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Characterization of CD4+ and CD8+ T cell responses in HIV-1 C-Clade infection.Ramduth, Dhanwanthie. January 2011 (has links)
HIV-1 specific CD4+ T cell activity in clade C infected subjects has not been
studied. CD4+ T cells play a vital role in controlling infectious diseases and there
is a need to augment our knowledge of HIV immunology to aid vaccine design.
We therefore embarked on a study to characterize HIV-1 specific CD4+ T cell
activity in both adults and infants; assess the relationship between CD4+ and
CD8+ immune responses; and the relationship between CD4+ T cell activity and
markers of disease progression (viral loads and CD4 counts). Our study revealed
that the magnitude of CD8+ T cell responses correlated significantly with CD4+ T
cell responses, but that the percentage of CD8+ T cells directed against HIV-1
was always greater than that of CD4+ T cells. Gag was the frequently targeted
HIV-1 protein by CD4+ T cells and had the highest density of epitopes targeted
by CD4+ T cells. Patients with either a dominant CD4 or CD8 T cell response
against Gag had significantly lower viral loads than patients in whom non-Gag
proteins were the main target (p< 0.0001 for CD4 activity and p= 0.007 for CD8
responses). Single IFN- producing CD4+ T cells were present in significantly
higher numbers than cells producing both IFN- and IL-2 simultaneously
(p=0.009). Gag also dominated the CD4+ T cell response in acutely infected
infants with IFN- production detected more frequently than IL-2 or TNF- .
Longitudinal analysis of infants receiving early ARV treatment and then ceasing
after 12 months revealed that early treatment conferred no protection against
increasing viremia and disease progression. CD4+ T cell responses were
detected sporadically in untreated infants indicating a dysfunctional immune
response in the face of constant exposure to high levels of viremia. Taken
together, the data reveal that a vaccine inducing Gag specific CD4+ T cell
responses has the potential to confer some degree of protection, but other
immunological parameters need to be investigated especially in infants. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.
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Immune activation during HIV-1 infection : implication for B cell dysfunctions and therapy monitoring /De Milito, Angelo, January 2002 (has links)
Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.
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Novel immunomodulatory oligonucleotides for cancer therapyRayburn, Elizabeth R. January 2007 (has links) (PDF)
Thesis (Ph.D.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed on June 26, 2009). Includes bibliographical references.
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Defining how polymorphisms at the SLAM family locus affect NK and T cell functionMooney, Jill Marie. January 2006 (has links) (PDF)
Thesis (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Not embargoed. Vita. Bibliography: 181-228.
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Cross-Reactive Memory CD4<sup>+</sup> and CD8<sup>+</sup> T Cells Alter the Immune Response to Heterologous Secondary Dengue Virus Infections in Mice: A DissertationBeaumier, Coreen Michele 08 February 2008 (has links)
Dengue virus (DENV) infects 50-100 million people worldwide every year and is the causative agent of dengue fever (DF) and the more severe dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). There are four genetically and immunologically distinct DENV serotypes (DENV-1, DENV-2, DENV-3, and DENV-4). Evidence suggests that an increased risk for DHF/DSS during secondary infection with a heterologous DENV serotype is due to an immunopathological response mediated by serotype-cross-reactive memory T cells from the primary infection. Furthermore, epidemiological studies have shown that the sequence of infection with different DENV serotypes affects disease severity. Though much has been learned from human studies, there exist uncontrollable variables that are intrinsic in this system such as genetic factors and unknown infection histories. These factors can skew experimental results, making interpretations difficult. Therefore, a murine model to study the immunologic aspects of sequential dengue infections would be an asset to the field of dengue research.
