanisms (cytokines production/release, adhesion molecules expression) and the microbicidal activity of peritoneal macrophages involved. Wistar male diabetic (alloxan, 42 mg/kg, iv, 10 days) and their respective controls (saline,iv) were subjected to intraperitoneal injection of S. aureus suspension (5x109CFU/mL) or an equivalent volume of PBS sterile. Animals were submitted to two treatments with NPH insulin administered subcutaneously : single dose (1IU and 4IU respectively , control and diabetic) 8 hours prior to euthanasia ; or 4 doses : first dose 2 hours before infection (4IU and 1IU , diabetic and control group, respectively), then half this dose of 17 pm and in the same time for the next 2 days, after 16 hours of the last dose, blood glucose was determined, and then it was carried out euthanasia and sampling. We evaluated: a) number of cells in peritoneal wash (PW), white blood cell count and blood sugar (glucose monitor) ; b) serum insulin and corticosterone (ELISA); c) concentrations of cytokines (IL-1&#946;, TNF-&#945;, IL-6, IFN-&#947;, IL-4, IL-10, IL-12) and chemokines (CINC -1, CINC-2, CINC-3 ) in supernatant of the SBA assay (ELISA); d) expression of adhesion molecules (P- selectin, ICAM-1, PECAM-1) in vascular endothelium ( immunohistochemistry); e) microbicidal activity. After infection with ATCC 25923 strain, compared to uninfected, diabetic rats showed an increase in leukocytes number (350%) and in concentrations of CINC-1 (1900%), IL-1&#946; (1300%), IFN-&#947; (280%), IL-4 (800%). Treatment of these animals with a single dose of insulin decreased concentrations of CINC-1 (17%) and IFN-&#947; (30%) and leukocytes number (55%); and increased IL-4 concentrations (260%); while treatment with 4 doses decreased leukocytes number (82%) and concentrations of CINC-1 (96%) and CINC-2 (45%); and increased concentrations of TNF-&#945; (270%), IFN-&#947; (220%), IL-1&#946; (42%), IL-6 (760%) and expression of ICAM-1 (1360%); while the concentrations of CINC-3, IL-10 and IL-12 were not affected by treatments with insulin. After infection with N315 HLA+ strain, compared to uninfected, diabetic rats showed an increase in leukocytes (200%), concentrations of CINC-1 (1000%), IL-4 (860%), IFN-&#947; (200%) and in the expression of PECAM-1 (800%); and CINC-2 decrease (92%). Treatment of these animals with a single dose of insulin decreased the concentration of CINC-1 (85%); and increased concentrations of CINC-2 (2030%), IL-1&#946; (370%) and IL-4 (250%); while treatment with 4 doses decreased the concentration of CINC-1 (92%); and increased leukocytes number (66%), concentrations of CINC-2 (100%), IL-1&#946; (490%), IL-6 (1870%) and IFN-&#947; (330%), and other parameters were not modified by treatments with insulin. These results suggest that both S. aureus strains activate differently the innate response during peritonitis, and insulin was not always able to modulate this response.