Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-02-03T13:11:46Z No. of bitstreams: 1 caiocesardesouzaalves.pdf: 1872262 bytes, checksum: f03fadd9407262d508f6744a7f73820f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-03T13:14:01Z (GMT) No. of bitstreams: 1 caiocesardesouzaalves.pdf: 1872262 bytes, checksum: f03fadd9407262d508f6744a7f73820f (MD5) / Made available in DSpace on 2017-02-03T13:14:01Z (GMT). No. of bitstreams: 1 caiocesardesouzaalves.pdf: 1872262 bytes, checksum: f03fadd9407262d508f6744a7f73820f (MD5) Previous issue date: 2007-08-30 / A Paracoccidioidomicose é uma micose sistêmica humana causada pelo fungo dimórfico, Paracoccidioides brasiliensis, que acomete, principalmente, indivíduos adultos do sexo masculino. O presente estudo propôs a padronização do modelo de infecção com P. brasiliensis pela via intratorácica em camundongos BALB/c. Este estudo foi monitorado pela detecção do P. brasiliensis através da contagem de unidades formadoras de colônia e pela presença de DNA do fungo nos pulmões dos animais infectados em diferentes pontos pósinfecção (2o, 7o, 15o, 30o, 45o, 60o e 90o dias) e a taxa de sobrevida dos camundongos. Além disto, foram avaliados alguns parâmetros imunológicos como a produção de óxido nítrico, TNF-alpha, IFN-gama, e IL-10 por células presentes no lavado intratorácico, contagem total e diferencial do número de células do lavado intratorácico, o estudo histopatológico dos pulmões e a detecção de anticorpos específicos anti-P. brasiliensis nos pulmões e no soro. Os resultados mostram um aumento gradual do número de colônias e de DNA de P. brasiliensis nos pulmões. Até o 15o dia após a infecção pode ser observado um aumento na produção de óxido nítrico e IFN-gama pelas células do lavado intratorácico, bem como um aumento do número total de células e da porcentagem de leucócitos mononucleares. A partir do 30o dia após a infecção observa-se um aumento de anticorpos específicos (IgG1) no soro e no pulmão, um aumento da produção de IL-10 e TNF-alpha pelas células do lavado intratorácico e conseqüente diminuição da produção de IFN-gama e óxido nítrico. Além disso, observa-se um aumento da porcentagem de células polimorfonucleares no lavado. No estudo histopatológico pode ser constatado um aumento gradual no tamanho e complexidade dos granulomas presentes nos cortes histológicos. Os camundongos utilizados no estudo de sobrevida começaram a morrer no 60o dia após a infecção. Os resultados mostram uma resposta inicial do hospedeiro com um perfil Th1 mudando durante a infecção para uma resposta Th2 que leva ao óbito dos camundongos BALB/c. / Paracoccidioidomycosis or South American blastomycosis, is a chronic granulomatous human male infection caused by the Paracoccidioides brasiliensis. The present study it considered the standardization of the model of infection with P. brasiliensis for the intrathoracic route in BALB/c mice. This study was monitored by the detection of the P. brasiliensis through the counting of colony forming units and by the presence of DNA of fungi in the lungs of the infected animals in different points (2, 7, 15, 30, 45, 60 and 90 days) and the survival rate of the mice. Moreover, some immune parameters had been evaluated as the nitric oxide production, TNF-alpha, IFN-gamma, and IL-10 for cells in the intrathoracic washed, total and distinguishing counting of cells of the intrathoracic washed, the lung histopathology and the detection of specific antibodies anti-P. brasiliensis in the lungs and serum. The results show a gradual increase of the number of colonies and P. brasiliensis DNA in the lungs. Until 15 day after the infection can be observed an increase in the nitric oxide production and IFN-gamma for the cells of the washed, as well as an increase of the total number of cells and the percentage of mononuclear. From 30 day after the infection observes an increase of specific antibodies (IgG1) in the serum and the lung, an increase of the production of IL-10 and TNF-alpha for the cells of the washed and consequent reduction of the IFN-gamma production and nitric oxide. Moreover, observed an increase of the percentage of cells polimorphonuclear in the washed. In the histopathology it can be evidenced a gradual increase in the size and complexity of granulomas in the cuts. The mice used in the survival study had started to die in 60 day after the infection. The results show an initial reply of the host with a Th1 profile moving during the infection for a Th2 reply that leads to the death of the BALB/c mice.