To examine the effect of sequential infection with different DENV serotypes on the CD8+ T cell response, we immunized Balb/c mice with a primary DENV infection on day 0 and subsequently challenged with a heterologous secondary DENV infection on day 28. We tested all possible sequences of infection with the four serotypes. We analyzed the T cell response to two previously defined epitopes on the DENV E (Ld-restricted) and NS3 (Kd-restricted) proteins. Using ELISPOT and intracellular cytokine staining, we measured the frequency of T cells secreting IFNγ and TNFα in response to stimulation with these epitopes during three phases: acute primary, acute secondary, and the memory phase after primary infection. We found that the T cell response in heterologous secondary infections was higher in magnitude than the response in acute primary infection or during the memory phase. We also found that the hierarchy of epitope specific responses, as measured by IFNγ secretion, was influenced by the sequence of infections. The adoptive transfer of immune serum or immune splenocytes suggested that memory T cells from the primary infection responded to antigens from the secondary infection. In vitroexperiments with T cell lines generated from mice with primary and secondary DENV infections suggested the preferential expansion of crossreactive memory T cells.
In testing all of the different possible sequences of infection, we observed that two different sequences of infection (e.g., DENV-2 followed by DENV-1 versus DENV-2 followed by DENV-3) resulted in differential CD8+ T cell responses to the NS3 peptide even though both secondary infection serotypes contain the identical peptide sequence. To investigate this phenomenon, we examined the role of CD4+ T cell help on the memory CD8+ T cell response. We found that CD4+ T cell cytokine responses differ depending on the sequence of infection. In addition, it was also shown that crossreactivities of the CD4+ T cell response are also sequence-dependent. Moreover, denguespecific memory CD4+ T cells can augment the secondary CD8+ T cell response. Taken together, we demonstrated that this serotype sequence-dependent phenomenon is the result of differential help provided by cross-reactive memory CD4+T cells.
The findings in this novel mouse model support the hypothesis that both CD4+ and CD8+ serotype-cross-reactive memory T cells from a primary dengue virus infection alter the immune response during a heterologous secondary dengue virus infection. These data further elucidate potential mechanisms whereby the specific sequence of infection with different dengue virus serotypes influences disease outcomes in humans.
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Activation and Role of Memory CD8 T Cells in Heterologous Antiviral Immunity and Immunopathology in the Lung: A DissertationChen, Hong 09 December 2002 (has links)
Each individual experiences many sequential infections throughout the lifetime. An increasing body of work indicates that prior exposure to unrelated pathogens can greatly alter the disease course during a later infection. This can be a consequence of a phenomenon known as heterologous immunity. Most viruses invade the host through the mucosa of a variety of organs and tissues. Using the intranasal mucosal route of infection, the thesis focused on studying modulation of lymphocytic choriomeningitis virus (LCMV)-specific memory CD8 T cells upon respiratory vaccinia virus (VV) infection and the role of these memory CD8 T cells in heterologous immunity against VV and altered immunopathology in the lung.
The VV infection had a profound impact on memory T cells specific for LCMV. The impact included the up-regulation of CD69 expression on LCMV-specific CD8 memory T cells and the activation of their in vivoIFN-γ production and cytotoxic function. Some of these antigen-specific memory T cells selectively expanded in number, resulting in modulation of the original LCMV-specific T cell repertoire. In addition, there was a selective organ-dependent redistribution of these LCMV-specific memory T cell populations in secondary lymphoid tissue (the mediastinal lymph node and spleen) and the non-lymphoid peripheral (the lung) organs. The presence of these LCMV-specific memory T cells correlated with IFN-γ-dependent enhanced VV clearance, decreased mortality and marked changes in lung immunopathology. Thus, the participation of pre-existing memory T cells specific for unrelated agents can alter the dynamics of mucosal immunity. This is associated with an altered disease course in response to a pathogen.
The roles for T cell cross-reactivity and cytokines in the modulation of memory CD8 T cells during heterologous memory CD8 T cell-mediated immunity and immunopathology were investigated. Upon VV challenge, there were preferential expansions of several LCMV-specific memory CD8 T cell populations. This selectivity suggested that cross-reactive responses played a role in this expansion. Moreover, a VV peptide, partially homologous to LCMV NP 205, stimulated LCMV-NP205 specific CD8 T cells, suggesting that NP205 may be a cross-reactive epitope. Poly I:C treatment of LCMV-immune mice resulted in a transient increase but no repertoire alteration of LCMV-epitope-specific CD8 T cells. These T cells did not produce IFN-γ in vivo. These results imply that poly I:C, presumably through its induced cytokines, was assisting in initial recruitment of LCMV-specific memory CD8 T cells in a nonspecific manner. VV challenge of LCMV-immune IL-12KO mice resulted in activation and slightly decreased accumulation of LCMV-specific CD8 T cells. Moreover, there was a dramatic reduction of in vivoIFN-γ production by LCMV-specific IL-12KO CD8 T cells in the lung. I interpreted this to mean that IL-12 was important to augment IFN-γ production by memory CD8 T cells upon TCR engagement by antigens and to induce further accumulation of activated memory CD8 T cells during the heterologous viral infection.
