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Marcadores nutricionais e inflamat?rios e sua associa??o com a morbimortalidade em hemodi?liseOliveira, Claudia Maria Costa de 10 December 2010 (has links)
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Previous issue date: 2010-12-10 / Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality.
Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months.
Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later.
Results: Patients were aged 52.2 ? 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ? 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson?s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk.
Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six
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months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients / Introdu??o: A desnutri??o proteico-cal?rica, o processo inflamat?rio sist?mico e as comorbidades s?o freq?entes em pacientes com insufici?ncia renal cr?nica em terapia dial?tica, contribuindo para a sua morbimortalidade.
Objetivo: Avaliar a correla??o entre par?metros nutricionais (antropom?tricos, laboratoriais e da bioimped?ncia el?trica - BIA) e inflamat?rios e a morbimortalidade de pacientes em hemodi?lise, bem como o impacto de suas altera??es ap?s 6 meses da avalia??o inicial.
Material e M?todos: Uma coorte de 143 pacientes de um ?nico centro de hemodi?lise em Fortaleza-Cear?-Brasil foi avaliada ao longo de 18 meses, sendo inclu?dos pacientes com mais de 3 meses de di?lise, idade superior a 18 anos e sem amputa??o de membros. Os pacientes foram submetidos ? avalia??o cl?nica do estado nutricional (avalia??o subjetiva global), antropom?trica (?ndice de massa corporal [IMC], percentual de peso ideal, circunfer?ncia do bra?o, circunfer?ncia muscular do bra?o, ?rea muscular do bra?o, prega cut?nea tricipital e percentual de massa gorda), laboratorial (albumina, creatinina e contagem de linf?citos como marcadores nutricionais e Prote?na C reativa, IL-6 e TNF-alfa como marcadores de inflama??o) e BIA (react?ncia, ?ngulo de fase e percentual de massa celular corporal) no in?cio do estudo e ap?s 3, 6 e 12 meses de seguimento. Foi pesquisada a associa??o entre as vari?veis do estudo e os ?bitos e as hospitaliza??es em 6 e 12 meses. As vari?veis com signific?ncia < 10% na an?lise bivariada foram inclu?das em um modelo multivariado de regress?o log?stica, que foi ajustado para idade, sexo, tempo em di?lise, classe s?cio-econ?mica (CSE) e ?ndice de comorbidade de Charlson (CCI), para identificar os fatores associados ? morbimortalidade. Foi ainda pesquisada a associa??o entre a altera??o das vari?veis entre a avalia??o inicial e a avalia??o ap?s 6 meses e os ?bitos e as hospitaliza??es nos 12 meses subseq?entes.
Resultados: 58% dos pacientes eram do sexo masculino, com idade m?dia de 52,2 ? 16,6 anos e tempo m?dio em di?lise de 5,27 ? 5,12 anos. A preval?ncia de desnutri??o variou entre 7,7 a 63,6%, de acordo com o marcador nutricional. As vari?veis associadas ? morbimortalidade foram: ?bito em 6 meses: creatinina ≤ 9,45 mg/dl, ?ngulo de fase ≤ 4,57 graus, CCI ≥ 4 e CSE ≤ 7; ?bito
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em 12 meses: idade ≤ 64,9 anos, react?ncia ≤ 51,7 ohms e CSE ≤ 7; hospitaliza??o em 6 meses: ?ngulo de fase ≤ 4,57 graus; hospitaliza??o em 12 meses: IMC ≤ 23,0 kg/m2, ?ngulo de fase ≤ 4,57 graus e CCI ≥ 4. O percentual de altera??o dos marcadores nutricionais e inflamat?rios em 6 meses de seguimento, avaliado em quartis, n?o apresentou um risco de mortalidade ou de hospitaliza??o significativamente diferente para as vari?veis pesquisadas, exceto para a diferen?a da albumina inferior ao percentil 25, que associou-se ao risco de ?bito em 12 meses.