Tuberculosis (TB) is still a global epidemic disease despite its discovery over 100 years ago. It is caused by Mycobacterium tuberculosis, which invades and replicates within macrophages, key cells of the innate immune system. The hallmark of tuberculosis is the granuloma which is an accumulation of Mycobacterium-infected cells surrounded by immune cells, and the containment of the bacteria is assured as long as the host immune response remains intact. Despite a well-developed immune response in the infected host, reactivation of latent tuberculosis infection (LTBI) may occur through the introduction of other bacterial pathogens, re-infection with M. tuberculosis or due to other immunosuppression, e.g. AIDS or cancer. The zebrafish–M. marinum model provides an ideal system for examining the pathogenesis of tuberculosis and the associated immune response of the host due to its vertebrate-like immune system, and the close phylogenetic relationship of M. marinum to M. tuberculosis. Granuloma formation and immune response to M. marinum have been investigated mainly in zebrafish embryos or larvae, which lack an adaptive immune response, and little work has been performed in adult fish. This complicates the transfer of findings in these models to chronic, latent or re-activated disease stages in humans, where adaptive immunity plays an important part. The aim of the research presented here was to investigate the immune response of the adult zebrafish to M. marinum infection, with the focus on the kidney as one of the major immune organs in fish. The results obtained support further use of the adult zebrafish-M. marinum model for human tuberculosis infections in the future. In the present study, adult zebrafish were infected with low doses of M. marinum (NCIMB 1297 or NCIMB 1298) and the kidney was investigated for histopathological changes in the form of granulomas over a period of two months(Chapter 3). No granulomas were detected in the fish infected with M. marinum NCIMB 1298 while in zebrafish infected with NCIMB 1297, macrophage aggregation and granuloma formation were detected as early as day 11 post-infection. Occurrence and severity of granulomas and the presence of replicating bacteria increased over time, resulting in a high density of non-caseating and caseating granulomas in the head and posterior kidney after two months of infection. Interleukin 1 beta (IL-1β), Interleukin-12 (IL-12), Tumor necrosis factor alpha (TNFα) and Interferon gamma (IFNγ) have been shown to be important cytokines functioning in defence against tuberculosis, especially IFNγ which is considered to play an important part in acute, chronic and latent tuberculosis. Changes in gene expression of these immune genes in adult zebrafish were investigated over the first two weeks of infection with M. marinum NCIMB 1298 and NCIMB 1297. The results obtained in the first week after infection were inconclusive for both strains investigated. In agreement with the results presented in Chapter 3, no specific immune response was detectable in fish infected with M. marinum NCIMB 1298. However, after 14 days, a high-fold change in IL-12 and TNFα expression were detected in fish infected with M. marinum NCIMB 1297, while IL-1β showed no changes compared to the control fish. Furthermore, no IFNγ expression was detectable over the first two weeks of infection. The delay in the expression of IL-12 and the lack of IFNγ expression can be explained by the ability of M. marinum to manipulate the host immune response, as described for M. tuberculosis and other intracellular bacteria. Besides in vivo investigations of the host-pathogen interactions, in vitro primary macrophage cultures from individual zebrafish kidneys were developed to investigate macrophage-specific gene expression to M. marinum infection (Chapter 4). Although the results looked promising, further optimization is required before the results of the in vitro assays can be fully compared to the in vivo results. Our understanding of reactivation in latent tuberculosis infection (LTBI) both in healthy and immune compromised individuals is insufficient and is delaying the development of treatments