This thesis also systematically examined what effect the sequence of two heterologous virus challenges had on viral clearance, early cytokine profiles and immunopathology in the lung after infecting mice immune to one virus with another unrelated viruses. Four unrelated viruses, [LCMV, VV, influenza A virus or murine cytomegalovirus (MCMV)], were used. There were many common changes observed in the acute response to VV as a consequence of prior immunity to any of three viruses, LCMV, MCMV or influenza A virus. These included the enhanced clearance of VV in the lung, associated with enhanced TH1 type responses with increased IFN-γ and suppressed pro-inflammatory responses. However, immunity to the three different viruses resulted in unique pathologies in the VV-infected lungs, but with one common feature, the substitution of lymphocytic and chronic mononuclear infiltrates for the usual acute polymorphonuclear response seen in non-immune mice. Immunity to influenza A virus appeared to influence the outcome of subsequent acute infections with any of the three viruses, VV, LCMV and MCMV. Most notably, influenza A virus-immunity protected against VV but it actually enhanced LCMV and MCMV titers. This enhanced MCMV replication was associated with enhanced TH1 type response and pro-inflammatory cytokine responses. Immunity to influenza A virus appeared to dramatically enhance the mild lymphocytic and chronic mononuclear response usually observed during acute infection with either LCMV or MCMV in non-immune mice, but LCMV infection and MCM infection of influenza A virus-immune mice each had its own unique features. Thus, the specific sequence of virus infections controls the outcome of disease.
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CD4 T Cell-Mediated Lysis and Polyclonal Activation of B Cells During Lymphocytic Choriomeningitis Virus Infection: A DissertationJellison, Evan Robert 10 January 2008 (has links)
CD4 T cells and B cells are cells associated with the adaptive immune system. The adaptive immune system is designed to mount a rapid antigen-specific response to pathogens by way of clonal expansions of T and B cells bearing discrete antigen-specific receptors. During viral infection, interactions between CD4 T cells and B cells occur in a dynamic process, where B cells that bind to the virus internalize and degrade virus particles. The B cells then present viral antigens to virus-specific CD4 T cells that activate the B cells and cause them to proliferate and differentiate into virus-specific antibody-secreting cells. Yet, non-specific hypergammaglobulinemia and the production of self-reactive antibodies occur during many viral infections, and studies have suggested that viral antigen-presenting B cells may become polyclonally activated by CD4 T cells in vivo in the absence of viral engagement of the B cell receptor. This presumed polyclonal B cell activation associated with virus infection is of great medical interest because it may be involved in the initiation of autoimmunity or contribute to the long-term maintenance of B cell memory.
In order to directly examine the interactions that occur between T cells and B cells, I asked what would happen to a polyclonal population of B cells that are presenting viral antigens, if they were transferred into virus-infected hosts. I performed these studies in mice using the well-characterized lymphocytic choriomeningitis virus (LCMV) model of infection. I found that the transferred population of antigen-presenting B cells had two fates. Some antigen-expressing B cells were killed in vivo by CD4 T cells in the first day after transfer into LCMV-infected hosts. However, B cells that survived the cytotoxicity underwent a dynamic polyclonal activation manifested by proliferation, changes in phenotype, and antibody production.
The specific elimination of antigen-presenting B cells following adoptive transfer into LCMV-infected hosts is the first evidence that MHC class II-restricted killing can occur in vivo during viral infection. This killing was specific, because only cells expressing specific viral peptides were eliminated, and they were only eliminated in LCMV-infected mice. In addition to peptide specificity, killing was restricted to MHC class II high cells that expressed the B cell markers B220 and CD19. Mice depleted of CD4 T cells prior to adoptive transfer did not eliminate virus-specific targets, suggesting that CD4 T cells are required for this killing. I found that CD4 T cell-dependent cytotoxicity cannot be solely explained by one mechanism, but Fas-FasL interactions and perforin are mechanisms used to induce lysis.