Conclus?o: Na avalia??o conjunta de par?metros antropom?tricos, laboratoriais, da BIA e inflamat?rios, o ?ngulo de fase, a react?ncia, a creatinina e o IMC foram identificados como preditivos de morbimortalidade. A diminui??o nos valores de albumina s?rica em 6 meses forneceu informa??o progn?stica adicional. Os autores acreditam no potencial dos marcadores da BIA, podendo detectar altera??es precoces no estado nutricional (mesmo antes de altera??es no IMC e exames laboratoriais) e enfatizam que estudos longitudinais com maior n?mero de pacientes em diferentes popula??es sejam realizados para confirma??o destes resultados e indica??o posterior desse exame no seguimento nutricional dos pacientes em hemodi?lise
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Associa??o do receptor toll-like 2 com o estado pr?-inflamat?rio do diabetes tipo 1Ururahy, Marcela Abbott Galv?o 30 March 2009 (has links)
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Previous issue date: 2009-03-30 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Inflammation has been pointed out as an important factor in development of chronic
diseases, as diabetes. Hyperglycemia condition would be responsible by toll-like
receptors, TLR2 and TLR4, and, consequently by local and systemic inflammation
induction. Thus, the objective of present study was to evaluate type 1 Diabetes mellitus
(T1DM) pro-inflammatory state through mRNA expression of TLRs 2 and 4 and proinflammatory
cytokines IL-1?, IL-6 and TNF-? correlating to diabetic nephropathy. In
order to achieve this objective, 76 T1DM patients and 100 normoglycemic (NG)
subjects aged between 6 and 20 years were evaluated. T1DM subjects were evaluated as
a total group DM1, and considering glycemic control (good glycemic control
DM1G, and poor glycemic control DM1P) and considering time of diagnosis (before
achieving 5 years of diagnosis DM1< 5yrs, and after achieving 5 years of diagnosis
DM1 <5yrs). Metabolic control was evaluated by glucose and glycated hemoglobin
concentrations; to assess renal function serum urea, creatinine, albumin, total protein
and urinary albumin-to-creatinine ratio were determined and to evaluate hepatic
function, AST and ALT serum activities were measured. Pro-inflammatory status was
assessed by mRNA expression of TLRs 2 and 4 and the inflammatory cytokines IL-1?,
IL-6 and TNF-?. Except for DM1G group (18.4%), DM1NC patients (81.6%) showed a
poor glycemic control, with glycated hemoglobin (11,2%) and serum glucose (225,5
md/dL) concentrations significantly increased in relation to NG group (glucose:
76,5mg/dL and glycated hemoglobin: 6,9%). Significantly enhanced values of urea
(20%) and ACR (20,8%) and diminished concentrations of albumin (5,7%) and total
protein (13,6%) were found in T1DM patients, mainly associated to a poor glycemic
control (DM1P increased values of urea: 20% and ACR:49%, and diminished of
albumin: 13,6% and total protein:13,6%) and longer disease duration (DM1 <5yrs -
increased values of urea: 20% and ACR:20,8%, and diminished of albumin: 14,3% and
total protein:13,6%). As regarding pro-inflammatory status evaluation, significantly
increased mRNA expressions were presented for TLR2 (37,5%), IL-1? (43%), IL-6
(44,4%) and TNF-? (15,6%) in T1DM patients in comparison to NG, mainly associated
to DM1P (poor glycemic control TLR2: 82%, IL-1?: 36,8% increase) and DM1 <5yrs
(longer time of diagnosis TLR2: 85,4%, IL-1?: 46,5% increased) groups. Results
support the existence of an inflammatory state mediated by an increased expression of
TLR2 and pro-inflammatory cytokines IL-1?, IL-6 and TNF-? in T1DM / A inflama??o tem sido descrita como um fator importante no desenvolvimento de
doen?as cr?nicas como o diabetes, e a condi??o da hiperglicemia seria a respons?vel
pela ativa??o dos receptores toll-like (TLRs), TLR2 e TLR4, e, conseq?entemente, pela
indu??o da inflama??o local e sist?mica. Nesse sentido, o presente estudo teve como
objetivo de avaliar o estado pr?-inflamat?rio do Diabetes mellitus tipo 1 (DM1) atrav?s
da express?o g?nica de TLRs 2 e 4 e das citocinas pr?-inflamat?rias IL-1?, IL-6 e TNF-
?, e correlacionar com o desenvolvimento da nefropatia diab?tica. Foram estudados 76
pacientes diab?ticos tipo 1 e 100 indiv?duos normoglic?micos NG, na faixa et?ria de 6
a 20 anos. Os indiv?duos diab?ticos foram avaliados como um grupo total DM1, e
subdivididos em fun??o do controle glic?mico (diab?ticos compensados DM1C, e
n?o-compensados DM1NC) e em fun??o do tempo de diagn?stico (diab?ticos com