for the disease. Therefore, the transcriptome profile of long-term infections (26 weeks) with M. marinum NCIMB 1297 in adult zebrafish was investigated to determine whether the gene expression in this model is comparable to LTBI in humans or other vertebrate model organisms (Chapter 5). In addition, transcriptome profiling was investigated in a group of long-term infected zebrafish exposed to stress to induce re-activation of the disease. Expression profiles in the long-term infected fish and the infected plus stressed fish differed from each other and displayed similar gene profiles to those found in the latent or re-activated disease states, respectively, in human and other vertebrate models. Infected fish displayed a profile highlighted by IFNγ, TNFα, NOS2b and IL-8 expression alongside activating and regulatory T cell responses, including involvement of cytotoxic T cells (CTLs). The transcriptome profile of the group of fish that had been infected and then stressed was distinguished by the lack of IFNγ expression and reduction in TNFα and NOS2b expression, as well as a lack of T cell response compared to the infected fish. In conclusion, the results obtained from Chapters 3 and 4 showed that M. marinum NCIMB 1298 is non-pathogenic to zebrafish. Infection with M. marinum NCIMB 1297, on the other hand, resulted in a similar immune response to that described for human and other mammalian vertebrate models (Chapters 3-5). These results support the use of the adult zebrafish-M. marinum model to investigate LTBI and disease reactivation, and will aid our understanding host-pathogen interactions for tuberculosis in the future.

O Granuloma \"lepróide canino\", quadro sindrômico, também denominada lepra canina, foi descrito pela primeira vez em 1973, no Zimbábue, em cães da raça Boxer e Bull mastiff e consiste em um dos tipos de micobacterioses tegumentares encontradas nos animais de companhia. No presente estudo, objetivou-se caracterizar os aspectos clínicos e epidemiológicos da enfermidade, nos animais atendidos no período de 1990 a 2010, no Serviço de Dermatologia do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, bem como determinar a ocorrência de similaridade gênica da micobactéria envolvida, entre os animais brasileiros e os descritos em trabalhos estrangeiros. A amostragem foi composta de 37 animais com diagnóstico estabelecido por exame histopatológico ou citobacterioscópico cutâneo, onde se verificou evidente predisposição racial (83,7%), principalmente da raça Boxer (61,2%), ampla distribuição etária e ausência de predisposição sexual. Os cães apresentavam bom estado geral, sem comprometimento sistêmico, apenas tegumentar, com predomínio das lesões de morfologia nodular (75,6%) e situadas em pavilhões auriculares (86,5%). O diagnóstico foi estabelecido a partir dos seguintes exames subsidiários: histopatologia cutânea (56,8%), citobacterioscopia (21,6%) e por ambas as metodologias (21,6%). Trata-se ainda de enfermidade ocorrente em várias unidades federativas brasileiras, no entanto parece ser pouco diagnosticada e assim submetida a tratamentos equivocados, o que foi verificado em 54% dos cães tratados preteritamente. Os fármacos empregados no tratamento sistêmico, rifampicina ou enrofloxacina, mostraram-se igualmente eficazes, com estabelecimento da alta clínica em tempo médio de 84,1 dias. Já técnica de reação em cadeia de polimerase (PCR) foi executada a partir de cortes histológicos cutâneos, emblocados em parafina, oriundos de 13 animais, sendo que em 09 (69,2%) deles se detectou a presença de Mycobacterium cepa CLGS, pelo método da PCR em tempo real e a confirmação do agente em comum entre os casos do Brasil e de outros países. / Canine leproid granuloma, syndromic, also called \"canine leprosy, was first described in 1973 in Zimbabwe in Boxer dogs and Bull mastiff and consists of a type of soft tissue mycobacterial infections found in pets. In the present study aimed to characterize the clinical and epidemiological aspects of the disease in animals treated between 1990-2010 at the Department of Dermatology, Veterinary Hospital, Faculty of Veterinary Medicine, University of São Paulo, and