Polyclonal B cell activation, hypothesized to be the cause of virus-induced hypergammaglobulinemia, has never been formally described in vivo. Based on previous studies of virus-induced hypergammaglobulinemia, which showed that CD4 T cells were required and that hypergammaglobulinemia was more likely to occur when virus grows to high titer in vivo, it was proposed that the B cells responsible for hypergammaglobulinemia may be expressing viral antigens to virus-specific CD4 T cells in vivo. CD4 T cells would then activate the B cells. However, because the antibodies produced during hypergammaglobulinemia are predominantly not virus-specific, nonvirus-specific B cells must be presenting viral antigens in vivo.
In my studies, the adoptively transferred B cells that survived the MHC class II-restricted cytotoxicity became polyclonally activated in LCMV-infected mice. Most of the surviving naïve B cells presenting class II MHC peptides underwent an extensive differentiation process involving both proliferation and secretion of antibodies. Both events required CD4 cells and CD40/CD40L interactions to occur but B cell division did not require MyD88-dependent signaling, type I interferon signaling, or interferon γ signaling within B cells. No division or activation of B cells was detected at all in virus-infected hosts in the absence of cognate CD4 T cells and class II antigen. B cells taken from immunologically tolerant donor LCMV carrier mice with high LCMV antigen load became activated following adoptive transfer into LCMV-infected hosts, suggesting that B cells can present sufficient antigen for this process during a viral infection. A transgenic population of B cells presenting viral antigens was also stimulated to undergo polyclonal activation in LCMV-infected mice. Due to the high proportion of B cells stimulated by virus infection and the fact that transgenic B cells can be activated in this manner, I conclude that virus-induced polyclonal B cell activation is independent of B cell receptor specificity. This approach, therefore, formally demonstrates and quantifies a virus-induced polyclonal proliferation and differentiation of B cells which can occur in a B cell receptor-independent manner.
By examining the fate of antigen-presenting B cells following adoptive transfer into LCMV-infected mice, I have been able to observe dynamic interactions between virus-specific CD4 T cells and B cells during viral infection. Adoptive transfer of antigen-presenting B cells results in CD4 T cell-mediated killing and polyclonal activation of B cells during LCMV infection. Studies showing requirements for CD4 T cells or MHC class II to control viral infections must now take MHC class II-restricted cytotoxicity into account. Polyclonal B cell activation after viral infection has the potential to enhance the maintenance of B cell memory or lead to the onset of autoimmune disease.
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Avaliação da citotoxicidade de materiais obturadores de canais radiculares: influência na liberação de fator de necrose tumoral alfa, interferon-y e óxido nítrico em cultura de células murinasRivas Gutiérrez, José Carlos [UNESP] 19 December 2006 (has links) (PDF)
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rivasgutierrez_jc_dr_arafo.pdf: 816322 bytes, checksum: ec255883d6c0c6ef8ebbe4d64cd79b98 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / Os macrófagos constituem uma população celular do sistema imune. Estas células podem ser ativadas por uma variedade de estímulos e suas principais funções incluem a fagocitose de partículas estranhas, apresentação de antígenos, produção de citocinas e compostos intermediários do nitrogênio (NO) e do oxigênio (H202). Os cimentos endodônticos são capazes de promover uma estimulação do sistema imune. Neste estudo, foram analisados os níveis de quantificação das citocinas, além do mediador óxido nítrico, como uma medida de estimulação de macrófagos peritoneais de camundongos. Através de análise estatística dos dados, foram observados os níveis de citotoxicidade dos macrófagos de camundongos estimulados pelos diferentes cimentos endodônticos, meio RPMI-1640 (grupo controle -) e LPS (grupo controle +). Os diferentes cimentos testados apresentaram concentrações com diferentes citotoxicidades: Sealapex 35ug/ml, Polímero de Mamona 8,75 ug/ml, do Epiphany 17,5 ug/ml, do