menos de 5 anos de diagn?stico DM1< 5anos, e a partir de 5 anos de diagn?stico
DM1 <5 anos). Para a avalia??o do controle metab?lico foram determinadas as
concentra??es de glicose e de hemoglobina glicada; para avaliar a fun??o renal as
concentra??es s?ricas de ur?ia, creatinina, albumina, prote?na total e a rela??o
albumina/creatinina (RAC) urin?ria; e para fun??o hep?tica a atividade s?rica de AST e
ALT. O estado pr?-inflamat?rio foi avaliado a partir da express?o do mRNA dos TLRs
2 e 4, e das citocinas IL-1?, IL-6 e TNF-?. Com exce??o do grupo DM1C (18,4%), os
pacientes DM1NC (81,6%) apresentaram um controle glic?mico insatisfat?rio, com
valores de mediana para glicose (225,5mg/dL) e hemoglobina glicada (11,2%)
significativamente superiores ao grupo NG (glicose: 76,5mg/dL e hemoglobina glicada:
6,9%). Foram obtidos valores aumentados para a ur?ia s?rica (20%) e RAC urin?ria
(20,8%); e diminu?dos para albumina (5,7%) e prote?na total (13,6%) nos indiv?duos
diab?ticos; e associados a um controle glic?mico insatisfat?rio (DM1NC aumento de
20% para ur?ia e 49% para RAC; e diminui??o de 8,6% para albumina e 12,1% para
prote?na total) e a um maior tempo de diagn?stico (DM1 <5anos aumento de 20% para
ur?ia e 20,8% para RAC; e diminui??o de 14,3% para albumina e 13,6% para prote?na
total). No tocante ? avalia??o do estado pr?-inflamat?rio, as express?es de mRNA se
apresentaram elevadas para TLR2 (37,5%), IL-1? (43%), IL-6 (44,4%) e TNF-?
(15,6%) nos indiv?duos diab?ticos em rela??o aos NG, sendo principalmente associadas
aos grupos DM1NC (controle glic?mico insatisfat?rio TLR2: 82%, IL-1?: 43% de
aumento) e DM1 <5 anos (maior tempo de diagn?stico TLR2: 85,4%, IL-1?: 46,5% de
aumento). O conjunto de resultados suporta a exist?ncia de um quadro inflamat?rio
mediado pelo aumento da express?o do TLR2 e das citocinas pr?-inflamat?rias IL-1?,
IL-6 e TNF-? no diabetes tipo 1
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Sinaliza??o end?gena do sistema Nociceptina/Orfanina FQ - receptor NOP: envolvimento na modula??o da depress?o experimental induzida por lipopolissacar?deoMedeiros, Iris Ucella de 14 August 2015 (has links)
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Previous issue date: 2015-08-14 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Durante as ?ltimas d?cadas t?m sido demonstrado que existe uma rela??o entre a depress?o maior e a ativa??o do sistema imunol?gico. Nociceptina/orfanina FQ (N/OFQ) ? o ligante natural do receptor acoplado ? prote?na Gi chamado NOP, ambos constituem um sistema pept?dico que est? envolvido na regula??o do humor e de respostas inflamat?rias. Considerando essas a??es, a presente tese teve como objetivo investigar as consequ?ncias do bloqueio da sinaliza??o do receptor NOP nos comportamentos doentio e do tipo depressivo induzidos pela administra??o de lipopolissacar?deo (LPS) em camundongos. A administra??o sist?mica de doses de LPS, que n?o causam sepse, induzem altera??es nos comportamentos de camundongos relacionadas com a atividade das citocinas pr?-inflamat?rias fator de necrose tumoral-? (TNF-?) e interleucinas 6 (IL-6) e 1? (IL- 1 ?). Ap?s 2 a 6 h e 24 h da inje??o intraperitoneal, camundongos tratados com LPS apresentam, respectivamente, o comportamento doentio e o comportamento do tipo depressivo. No presente trabalho, a administra??o de LPS (0,8 mg/kg, ip) induziu sinais de doen?a em camundongos Swiss e CD-1, como perda de peso, redu??o transit?ria da temperatura retal e diminui??o da ingest?o de ra??o e ?gua. Al?m disso, nas 24 h ap?s a inje??o de LPS, essas mesmas linhagens de camundongos mostraram aumento no tempo de imobilidade durante os 6 min que foram submetidos ao teste de suspens?o pela cauda (TSC). O tratamento com nortriptilina (30 mg/kg, ip, 60 minutos antes do TSC) reduziu o tempo de imobilidade dos camundongos controle e tratados com LPS, e foi utilizado como antidepressivo padr?o. A administra??o pr?via ao LPS do antagonista do receptor NOP SB-612111 (10 mg/kg, ip), n?o alterou os comportamento doentio e do tipo depressivo induzidos pelatoxina. No entanto, quando injetado 24 h ap?s o tratamento com LPS, SB-612111 (ip, 30 minutos antes do TSC), como tamb?m o antagonista pept?dico do receptor NOP UFP-101 (10 nmol/2ul, icv, 5 min antes do TSC), inverteram significativamente os efeitos da toxina. O protocolo de indu??o do comportamento do tipo depressivo pela administra??o intraperitoneal de LPS tamb?m foi testado em camundongos nocautes para o receptor NOP (NOP(-/-)) e seus respectivos wild types (NOP(+/+)). O tratamento com LPS provocou altera??es significativas, como a redu??o tempor?ria da temperatura retal nos camundongos NOP(-/-) e perda de peso corporal e redu??o no consumo de ra??o e ?gua em ambos os camundongos NOP(+/+) e NOP(-/-). O consumo de ?gua foi significativamente diferente entre os gen?tipos. A inje??o de LPS induziu altera??es transit?rias nas citocinas pr?