INTRODUÇÃO E OBJETIVOS: A a-Glutathiona-S-transferase (aGST) vem sendo proposta como um marcador sensível e não-invasivo de lesão hepática em pacientes com Hepatite pelo vírus C. Avaliamos neste trabalho como a (aGST) se correlaciona com características bioquímicas e histológicas em pacientes com HCV. MATERIAL E MÉTODOS: Realizamos a determinação da concentração plasmática das aGST, alanina aminotransferase (ALT), aspartato aminotransferase (AST) e gama-glutamyltransferase (gGT) em 114 pacientes com HCV, dos quais 97 foram submetidos à biópsia hepática em até 6 meses da realização dos testes bioquímicos. Avaliamos também os níveis de aGST em 66 doadores de sangue sadios, que serviram como controles. Comparamos os níveis de aGST com as demais provas bioquímicas e a histologia hepática. RESULTADOS: A aGST estava elevada em 85.96% dos pacientes com HCV e mostrou associação com a elevação das aminotransferases (p<0.01). O valor de 4mg/dL mostrou as melhores sensibilidade (85,96%) e especificidade (92,42%) para determinar a normalidade do teste aGST. aGST ³ 8mg/dL mostrou a melhor especificidade para determinar lesão histológica hepática mais agressiva e o melhor valor preditivo positivo e razão de verossimilhança positiva para inflamação portal e atividade parenquimatosa mais agressiva nos pacientes com HCV. CONCLUSÕES: A aGST está relacionada à lesão hepática na infecção pelo HCV (valor de corte = 4mg/dL) e lesões histológicas hepáticas mais agressivas (valor de corte = 8mg/dL). Neste contexto, a aGST poderia ser utilizada em pacientes com Hepatite pelo HCV com ALT elevada, como um indicador complementar de lesão histopatológica mais agressiva. Entretanto, seu valor preditivo positivo não é suficientemente elevado para evitar a necessidade de realizar a biópsia hepática, mesmo quando está acima de 8mg/dL. / BACKGROUND/AIMS: a-Glutathione-S-transferase (aGST) has been proposed as a sensitive non-invasive indicator of hepatocellular injury due to Hepatitis C virus (HCV) infection. In this work, we evaluate how alpha-GST concentration correlates with biochemical and histological features in HCV patients. METHODS: We assayed plasma aGST, alanine aminotransferase (ALT), spartate aminotransferase (AST) and gama-glutamyl-transferase (gGT) in 114 HCV+ patients, among whom liver biopsy was performed in 97, within 6 months of the biochemical evaluation. We also assessed aGST levels in 66 health blood donors, aimed to serve as control. We compared aGST levels with other biochemical tests and liver histology. RESULTS: In 85.96% of HCV patients aGST was elevated and showed association with serum aminotransferases (p<0.01). The value of 4mg/dL (or lower) showed the best sensitivity (85.96%) and specificity (92.42%) to determine normality on the aGST test. aGST levels 8mg/dL and higher showed the best specificity to determine the presence of more aggressive liver histological damage among HCV patients and the best predictive positive value and positive likelihood for more aggressive portal inflammation and lobular activity. CONCLUSION: aGST is related to HCV infection (cut-off = 4mg/dL) and more aggressive liver histological damage (cut-off = 8mg/dL). In this sense, aGST could be used in HCV patients with altered ALT levels as an indicator of more aggressive hystopathological damage. However, its positive predictive value (PPV) is not high enough to preclude the decision of performing hepatic biopsy, even when it is above 8mg/dL.