Epiphany + Primer 17,5 ug/ml, do Primer 35 ug/ml, do EndoRez 17,5 ug/ml e do AH Plus 70 ug/ml. Após a adequação das concentrações viáveis dos cimentos testados conclui-se que o material que mais estimulou a liberação de NO foi Primer, seguido do Endorez, AH Plus, Ephiphany, Sealapex, Epiphany + Primer. O Polímero de Mamona foi o que estimulou a uma menor produção de NO. Em relação à produção de TNF-alfa o material que estimulou maior produção foi o Primer, seguido de Epiphany, AH Plus, Epiphany + Primer, Sealapex e Polímero de Mamona. O EndoRez não foi capaz de estimular a produção de TNF-alfa. Nenhum dos cimentos testados induziu à liberação de IFN-y, sugerindo que outro mediadores tais como IL-1 e IL-12 possam estar envolvidos na liberação de NO observada no presente estudo. / It was evaluated the citotoxicity of the sealers, Sealapex, Polímero de Mamona, Epiphany, EndoRez and AH Plus in relation to the release of Nitric Oxide, Tumor Necrotic Factor-Alpha and Interferon Gamma in murine cells culture. After the ideal concentration was found, according to MTT test, it was conduded that the sealers with higher release were Polímero de Mamona, EndoRez, Epiphany + Primer, Epiphany, Primer do Epiphany = Sealapex and AH Plus. All sealers reached lower levels of citotoxicity than control.
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Expressão gênica de FOXP3, indoleamina 2,3 dioxigenase, IL10 e CSF1 em útero de vacas que receberam infusão intrauterina de antígenos maternos e paternos no período peri-ovulatórioJunqueira, Talita Vieta 05 October 2015 (has links)
In cattles, most of pregnancy losses occurs at the beginning of gestation, notably from
the 7th to the 16th day of the cycle, a period in which, the embryo depends entirely on the
uterine environment to survive and to start their preimplantation growth. During this period,
the embryonic death after embryo transfers performed in vitro (TE-IVP) or in vivo (TE-OM)
is on average nearly twice as high as that produced by natural mating or artificial insemination
(AI). The recipient sensitization against the paternal and maternal MHC molecules of
allogeneic embryo might be one of the causes of high rates of pregnancy loss observed after
TE. Studies in humans and in various species have pointed that the sensitization with
conceptus antigens may affect the reproductive performance facilitating the recognition and
the maternal acceptance of allogeneic embryo through induction of cytokyne and
immunoregulatory cells in the the uterine microenvironment. The purpose of this study is to
determine whether simultaneous or separate administration of paternal and maternal antigens
in the uterus of the cows embryo recipientes, during the estrus, increases the expression of
genes which can facilitate recognition and development of allogeneic embryos during early
pregnancy. Forty-five crossbed cows were evaluated. The animals were divided in four
treatments: T0: control; T1: Semen; T2: PBMCs and T3: PBMCs+Semen. The cows were
estrus synchronized and received antigens in the uterine body on the estrus day. Uterine
biopsies were collected in vivo on D0 for control, and after seven (D7) and fourteen (D14)
days after the estrus and administration of antigens in order to evaluate the treatment effect on
the uterine environment of the receiving at the moment of the anovoluation procedure would
occur in TE-IVP, and during the period in which the bovine embryo would have their
preimplantation growth, respectively. The gene expression was evaluated in real time PCR,
and then transcribed from FOXP3, IDO, IL-10 and CSF-1 were detected in all RNA samples
extracted from uterine biopsies. Semiquantitative analyses of relative gene expression among
the control and the treat groups demonstrated that none of the treatments significantly
incresed those gene expressions. Furthermore, at D14 all the treatments leaded to a decline in
amount CSF-1 transcripts and, further, treatment with both antigens also to a drop in the
abundance of IL-10 transcripts. In conclusion, the isolated or simultaneous antigens
admnistration in the in the uterus of IVP embryo recipient cows seems not to increase the
maternal tolerance to alloantigens embryo nor benefit conditions for their growth and
preimplantation development, at least with regard to the effect mediated by FOXP3, IDO, IL-