-inflamat?rias. Nas 6 horas ap?s o tratamento com LPS, os n?veis s?ricos de TNF-? mostraram-se aumentados significativamente nos camundongos NOP (+/+) e NOP (-/-), j? os n?veis de IL-6 mostraram-se significativamente aumentados apenas no soro dos camundongos NOP (+/+). Nas 24 horas ap?s a inje??o de LPS, os n?veis s?ricos das citocinas pr?-inflamat?rias retornaram ? linha de base. O tratamento com LPS provocou efeitos de tipo depressivo nos camundongos NOP (+/+), mas foi ineficaz nos camundongos NOP (-/-). Os dados obtidos nesta tese mostram que o bloqueio farmacol?gico e gen?tico da sinaliza??o mediada pelo receptor NOP n?o previne os comportamentos doentio e do tipo depressivo induzidos por LPS, no entanto revertem o comportamento do tipo depressivo. Em conclus?o, esses resultados evidenciam o envolvimento do sistema pept?dico N/OFQ - receptor NOP na modula??o dos comportamentos relacionados ao humor e ? ativa??o do sistema imunol?gico. / During the last decades, it has been established that there is a relationship between major depression and activation of immune system. Nociceptin/orphanin FQ (N/OFQ) is the natural ligand of a Gi-protein coupled receptor named NOP, both compose the peptidergic system wich is involved in the regulation of mood states and inflammatory responses. Considering these actions, the present thesis aimed to investigate the consequences of blocking NOP signaling in lipopolysaccharide (LPS)-induced sickness and depressive-like behaviors in mice. Systemic administration of LPS doses, that do not cause sepsis in mice, induce changes in their behaviors related with activity of pro-inflammatory cytokines tumor necrosis factor-? (TNF-?) and interleukins 6 (IL-6) and 1? (IL-1 ?). At the time points of 2 to 6 h and 24 h after intraperitoneal injection, mice treated with LPS displayed, respectively, sickness and depressive-like behaviors. In the present work the administration of LPS 0.8 mg/kg (ip) significantly induced sickness signs in Swiss and CD-1 mice, such as weight loss, transient reduction in rectal temperature and decrease of food and water intake. Moreover at 24 h after LPS injection these same mice strains displayed significantly increased immobility time on the tail suspension test (TST) when compared with control mice, this alteration was not related with possible locomotion impairments as verified on the open field test. Treatment with Nortriptyline 30 mg/kg (ip, 60 min prior the TST) reduced the immobility time of control and LPS-treated mice and was used as standard antidepressant. The NOP receptor antagonist SB-612111 (10 mg/kg, ip), 30 min prior LPS, did not modify LPS-induced sickness signs and depressive-like behavior. However, when injected 24 h after LPS treatment, SB-612111 (ip, 30 min prior the TST) as well as the peptidergic NOP receptor antagonist UFP-101 (10 nmol/2?L, icv, 5 min prior the TST) significantly reversed the toxin effects. The protocol of LPS-induced depressive-like states was also tested in NOP receptor knockout mice (NOP(-/-)) and their respective wild types (NOP(+/+)). LPS evoked transient rectal temperature reduction in NOP(-/-) mice and loss of body weight, food and water intake reduction in both NOP(+/+) and NOP(-/-) mice. The consumption of water was significantly different due to the genotype. LPS injection induced transient changes in pro-inflammatory cytokines. At 6 h after LPS injection, serum levels of TNF-? were significantly increased in NOP(+/+) and NOP(-/-) mice, as the IL-6 levels were significantly increased just in NOP(+/+) serum. At 24 h after LPS treatment the pro-inflammatory cytokines had returned to the baseline levels in both genotypes. LPS treatment elicited depressive-like effects in NOP(+/+) but not in NOP(-/-) mice. The data obtained during the execution of this doctoral thesis reveal that pharmacological and genetic blockade of NOP signaling does not affect LPS evoked sickness signs while reversing depressive-like behavior. In conclusion, these results highlight the involvement of the peptidergic system N/OFQ - NOP receptor in the modulation of behaviors related to mood and activation of the immune system.