A importância em conhecer o padrão alimentar em mosquitos da Família Culicidae permite esclarecer alguns aspectos relacionados à transmissão de zoonoses e estimar o grau de contato humano-vetor que é fator relevante em estudos epidemiológicos. Com o objetivo de explorar o comportamento alimentar dessa Família, em área epizoótica de febre amarela silvestre, foram coletados exemplares nos municípios de Santo Antônio das Missões e Garruchos, Estado do Rio Grande do Sul. Fêmeas ingurgitadas foram obtidas por aspiração em ambiente de mata, no período de setembro de 2005 a abril de 2007 e identificadas segundo fonte de sangue ingerido através da técnica imunoenzimática ELISA de captura no sistema avidinabiotina. Foram testadas seis fontes de alimento: ave, bovino, eqüino, humano, macaco e rato. Os resultados obtidos mediante a padronização de anticorpos monoclonais possibilitaram demonstrar pela primeira vez o reconhecimento de sangue humano ingerido nesses mosquitos pelo emprego da subclasse IgG1 e comprovar a sensibilidade e especificidade da técnica ELISA de captura. No município de Santo Antônio das Missões, de um total de 190 amostras, 60,9% reagiram para sangue de boi, 23,6% para humano, 9,9% para ave, 1,9% para macaco e 3,7% para combinações de dois hospedeiros. Quanto às amostras referentes ao município de Garruchos, das 158 fêmeas capturadas na área Cachoeirinha pode-se observar reatividade para ave (16%), boi (29,6%), humano (36,8%), cavalo (4%), macaco (0,8%) e combinações de hospedeiros (12,8%), enquanto que para as 149 fêmeas pertencentes à área de São José, detectou-se sangue ingerido de boi em (51,5%), ave e humano (11,5%), macaco (6,2%), cavalo (0,8%) e mistos (18,5%). Aedes scapularis, Aedes crinifer, Culex (Culex) spp., Haemagogus leucocelaenus apresentaram maior número de fêmeas ingurgitadas nos dois municípios. Os resultados obtidos com Aedes scapularis sugerem ecletismo, conforme combinações detectadas em amostras de sangue de diferentes fontes. Haemagogus leucocelaenus apresentou a maior proporção de amostras contendo sangue humano em relação às demais fontes e essa característica traz implicações, por ser espécie incriminada na transmissão e por se tratar de área de ocorrência de epizootias de febre amarela. / The knowledge of mosquitoes Culicidae host feeding patterns permits to clarify some aspects related to zoonosis transmission and to estimate the degree of human-vector contact which is relevant in epidemiological studies. Aiming to explore the feeding behavior of these mosquitoes, specimens were collected in the municipalities of Santo Antônio das Missões and Garruchos, Rio Grande do Sul, an epizootic area of sylvatic yellow fever. Engorged females were collected by aspiration from forested areas from September 2005-April 2007 and their blood meals were identified using the avidin-biotin system of immunoenzymatic ELISA capture. Six blood meal sources were tested: bird, cattle, horse, human, monkey and rat. The result achieved with the species-specific IgG1 mAb was unprecedented for mosquito blood meal identification and reinforced the sensibility and specificity of the immunoenzymatic ELISA capture. Of the 190 samples from Santo Antônio das Missões, 60.9% reacted to cattle, 23.6% to human, 9.9% to bird, 1.9% to monkey and 3.7% to mixed blood meals. In Garruchos, of the 158 females collected in Cachoeirinha, 16.0% reacted to bird, 29.6% to cattle, 36.8% to human, 4.0% to horse, 0.8% to monkey and 12.8% to mixed blood, while of the 149 engorged females from São José, blood from cattle accounted for 51.5%, of blood identified, bird and human 11.5%, monkey 6.2%, horse 0.8% and mixed blood 18.5%. Blood engorged females of Aedes scapularis, Aedes crinifer, Culex (Culex) spp., Haemagogus leucocelaenus predominated in the two municipalities. The results obtained with Aedes scapularis suggests its eclecticism, according to the combinations of blood which were detected from different sources. Haemagogus leucocelaenus was found to have the highest proportion of samples containing human blood in comparison with other sources, which has implications, on account of being incriminated in the transmission and also for taking into consideration the outbreaks reported that underline the risk of yellow fever.