10 and CSF-1 on D7 and D14 in the estrous cycle. / A maioria das perdas gestacionais em bovinos acontece no início da gestação,
particularmente entre os dias 7 e 16, período no qual o embrião é totalmente dependente do
ambiente uterino para sobreviver e iniciar seu crescimento pré-implantação. Durante esse
período, a mortalidade embrionária após transferência de embriões produzidos in vitro (TEPIV)
ou in vivo (TE-OM) é em média quase duas vezes mais elevada do que aquela derivada
de embriões originados de monta natural ou inseminação artificial (IA). A sensibilização da
receptora contra as moléculas MHC paternas e maternas do embrião alogênico pode ser uma
das causas das altas taxas de perdas gestacionais observadas após TE. Estudos realizados em
humanos e em várias espécies têm demonstrado que a sensibilização com antígenos do
concepto pode ser uma maneira útil de afetar o desempenho reprodutivo facilitando o
reconhecimento e a aceitação materna do embrião alogênico através da indução de citocinas e
células imunorregulatórias no microambiente uterino. Nesse sentido, o presente estudo teve
como foco principal determinar se a administração simultânea ou isolada de antígenos paterno
e materno no útero de fêmeas bovinas receptoras de embrião PIV, no dia do estro, aumenta a
expressão de genes que podem facilitar o reconhecimento e desenvolvimento do embrião
alogênico durante o início da gestação. Para isto, foram utilizadas 45 vacas cruzadas divididas
em 4 tratamentos: T0: controle; T1: Sêmen; T2: PBMCs e T3: PBMCs+Sêmen. As fêmeas
bovinas foram sincronizadas ao estro e receberam os antígenos no corpo uterino no dia do cio
(D0). Biópsias uterinas foram coletadas in vivo no D0, para controle, e 7 (D7) e 14 (D14) dias
após o cio e a administração dos antígenos, para avaliar o efeito do tratamento no ambiente
uterino da receptora no momento em que ocorreria o procedimento de anovulação em TE-PIV
e durante o período no qual o embrião bovino já teria iniciado seu crescimento préimplantação,
respectivamente. A expressão gênica foi avaliada por PCR em tempo real e
transcritos de FOXP3, IDO, IL-10 e CSF-1 foram detectados em todas as amostras de RNA
extraídas das biópsias uterinas. A análise semiquantitativa da expressão gênica relativa entre
os grupos controle e tratado mostrou que nenhum dos tratamentos promoveu aumento
significativo na expressão desses genes. Além disso, no D14 todos os tratamentos
promoveram uma queda na quantidade de transcritos de CSF-1 e, ainda, o tratamento com
ambos os antígenos também promoveu uma queda na abundância de transcritos de IL-10. Em
conclusão, a administração isolada ou simultânea de ambos os antígenos no útero de vacas
receptoras de embrião PIV parece não propiciar aumento da tolerância materna aos
aloantígenos do embrião nem condições favoráveis a seu crescimento e desenvolvimento préimplantação,
pelo menos no que se refere ao efeito mediado por FOXP3, IDO, IL-10 e CSF-1
no D7 e D14 do ciclo estral. / Mestre em Biologia Celular e Estrutural Aplicadas
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Comparação entre testes químico (o-toluidina) e imunoquímico de pesquisa de sangue oculto nas fezes e correlação com os achados colonoscópicos / Comparison between chemical (toluidine) and immunochemical faecal occult blood tests and correlation with the colonoscopic findingsLuana Vilarinho Borges 24 April 2013 (has links)
Introdução: O sangramento colorretal é considerado um sinal de alarme e não deve ser ignorado. A perda de sangue pode não ser identificada pelo paciente, o que caracteriza a presença de sangue oculto. Este diagnóstico pode ser confirmado por testes de Pesquisa de Sangue Oculto nas Fezes (PSOF), através de métodos químicos ou imunoquímicos de identificação da hemoglobina. O resultado positivo de um teste de PSOF requer investigação complementar com colonoscopia, exame invasivo, de alto custo e que exige preparo intestinal. Justifica-se, portanto, a aplicação de um teste diagnóstico mais sensível e específico. No presente estudo, foram avaliados quatro diferentes testes de PSOF em 176 pacientes submetidos à colonoscopia e seus resultados foram comparados. Objetivos: 1) avaliar o grau de concordância entre os testes de PSOF e a colonoscopia. 