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An?lise imuno-histoqu?mica das prote?nas VEGF e HIF-1? na doen?a periodontalVasconcelos, Roseane Carvalho 28 February 2012 (has links)
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Previous issue date: 2012-02-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Periodontal disease is a complex inflammatory and infectious condition that immune host, front of the microbial aggressions, can lead to disease progression, resulting in tissue destruction. The tissue damage induces the release of regulatory molecules, which protective roles and / or destructive, including proteins VEGF (vascular endothelial growth factor vascular) and HIF-1 ? (hypoxia-induced factor ? -1). Thus, this study investigated,
quantitatively and comparatively, the immunohistochemical expression of VEGF (vascular endothelial growth factor) and HIF-1 ? (hypoxia induced factor 1-?), proteins involved in
inflammation, angiogenesis and hypoxia, in human gingival tissues. Therefore, 75 samples of gingival tissues were examined. Thirty samples were chronic periodontitis, 30 with chronic
gingivitis and 15 healthy gingival. After sections analysis, positives and negatives inflammatory and endothelial cells in the connective tissue were counted and converted into
percentage. Data were statistically analyzed using Kruskal-Wallis test and Spearman correlation. The results showed that both proteins marked. It was observed higher immunoreactivity for HIF-1 ? at chronic gingivitis and periodontitis specimens compared to healthy sites, however, no statistically significant differences were observed among them (p>0.05). The VEGF immunostaining showed similarity among the cases of periodontitis, gingivitis and healthy gingiva. Moderate and positive correlation statistically significant differences were verified for the expressions of VEGF and HIF-1? in gingival health (r = 0,529, p = 0.04). Thus, it can be conclude that possibly the route of HIF-1 ?, is activated in periodontal disease may have involvement of the protein in pathogenesis and progression of
disease, and that activation of VEGF, can be in addition to being triggered transcription by HIF-1 ? may be also influenced by other additional factors such as the action of periodontal
microorganisms endotoxins / A doen?a periodontal ? uma condi??o infecciosa e inflamat?ria complexa em que a resposta imune do hospedeiro, frente aos produtos microbianos, pode conduzir ? progress?o da doen?a. A agress?o tecidual induz a libera??o de mol?culas reguladoras, que desempenham pap?is protetores e/ou destrutivos, incluindo as prote?nas VEGF (Fator de crescimento endotelial vascular) e o HIF-1 ? (Fator induzido por hip?xia -1 ?). Diante disso, este estudo buscou analisar, de forma quantitativa e comparativa, a express?o imuno-histoqu?mica destas prote?nas, envolvidas nos processos de angiog?nese e hip?xia, observadas em condi??es
inflamat?rias. Para tanto, 75 amostras de tecidos gengivais foram examinadas. Destas, 30 foram de periodontite cr?nica, 30 de gengivite cr?nica e 15 de gengivais saud?veis. Foram
contadas, as c?lulas inflamat?rias e endoteliais, positivas e negativas, no tecido conjuntivo fibroso, e posteriormente, convertidas em porcentagem. Os dados foram analisados
estatisticamente por meio do teste de Kruskal-Wallis e Correla??o de Spearman. Os resultados mostraram imunoexpress?o para ambas as prote?nas. Foi observada, uma elevada imunoexpress?o para HIF-1 ?, nos esp?cimes de periodontite e gengivites cr?nicas, em rela??o aos s?tios saud?veis, por?m, sem diferen?as estat?sticas entre elas (p>0,05). A imunoexpress?o do VEGF demonstrou similaridade, entre os casos de periodontite, gengivite e gengiva saud?vel. Correla??o positiva moderada e diferen?a estatisticamente significativa foram verificadas para as express?es do VEGF e HIF-1?, em gengivais saud?veis (r=0.529; p= 0.04). Desta forma, pode-se concluir que, possivelmente a via de ativa??o do HIF-1 ?, est? ativada na doen?a periodontal, podendo haver participa??o desta prote?na, na patog?nese e progress?o da doen?a periodontal e que a ativa??o do VEGF, al?m de ser desencadeada via transcri??o do HIF-1 ?, pode ser tamb?m, influenciada por outros fatores adicionais, como, por exemplo, a??o das endotoxinas bacterianas periodontopatog?nicas
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Efeito agudo da vibra??o de corpo inteiro nos par?metros cardiorrespirat?rios e inflamat?rios em indiv?duos com doen?a pulmonar obstrutiva cr?nicaLage, Vanessa Kelly da Silva 05 May 2017 (has links)