INTRODUÇÃO E OBJETIVOS: A a-Glutathiona-S-transferase (aGST) vem sendo proposta como um marcador sensível e não-invasivo de lesão hepática em pacientes com Hepatite pelo vírus C. Avaliamos neste trabalho como a (aGST) se correlaciona com características bioquímicas e histológicas em pacientes com HCV. MATERIAL E MÉTODOS: Realizamos a determinação da concentração plasmática das aGST, alanina aminotransferase (ALT), aspartato aminotransferase (AST) e gama-glutamyltransferase (gGT) em 114 pacientes com HCV, dos quais 97 foram submetidos à biópsia hepática em até 6 meses da realização dos testes bioquímicos. Avaliamos também os níveis de aGST em 66 doadores de sangue sadios, que serviram como controles. Comparamos os níveis de aGST com as demais provas bioquímicas e a histologia hepática. RESULTADOS: A aGST estava elevada em 85.96% dos pacientes com HCV e mostrou associação com a elevação das aminotransferases (p<0.01). O valor de 4mg/dL mostrou as melhores sensibilidade (85,96%) e especificidade (92,42%) para determinar a normalidade do teste aGST. aGST ³ 8mg/dL mostrou a melhor especificidade para determinar lesão histológica hepática mais agressiva e o melhor valor preditivo positivo e razão de verossimilhança positiva para inflamação portal e atividade parenquimatosa mais agressiva nos pacientes com HCV. CONCLUSÕES: A aGST está relacionada à lesão hepática na infecção pelo HCV (valor de corte = 4mg/dL) e lesões histológicas hepáticas mais agressivas (valor de corte = 8mg/dL). Neste contexto, a aGST poderia ser utilizada em pacientes com Hepatite pelo HCV com ALT elevada, como um indicador complementar de lesão histopatológica mais agressiva. Entretanto, seu valor preditivo positivo não é suficientemente elevado para evitar a necessidade de realizar a biópsia hepática, mesmo quando está acima de 8mg/dL. / BACKGROUND/AIMS: a-Glutathione-S-transferase (aGST) has been proposed as a sensitive non-invasive indicator of hepatocellular injury due to Hepatitis C virus (HCV) infection. In this work, we evaluate how alpha-GST concentration correlates with biochemical and histological features in HCV patients. METHODS: We assayed plasma aGST, alanine aminotransferase (ALT), spartate aminotransferase (AST) and gama-glutamyl-transferase (gGT) in 114 HCV+ patients, among whom liver biopsy was performed in 97, within 6 months of the biochemical evaluation. We also assessed aGST levels in 66 health blood donors, aimed to serve as control. We compared aGST levels with other biochemical tests and liver histology. RESULTS: In 85.96% of HCV patients aGST was elevated and showed association with serum aminotransferases (p<0.01). The value of 4mg/dL (or lower) showed the best sensitivity (85.96%) and specificity (92.42%) to determine normality on the aGST test. aGST levels 8mg/dL and higher showed the best specificity to determine the presence of more aggressive liver histological damage among HCV patients and the best predictive positive value and positive likelihood for more aggressive portal inflammation and lobular activity. CONCLUSION: aGST is related to HCV infection (cut-off = 4mg/dL) and more aggressive liver histological damage (cut-off = 8mg/dL). In this sense, aGST could be used in HCV patients with altered ALT levels as an indicator of more aggressive hystopathological damage. However, its positive predictive value (PPV) is not high enough to preclude the decision of performing hepatic biopsy, even when it is above 8mg/dL.

My dissertation hypothesis is that bovine trophoblast cells express cell-surface and secreted non-classical major histocompatibility complex class I (MHC-Ib) proteins which inhibit NK cells and other leukocytes by binding to inhibitory receptors (e.g., LILRB1, LILRB2, KIR2DL4, and/or CD94/NKG2A). Extremely polymorphic and ubiquitously expressed classical MHC class I (MHC-Ia) proteins, which present foreign antigenic peptides to CD8+ T lymphocytes, are involved in acceptance or rejection of tissue grafts. Non-classical MHC class I (MHC-Ib) glycoproteins, such as Human Leukocyte Antigen-G (HLA-G) and murine Qa-2, are important modulators of the maternal immune system during pregnancy. MHC-Ib proteins are: (a) oligomorphic or monomorphic, (b) expressed in specific tissues under specific condtions, and (c) produced as surface and/or soluble isoforms due to alternative splicing. Third trimester-bovine trophoblast cells express both MHC-Ia and MHC-Ib proteins. The MHC-Ib proteins expressed by trophoblast cells during the third trimester of pregnancy are encoded by four bovine leukocyte antigen (BoLA) loci: BoLA-NC1, BoLA-NC2, BoLA-NC3, and BoLA-NC4. Two MHC-Ia (N*01701 and N*01802) and three MHC-Ib (NC1*00501, NC3*00101 and NC4*00201) proteins showed cell-surface expression in transfection studies performed in murine P815 and human K562 cells. Two additional isoforms, NC1*00401 and NC2*00102, were not detected on the surface of these cells. Nevertheless, both class Ia proteins, N*01701 and N*01802, and five class Ib proteins, NC1*00401, NC1*00501, NC2*00102, NC3*00101, and NC4*00201, were detected in crude cell lysates on Western blots. Precipitation of proteins from culture supernatants showed that cell-surface MHC-Ia (N*01701 and N*01802) and MHC-Ib proteins (NC1*00501, NC3*00101, and NC4*00201) are shed from the surface of these cells into the media. The mechanism of shedding of these proteins is, however, not known. Monoclonal antibodies W6/32, IL-A88, H1A, H6A, H11A, H58A, and PT-85A recognized surface MHC-I isoforms with varying affinity. We were able to develop a sandwich enzyme-linked immunosorbent assay (ELISA) using either H1A or IL-A88 antibody as the capture antibody and the W6/32 antibody for detection. We produced monoclonal antibodies against cattle NC1*00501 and NC3*00101 proteins. One monoclonal antibody generated against BoLA-NC3*00101 was highly specific. Unfortunately, due to failure to clone the NC3*00101- hybridoma, we no longer have an infinite source of this monoclonal antibody for NC3*00101. We eluted peptides from NC3*00101-transfected MHC-null K562 cells and identified peptides using liquid chromatography-mass spectrum (LC-MS) analysis. Analysis of peptide binding data using the SAS Proc mixed statistical program, suggested that the peptide EVTNQLVVL is a potential peptide ligand, which can be used to make tetramers for enumeration of antigen-specific leukocytes.