2) avaliar a sensibilidade, a especificidade e os valores de predição dos testes químico e imunoquímico de PSOF, em pacientes submetidos à colonoscopia. Métodos: Pacientes com indicação de realizar colonoscopia foram submetidos também à PSOF pelo método químico (o-toluidina) e pelo método imunoquímico, empregando três kits comerciais disponíveis no mercado. Os pacientes foram avaliados quanto à indicação do exame colonoscópico, resultado da colonoscopia e uso de alimentos e medicamentos que pudessem interferir no resultado dos testes fecais. Fundamentado nos achados endoscópicos, a colonoscopia foi categorizada em positiva ou negativa, de acordo com a possível fonte de sangramento colorretal. O grau de concordância entre os testes de PSOF foi avaliado pelo índice Kappa. Resultados: Dos 176 pacientes, houve predomínio do sexo feminino (64,8%), com média de idade de 55,5 anos. As indicações clínicas mais frequentes para realização de colonoscopia foram alteração do hábito intestinal, doença inflamatória intestinal, dor abdominal e anemia. Os principais achados foram pólipos < 1 cm, doença diverticular não complicada do cólon e exame normal. Quarenta e quatro (25%) colonoscopias foram categorizadas como positivas quanto à fonte de sangramento colorretal. Observou-se concordância (p<0,05) entre todos os testes avaliados e a colonoscopia. O teste da o-toluidina apresentou concordância pobre (Kappa 0,03), enquanto os demais testes apresentaram concordância moderada (Kappa entre 0,43-0,48). O teste da o-toluidina revelou menor sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo em comparação aos testes imunoquímicos. Conclusões: Os testes imunoquímicos apresentaram melhores índices de concordância com a colonoscopia, quando comparados ao teste da o-toluidina. Os testes imunoquímicos revelaram maior sensibilidade, especificidade e valores de predição na detecção de sangramento colorretal / Introduction: Colorectal bleeding is considered an alarm sign and should not be ignored. Blood loss can not be identified by the patient, which characterizes the presence of occult blood. This diagnosis can be confirmed by Faecal Occult Blood Testing (FOBT), through chemical or immunochemical methods. The positive outcome of a test requires complementary research FOBT with colonoscopy, an examination of invasive, costly and requires bowel preparation. It is justifiable, therefore, the application of diagnostic tests with better sensitivity and specificity. In the present study, we evaluated four different tests of PSOF in 176 patients undergoing colonoscopy and their results were compared. Objectives: 1) evaluate the degree of concordance between the PSOF tests and colonoscopy 2) assess the sensitivity, the specificity and the prediction values of the chemical and immunochemical FOBTs, in patients undergoing colonoscopy. Methods: Patients with indication of perform colonoscopy were subjected also to FOBT by the chemical method (toluidine test) and by the immunochemical method employing three commercial kits available in the market. Patients were evaluated regarding the indication of the colonoscopic examination, colonoscopy result, and use of foods and drugs that could interfere in the results of the faecal tests. Based on the endoscopic findings, the colonoscopy was rated as positive or negative, according to the possible colorectal bleeding source. The degree of accordance between FOBTs was evaluated by the Kappa index. Results: Among the 176 patients, there was a predominance of female gender (64.8%) with an average age of 55.5 years old. The most frequent clinical indication for colonoscopy were bowel habit changes, inflammatory bowel disease, abdominal pain and anemia. The main findings of colonoscopy were polyps <1 cm, uncomplicated colonic diverticular disease and normal exam. Forty-four (25%) colonoscopies were categorized as positive as to the possible source of colorectal bleeding. There was agreement (p<0.05) between all tests evaluated and the colonoscopy. The toluidine test presented poor accordance (Kappa 0.03), while the others showed moderate concordance (Kappa 0.43-0.48). The toluidine test showed less sensitivity, specificity, positive predictive value and negative predictive value compared to immunochemical tests. Conclusions: Immunochemical tests showed the best indexes of agreement with colonoscopy, when compared to the toluidine test. The immunochemical tests have shown greater sensitivity, specificity and predictive values in detecting colorectal bleeding
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