to determine the occurrence of genetic similarity of mycobacteria involved, of dogs from Brazil and other countries. The sample consisted of 37 animals with diagnosis established by histopathology or cytology skin, where there was clear racial predisposition (83.7%), mainly Boxer (61.2%), broad age distribution and no sexual predisposition. The dogs were in good general condition, without systemic involvement, only cutaneous, with a predominance of nodular lesions morphology (75.6%) located in the ears (86.5%). The diagnosis was established from the following exams: cutaneous histopathology (56.8%), citology (21.6%) and by both methods (21.6%). It is still disease occurring in several Brazilian states, however appears to be underdiagnosed and thus subjected to inappropriate treatment, which was observed in 54% of dogs treated. The drugs used in systemic treatment, rifampin and enrofloxacin, were equally effective, with the establishment of recovery a mean of 84.1 days. Already technique of polymerase chain reaction (PCR) was performed from histological sections of skin, paraffin embedded, from 13 animals, while in 09 (69.2%) of them detected the presence of Mycobacterium strain CLGS by method of real-time PCR and confirmation of the agent in common between the cases of Brazil and other countries.

Este estudo avaliou pacientes portadores de cromoblastomicose, sendo feita uma categorização clínica em dois grupos, de acordo com a forma clínica da lesão dermatológica: o primeiro composto por indivíduos com lesões elevadas e o segundo formado por casos com lesões planas, com biópsias realizadas antes e depois dos tratamentos. Através de critérios semiquantitativos, os elementos anatomopatológicos foram analisados, constatando-se a presença do padrão granulomatoso chamado granuloma micótico misto organizado, com baixa intensidade em lesões planas e alta em elevadas. Evidenciou-se que pacientes com lesões planas evoluíram bem clinicamente, com exames micológicos negativos e sem recidivas (bons respondedores), porém aqueles com lesões elevadas apresentaram evolução clínica desfavorável, com exames micológicos positivos e doença recidivante ou recalcitrante, apesar dos tratamentos recebidos (maus respondedores). E, entre os componentes histopatológicos reacionais à invasão fúngica, verificou-se associação significativa para fibrose, podendo levar a um pior prognóstico. Estes achados clínicos e histopatológicos conferem a esta patologia uma idéia de polaridade, à guisa dos fenômenos das formas polares da hanseníase, da fagocitose, e dos agentes de baixa virulência. Os autores propõem uma classificação morfológica dos granulomas da CBM em dois tipos polares: granuloma micótico misto organizado (GMMO) polar com alta intensidade dos elementos celulares (que corresponderia ao polar não tuberculóide) e GMMO polar com baixa intensidade (que corresponderia ao polar tuberculóide). / Patients with chromoblastomycosis were studied and dichotomized into two groups according to the clinical lesions: flat and elevated ones which were biopsied before and after treatments. Histopathological structures underwent through semiquantitatively analisys evidencing the mixed organized mycotic granuloma with low intensity of histopathological elements in flat lesions and high in elevated ones. Flat lesions have improved clinically with negative micological studies (good responders) while elevated lesions’ patients did not (bad responders). It was found significant association between evidence of fungus and fibrosis with a poor prognosis. Clinical and histopathological findings suggest a polarity concept to this disease based on the fenomenal polar forms of hanseniasis, fagocitosis and the low virulence agents. The authors proposed a morphological classification of the chromoblastomycosis’ granulomas into two polar types: polar mixed organized mycotic granuloma (MOMG) with high intensity of the cellular elements (like the polar non tuberculoid type) and the polar MOMG with low intensity (like the polar tuberculoid type).

No description available.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniversitet, 2009. / Härtill 3 uppsatser.