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Previous issue date: 2017 / A Doen?a Pulmonar Obstrutiva Cr?nica (DPOC) ? caracterizada por uma obstru??o cr?nica persistente ao fluxo a?reo. Estudos que avaliaram o uso da vibra??o de corpo inteiro (VCI) em pacientes com DPOC demonstraram melhora em par?metros cl?nico-funcionais, contudo, o conhecimento a respeito do efeito agudo da VCI na DPOC ainda ? escasso O estudo teve como objetivo, caracterizar a intensidade do exerc?cio em diferentes frequ?ncias de VCI e dos tipos de agachamento (est?tico ou din?mico) durante uma sess?o de exerc?cio, bem como, avaliar o efeito agudo do exerc?cio sobre as respostas cardiorrespirat?rias e inflamat?rias na DPOC.Os volunt?rios da pesquisa foram pareados quanto ao sexo, idade, IMC e foram divididos em 2 grupos, sendo eles: grupo controle (GC, n=13), composto por sujeitos sem DPOC e grupo DPOC (DPOC, n=13). A familiariza??o e aplica??o do Teste de Caminhada de 6 minutos foram realizadas em 1 dia, ap?s 1 semana, a caracteriza??o com o exerc?cio de VCI foi realizada em 4 dias com um intervalo de 48 horas entre as sess?es. O agachamento est?tico foi realizado nas frequ?ncias 30, 35 e 40 Hz e o agachamento din?mico na frequ?ncia 35 Hz. Os dois grupos passaram pelas mesmas condi??es experimentais. Foram mensurados os par?metros cardiorrespirat?rios durante todos os dias de exerc?cio e os par?metros inflamat?rios foram avaliados durante o exerc?cio est?tico na frequ?ncia de 35 Hz atrav?s da concentra??o plasm?tica da adiponectina, resistina, IL-6, IL-8, IL-10, BDNF e receptores sol?veis de TNF (STNFR-1 e STNFR-2). Os resultados demonstraram que o agachamento est?tico promoveu maior varia??o (39,2%) na FC quando comparado ao din?mico. A an?lise nas 3 frequ?ncias de VCI demonstraram comportamento semelhante entre os grupos com aumentos significativos do VO2 (GC: 27,4 a 40% e DPOC: 21,5 a 28,5%) e da FC (GC: 10,2 a 12,5% e DPOC: 4,3 a 12,7%). Foram encontradas altas concentra??es basais das adipocinas e IL-8 e baixos valores de IL-10 no grupo DPOC. Ap?s a VCI foi observado aumento das concentra??es de IL-10 (40,6%) no grupo DPOC alcan?ando valores semelhante a concentra??o basal do GC. Em conclus?o, o presente estudo traz subs?dios para a elabora??o de protocolos de treinamento com a VCI, uma vez que o exerc?cio foi caracterizado como de baixa intensidade (<2 METs) nas frequ?ncias avaliadas, sendo aplic?vel e seguro na DPOC. Adicionalmente, a VCI parece modular as concentra??es de IL-10 na popula??o de DPOC avaliada. / Disserta??o (Mestrado) ? Programa Multic?ntrico de P?s-gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / Chronic Obstructive Pulmonary Disease (COPD) is characterized by chronic persistent airflow obstruction. Studies evaluating the use of whole body vibration (WBV) in patients with COPD have shown improvement in clinical-functional parameters, however, knowledge about the acute effect of WBV in COPD is still scarce. The objective of this study was to characterize the intensity (static or dynamic) during an exercise session, as well as to evaluate the acute effect of exercise on cardiorespiratory and inflammatory responses in COPD. The study volunteers were matched for gender, age, BMI and were divided into 2 groups: control group (GC, n = 13), composed of subjects without COPD and COPD group (COPD, n = 13). Familiarization with WBV exercise and the application of the 6-minute Walk Test were performed in one day, after 1 week, the characterization of the WBV exercise was performed in 4 days with a 48-hour interval between sessions. Static squatting was performed at frequencies 30, 35 and 40 Hz and dynamic squatting at 35 Hz frequency. Both groups underwent the same experimental conditions. Cardiorespiratory parameters were measured during all exercise days and inflammatory parameters were evaluated during static exercise at the 35 Hz frequency through the plasma concentration of adiponectin, resistin, IL-6, IL-8, IL-10, BDNF and soluble TNF receptors (STNFR-1 and STNFR-2). The results showed that static squatting promoted greater variation (39.2%) in HR when compared to dynamic. The analysis of 3 frequencies of WBV showed similar results between the groups with significant increases in VO2 (GC: 27.4 to 40% and COPD: 21.5 to 28.5%) and HR (CG: 10.2 a 12.5% e COPD: 4.3 a 12.7%). Baseline concentrations of adipokines and IL-8 showed higher values, in the other hand low IL-10 values were found in the COPD group. After WBV, an increase in IL-10 concentrations (40.6%) was observed in the COPD group reaching values similar to basal GC concentration. In conclusion, the present study provides subsidies for the elaboration of training protocols with WBV, since exercise was characterized as low intensity (<2 METs) in the frequencies evaluated, being applicable and safe in COPD. In addition, VCI appears to modulate IL-10 concentrations in the COPD population evaluated.