Försämrat immunförsvar och ökad risk att drabbas av bakterie- och virusinfektioner förekommer hos patienter med blodsjukdomarna multipelt myelom, Waldenströms makroglobulinemi samt hos vissa patienter med blodsjukdomen monoklonal gammopati av oklar signifikans. Infektionerna kräver ofta antibiotikabehandling och behandling med antivirala medel. I dagsläget är det svårt att förutsäga vilka av patienterna som kommer att drabbas av svåra och ibland livshotande infektioner. Därför ges många av patienterna förebyggande antibiotikabehandling. I studiens början sattes en enzyme-linked immunosorbent assay (ELISA) för detektion av antikroppar mot Moraxella catarrhalis upp. I studien undersöktes om antikroppstitrar i serum mot bakterien Moraxella catarrhalis var lägre hos patientgrupperna än hos friska kontrollpersoner i samma ålder och om variationer förekom mellan patientgrupperna samt hur kontrollgrupper i olika åldrar skiljde sig från varandra. Kontrollgrupperna som undersöktes var mellan 20-40 år, 40-60 år samt 60 år och äldre. Resultatet var att patienterna med multipelt myelom hade lägst antikroppstitrar, patienter med monoklonal gammopati av oklar signifikans hade något högre och patienter med Waldenströms makroglobulinemi hade ännu högre antikroppstitrar. Kontrollgruppen äldre än 60 år hade högre antikroppstitrar än både kontrollgruppen 20-40 år och 40-60 år. Lägst antikroppstitrar hade kontrollgrupp 40-60 år men ingen signifikant skillnad påvisades mellan kontrollgrupp 20-40 år och 40-60 år.

<p>More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has&nbsp / been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term&nbsp / delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in&nbsp / Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother&rsquo / s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were&nbsp / collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of&nbsp / periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association&nbsp / between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant&nbsp / associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM&nbsp / against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to&nbsp / PLBW. </p>

<p>More than 20 million infants in the world (15.5 % of all births) are born with low birth weight. Ninety-five % of them are in developing countries. Oral colonization of Gramnegative anaerobes has&nbsp / been implicated as a risk factor for preterm delivery of low birth weight (PLBW) infants. The objective of this study was to investigate the association between periodontal pathogens and pre-term&nbsp / delivery of low birth weight (PLBW) infants. The study sample included 200 randomly selected women admitted to the department of obstetrics-gynecology of the teaching hospital of Butare in&nbsp / Rwanda. Mothers were asked to complete a questionnaire in order to identify factors which might pose a health risk to them and their infants. Gingival crevicular fluid (GCF) was collected from each quadrant of the mother&rsquo / s month (using paper points) within 24 hours of delivery. Ten ml of foetal cord serum samples were collected at delivery and 10 ml of maternal serum samples were&nbsp / collected within 48 of delivery. GCF was examined by PCR for the presence of 5 periodontopathogens and ELISA was used for the evaluation of cytokines (IL-6 and IL-10) and immunoglobulins (IgM, IgG) in foetal cord and maternal blood against the periodontopathogens. P. intermedia showed significant associations either on its own or in combinations with most indicators of&nbsp / periodontal disease used in this study, while Aa and members of the red complex were significantly associated with gum bleeding and reduced frequency of tooth brushing. A strong association&nbsp / between PLBW and maternal and foetal cord serum sample levels of IL-10 was observed. Also, a good association was observed between PLBW and FCB sample levels of IL-6. Significant&nbsp / associations were observed between PLBW and maternal IgG against the different peridontopathogens. The findings of this study may suggest that the levels of maternal IgG and foetal IgM&nbsp / against the different periodontopathogens are associated with dissemination of maternal periodontopathogens to the foetus thereby illiciting an inflammatory response which contributes to&nbsp / PLBW. </p>

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Washington, 2008. / Vita. Includes bibliographical references (leaves 298-310).

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, 2007. / Bibliyografya var.