Syfte. Syftet med detta arbete var att undersöka förekomsten och behandling av granulom vid gastrostomier hos barn och ungdomar under 18 år i Sverige. Syftet var även att undersöka sjuksköterskors kunskaper om granulombehandling hos barn och ungdomar under 18 år med gastrostomi i Sverige. Metod. Den forskningsdesign som valdes var av kvantitativ metod genom enkätundersökning. Enkäterna skickades ut till sjuksköterskor som arbetar i Sverige och finns med i något av följande nätverk: Nätverket för habiliteringssjuksköterskor, Nätverket för habiliteringssjuksköterskor inom nutrition och/eller Nätverket för nutritionssjuksköterskor. Resultat. Det upplevdes att granulombesvären var varierande och berodde på barnets övriga hälsa. 52% uppskattade att barnen utvecklade granulom inom två månader efter inläggning av gastrostomin. 34% av deltagarna uppskattade att ca 25% av barn och ungdomar med gastrostomier utvecklar granulom. 46% använde en kombination av lapis och kortisonsalva som behandlingsmetod vid granulom. Slutsats. De behandlingar som idag används för granulom är lapis och kortisonsalva, dessa används av många i kombination med varandra och verkar ha ett gott resultat. Sjuksköterskors kunskap inom området är brett och många har en gemensam åsikt om att granulombildning ofta har ett samband med patientens övriga hälsa. / Aim. The aim of the study was to investigate the occurrence and treatment of granulomas in children and adolescents under the age of 18 with gastrostomy in Sweden. The aim was also to investigate nurses knowledge of granulomatreatment in children and adolescents under the age of 18 with gastrostomy in Sweden. Methods. The design was of quantitative method by questionnaire. A questionnaire was sent to nurses who work in Sweden and are included in one of the following networks: Network for rehabilitation nurses, Network for rehabilitation nurses in nutrition and / or Network for nutrition nurses. Results. The severity of granuloma varied, depending on the child's general health. 52% estimated that the children developed granulomas within two months after insertion of the gastrostomy. 34% of respondents estimated that about 25% of children and adolescents with gastrostomier develop granulomas.46% used a combination of lapis and cortisone ointment as a treatment for granuloma. Conclusion.The treatments currently used for granulomas is lapis and cortisone ointment, these are used by many in combination with each other and seem to have a good result. Nurses' knowledge in the field is extensive and many have a common view that granuloma formation is often linked to the patients general health.

Este estudo avaliou pacientes portadores de cromoblastomicose, sendo feita uma categorização clínica em dois grupos, de acordo com a forma clínica da lesão dermatológica: o primeiro composto por indivíduos com lesões elevadas e o segundo formado por casos com lesões planas, com biópsias realizadas antes e depois dos tratamentos. Através de critérios semiquantitativos, os elementos anatomopatológicos foram analisados, constatando-se a presença do padrão granulomatoso chamado granuloma micótico misto organizado, com baixa intensidade em lesões planas e alta em elevadas. Evidenciou-se que pacientes com lesões planas evoluíram bem clinicamente, com exames micológicos negativos e sem recidivas (bons respondedores), porém aqueles com lesões elevadas apresentaram evolução clínica desfavorável, com exames micológicos positivos e doença recidivante ou recalcitrante, apesar dos tratamentos recebidos (maus respondedores). E, entre os componentes histopatológicos reacionais à invasão fúngica, verificou-se associação significativa para fibrose, podendo levar a um pior prognóstico. Estes achados clínicos e histopatológicos conferem a esta patologia uma idéia de polaridade, à guisa dos fenômenos das formas polares da hanseníase, da fagocitose, e dos agentes de baixa virulência. Os autores propõem uma classificação morfológica dos granulomas da CBM em dois tipos polares: granuloma micótico misto organizado (GMMO) polar com alta intensidade dos elementos celulares (que corresponderia ao polar não tuberculóide) e GMMO polar com baixa intensidade (que corresponderia ao polar tuberculóide). / Patients with chromoblastomycosis were studied and dichotomized into two groups according to the clinical lesions: flat and elevated ones which were biopsied before and after treatments. Histopathological structures underwent through semiquantitatively analisys evidencing the mixed organized mycotic granuloma with low intensity of histopathological elements in flat lesions and high in elevated ones. Flat lesions have improved clinically with negative micological studies (good responders) while elevated lesions’ patients did not (bad responders). It was found significant association between evidence of fungus and fibrosis with a poor prognosis. Clinical and histopathological findings suggest a polarity concept to this disease based on the fenomenal polar forms of hanseniasis, fagocitosis and the low virulence agents. The authors proposed a morphological classification of the chromoblastomycosis’ granulomas into two polar types: polar mixed organized mycotic granuloma (MOMG) with high intensity of the cellular elements (like the polar non tuberculoid type) and the polar MOMG with low intensity (like the polar tuberculoid type).