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Efeitos da perda de peso corporal induzida por dieta hipolip?dica ad libitum e pela restri??o cal?rica com dieta hiperlip?dica na inflama??o do tecido adiposo de camundongos obesosRodrigues, Manuela Ortega Marques 01 December 2017 (has links)
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Previous issue date: 2017 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG) / A expans?o do tecido adiposo branco na obesidade leva ? express?o alterada de prote?nas
em seus adip?citos, bem como a infiltra??o de c?lulas do sistema imune, especialmente
macr?fagos, cujas secre??es levam ao desenvolvimento da inflama??o cr?nica de baixo grau, a
qual ? considerada subjacente ao desenvolvimento de in?meras comorbidades. Dentre as formas
de tratamento da obesidade, dietas de restri??o cal?rica (RC) nutricionalmente balanceadas
induzem a perda de peso e melhorias em marcadores sist?micos da inflama??o, mas os efeitos
diretos no tecido adiposo visceral ainda s?o controversos. No entanto, existe uma lacuna sobre
qual o impacto dessas dietas na inflama??o local, mesmo em condi??es de sobrecarga lip?dica.
Assim, o objetivo deste estudo foi avaliar os efeitos da perda de peso corporal induzida por dieta
hipolip?dica ad libitum e pela restri??o cal?rica com dieta hiperlip?dica na inflama??o do tecido
adiposo visceral de camundongos obesos. Para tal, inicialmente, camundongos C57BL/6 com 12
semanas de idade, machos, foram divididos em dois grupos: LF ? alimentados com dieta
controle hipolip?dica ? do ingl?s low fat (10% das calorias, fonte ?leo de soja, rica em ?cidos
graxos poli-insaturados); e HF ? alimentados com dieta controle hiperlip?dica ? do ingl?s high
fat (60% calorias, fonte banha de porco, rica em ?cidos graxos saturados) para indu??o da
obesidade. Ap?s oito semanas, seis animais de cada grupo foram eutanasiados para verifica??o
da adiposidade visceral e estado inflamat?rio (dosagens de prote?na C reativa ? PCR s?rica e
hep?tica). Em seguida, os animais HF foram aleatoriamente divididos em tr?s grupos HF ?
continuaram recebendo dieta HF; LFAL ? submetidos ao emagrecimento pela substitui??o da
dieta HF pela LF e acesso livre (ad libitum) e RHF ? submetidos ao emagrecimento por
receberem quantidades restritas em calorias da dieta HF para atingir o mesmo peso corporal dos
animais LFAL. A partir deste momento, esses grupos foram alimentados, juntamente com os
animais LF, por mais sete semanas. Ao final, foram avaliados o ganho/perda de peso corporal, a
adiposidade, as concentra??es s?ricas e hep?ticas de PCR, e as concentra??es de leptina,
adiponectina, e das citocinas IL-6, TNF e MCP-1 no tecido adiposo retroperitoneal, al?m da
morfologia dos adip?citos e a presen?a de infiltrados inflamat?rios no tecido adiposo
retroperitoneal. Ao final da fase de indu??o da obesidade, os animais HF estavam obesos e
inflamados. Ao final da fase de indu??o da perda de peso, os grupos LFAL e RHF tiveram pesos
corporais semelhantes, menores que o HF e se igualaram ao LF. No entanto, houve maior
dificuldade em perder peso pelo grupo RHF em compara??o ao LFAL, dado pelas diferen?as
significativas entre os deltas de perda de peso, que foram menores para RHF e pelos coeficientes
de efici?ncia energ?tica, que foram maiores para o grupo RHF. Os animais LFAL retornaram a
adiposidade e a hipertrofia dos adip?citos viscerais a valores semelhantes ao grupo LF. Isto
provavelmente foi o que levou ? menor concentra??o de leptina com concomitante aumento da
adiponectina e menor infiltra??o de c?lulas inflamat?rias neste tecido, igualando-se tamb?m ao
LF. Em consequ?ncia, houve menor concentra??o tecidual de citocinas pr?-inflamat?rias, al?m
de menor concentra??o hep?tica e circulante de PCR. J? para os animais RHF, houve apenas
atenua??o da adiposidade e da hipertrofia dos adip?citos retroperitoneais. Isso foi suficiente para
restabelecer a concentra??o local de leptina a n?veis semelhantes ao grupo LF, embora n?o tenha
elevado a concentra??o de adiponectina. Al?m disso, a infiltra??o de c?lulas inflamat?rias
menteve-se tamb?m elevada. N?o houve redu??o da concentra??o de citocinas pr?-inflamat?rias,
? exce??o da IL-6, que reduziu levemente. A concentra??o hep?tica de PCR foi atenuada, o que