Este estudo avaliou pacientes portadores de cromoblastomicose, sendo feita uma categorização clínica em dois grupos, de acordo com a forma clínica da lesão dermatológica: o primeiro composto por indivíduos com lesões elevadas e o segundo formado por casos com lesões planas, com biópsias realizadas antes e depois dos tratamentos. Através de critérios semiquantitativos, os elementos anatomopatológicos foram analisados, constatando-se a presença do padrão granulomatoso chamado granuloma micótico misto organizado, com baixa intensidade em lesões planas e alta em elevadas. Evidenciou-se que pacientes com lesões planas evoluíram bem clinicamente, com exames micológicos negativos e sem recidivas (bons respondedores), porém aqueles com lesões elevadas apresentaram evolução clínica desfavorável, com exames micológicos positivos e doença recidivante ou recalcitrante, apesar dos tratamentos recebidos (maus respondedores). E, entre os componentes histopatológicos reacionais à invasão fúngica, verificou-se associação significativa para fibrose, podendo levar a um pior prognóstico. Estes achados clínicos e histopatológicos conferem a esta patologia uma idéia de polaridade, à guisa dos fenômenos das formas polares da hanseníase, da fagocitose, e dos agentes de baixa virulência. Os autores propõem uma classificação morfológica dos granulomas da CBM em dois tipos polares: granuloma micótico misto organizado (GMMO) polar com alta intensidade dos elementos celulares (que corresponderia ao polar não tuberculóide) e GMMO polar com baixa intensidade (que corresponderia ao polar tuberculóide). / Patients with chromoblastomycosis were studied and dichotomized into two groups according to the clinical lesions: flat and elevated ones which were biopsied before and after treatments. Histopathological structures underwent through semiquantitatively analisys evidencing the mixed organized mycotic granuloma with low intensity of histopathological elements in flat lesions and high in elevated ones. Flat lesions have improved clinically with negative micological studies (good responders) while elevated lesions’ patients did not (bad responders). It was found significant association between evidence of fungus and fibrosis with a poor prognosis. Clinical and histopathological findings suggest a polarity concept to this disease based on the fenomenal polar forms of hanseniasis, fagocitosis and the low virulence agents. The authors proposed a morphological classification of the chromoblastomycosis’ granulomas into two polar types: polar mixed organized mycotic granuloma (MOMG) with high intensity of the cellular elements (like the polar non tuberculoid type) and the polar MOMG with low intensity (like the polar tuberculoid type).

Periprosthetic osteolysis remains the leading complication of total hip arthroplasty. It often results in aseptic loosening of the implant with a requirement for a revision surgery. Wear-generated particular debris is the main cause of initiating this destructive process. The most important cellular target for wear debris is a macrophage, which responds to particle challenge by activatig proinflamatory signals, which contribute to increased bone resorption. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and the expression of the osteoclastic mediator RANKL in the tissues around aseptically loosened cemented and non-cemened total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision hip replacement for aseptic loosening. We had observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have shown that RANKL is present only in the tissues with a large amount of wear debris and predominantly in the cases involving lacunar type of osteolysis. Key words:...