n?o refletiu na concentra??o s?rica dessa prote?na. Concluiu-se que a restri??o cal?rica com dieta
hiperlip?dica foi menos eficiente em promover a perda de peso e de adiposidade e n?o melhorou
a inflama??o do tecido adiposo visceral, comparada com a dieta hipolip?dica ad libitum. Inferiuse
que a ingest?o de dieta com sobrecarga de lip?deos (60% das calorias) e de ?cidos graxos
saturados foi mais determinante da inflama??o local do que a restri??o cal?rica per se. / Disserta??o (Mestrado) ? Programa Multic?ntrico de P?s-gradua??o em Ci?ncias Fisiol?gicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / The expansion of white adipose tissue in obesity leads to altered protein expression in its
adipocytes, as well as the infiltration of immune cells, especially macrophages, whose secretions
lead to the development of chronic low-grade inflammation, which underlies the development of
several comorbidities. Among treatments, caloric restriction (CR) nutritionally balanced diets
induce weight loss and ameliorates inflammation systemic markers, but adipose tissue effects are
still controversial. Moreover, there is a gap on the impact of these diets on local inflammation,
even under lipid overload. Thus, the aim of this study was to evaluate effects of body weight loss
induced by a low fat ad libitum diet and a CR in a high fat diet in the visceral adipose tissue
inflammation of obese mice. Firstly, 12 weeks of age male C57BL/6 mice were divided into two
groups: LF - fed a control low fat diet (10% calories, source soybean oil, high in polyunsaturated
fatty acids); and HF - fed a control high fat diet (60% calories, source lard, high in saturated fatty
acids) for obesity induction. After eight weeks, six animals from each group were euthanized to
verify visceral adiposity and inflammatory status (serum and hepatic C-reactive protein-CRP).
Then, HF animals were randomly divided into three groups: HF ? keept at HF diet; LFAL - a
weight loss group that was switched from HF to LF and maintained on it ad libitum; RHF - a
weight loss group that received restricted amounts of HF to maintain the same body weight as
LFAL. Thereafter, these groups were fed, along with the LF animals, for another seven weeks.
At end, body weight gain / loss, adiposity, serum and hepatic CRP concentrations, and adipose
retroperitoneal tissue concentrations of leptin, adiponectin, IL-6, TNF and MCP-1 were
evaluated, as well as adypocite morphology and the presence of inflammatory infiltrates in the
retroperitoneal adipose tissue. Obesity was induced, since HF animals had higher weights,
adiposity and were inflamed. At the end of the weight loss period, both LFAL and RHF had
similar body weight, lower than HF and equal to LF. However, it was more dificcult to loose
wheight by the RHF group compared to LFAL, since weight loss deltas were lower for RHF and
energy efficiency ratios were higher for RHF group. LFAL animals returned visceral adiposity
and retroperitoneal adipocyte hypertrophy similarly to the LF group. Also, there was a lower
leptin level with concomitant increase of adiponectin and less infiltration of inflammatory cells
in this tissue, also matching to LF. Still, there was a lower tissue concentration of
proinflammatory cytokines, and a lower hepatic and serum CRP. For RHF animals, there was
only an attenuation in adiposity and visceral adipocyte hypertrophy, although it was sufficient to
restore local leptin concentration similarly to LF. However, this regimen was not able to elevate
the adiponectin concentration. In addition, the inflammatory cells infiltration was highly
elevated. There was no reduction in proinflammatory cytokines concentration, despite IL-6,
which was reduced slightly. Hepatic CRP concentration was attenuated, which did not reflect in
its serum concentrations. In mice with diet-induced obesity, the weight loss by means a CR in a
high fat diet was less effective in promoting wheight and adiposity losses and it did not improve
visceral adipose tissue inflammation. It can be inferred that a lipid overload (60% from calories)
as well as a saturated fatty acid surplus from the high fat diet were more determinant of local
inflammation than caloric restriction per se.
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