INTRODUÇÃO: Líquen plano pilar (LPP) e alopecia frontal fibrosante (AFF) são alopecias cicatriciais linfocíticas crônicas, caracterizadas pela destruição permanente da unidade pilossebácea. Neuropeptídeos como a substância P (SP) e o peptídeo relacionado ao gene da calcitonina (CGRP) têm sido implicados no metabolismo lipídico das glândulas sebáceas e na manutenção do estado inflamatório de diversas doenças. OBJETIVOS: 1. Quantificar e comparar a expressão dos neuropeptídeos SP e CGRP em amostras do couro cabeludo (áreas afetadas e aparentemente não afetadas) e séricas de pacientes com LPP e AFF, em relação a indivíduos sadios, utilizando a técnica de ELISA. 2. Analisar áreas afetadas e aparentemente não afetadas de pacientes com LPP e AFF através da imunofluorescência direta (IFD). MÉTODO: 20 pacientes (10 com LPP e 10 com AFF) e 11 indivíduos sadios foram submetidos a biópsias com punch de 4mm do couro cabeludo e coleta de amostras sanguíneas. Pacientes foram submetidos a biópsias das áreas afetadas e aparentemente não afetadas do couro cabeludo, as quais foram pareadas com amostras da região anterior e posterior do couro cabeludo dos indivíduos-controle. As amostras dos pacientes foram enviadas para análise histopatológica, IFD e teste de ELISA para SP e CGRP. As amostras dos controles foram submetidas à análise histopatológica e aos mesmos testes de ELISA. Sintomas (dor, prurido, queimação e formigamento) e sinais inflamatórios (eritema difuso, eritema peripilar e descamação peripilar) na região afetada dos pacientes também foram avaliados. Este estudo foi realizado nas Universidades de São Paulo (BRA) e de Minnesota (EUA), entre os anos de 2012 e 2014. RESULTADOS: A análise histopatológica evidenciou infiltrado perifolicular linfocítico típico em 70% das áreas aparentemente não afetadas do couro cabeludo de pacientes com LPP e AFF, além de fibrose e depósitos de mucina perifoliculares. Em relação à IFD, o resultado se mostrou positivo em 50% das amostras das áreas afetadas e em 40% das áreas aparentemente não afetadas dos pacientes com LPP, em comparação a 40% e 20% nos casos de AFF, respectivamente. No teste de ELISA, pacientes do grupo LPP e infiltrado histopatológico de moderado a intenso na área afetada, demonstraram maior expressão de SP na área afetada, em comparação àquela aparentemente não afetada (P=0,046). Já pacientes do grupo AFF com o mesmo grau histopatológico de inflamação, demonstraram maior expressão de SP na área aparentemente não afetada, em comparação à área afetada (P=0,050). No teste de ELISA para CGRP, pacientes com LPP e inflamação histopatológica de leve a ausente na área afetada, tiveram maior expressão deste neuropeptídeo na área aparentemente não afetada, em comparação à área afetada (P=0,048). Por outro lado, pacientes com AFF que tinham o mesmo grau de inflamação histopatológica, a expressão deste neuropeptídeo foi favorecida na área afetada, em relação àquela aparentemente não afetada (P=0,050). Todas as amostras séricas dos pacientes e controles e do couro cabeludo dos indivíduos-controle tiveram resultados indetectáveis para SP e CGRP no teste de ELISA. Nenhuma relação entre sinais e sintomas inflamatórios e expressão de SP e CGRP no teste de ELISA foi vista. CONCLUSÃO: O acometimento das áreas aparentemente não afetadas do couro cabeludo de pacientes com LPP e AFF ao exame histopatológico, sugere que ambas as doenças possam acometer de forma difusa esta região. Apesar da semelhança dos achados histopatológicos entre pacientes com LPP e AFF, resultados antagônicos dos neuropeptídeos encontrados no teste de ELISA apontam para mecanismos fisiopatogênicos distintos. A inflamação neurogênica poderia explicar a sintomatologia e contribuir para a patogênese destas doenças / INTRODUCTION: Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are primary lymphocytic cicatricial alopecias characterized by permanent destruction of the pilossebaceous unit. Neuropeptides such as substance P (SP) and calcitonin gene-related peptide (CGRP) are related to lipid metabolism in sebaceous glands and to the maintenance of many inflammatory chronic disorders. OBJECTIVES: 1. Quantify SP and CGRP expression in affected and in normal-appearing scalp areas and serum samples from patients with LPP and FFA, and compare to healthy controls using ELISA technique. 2. Compare affected and normal-appearing areas from patients with LPP and FFA, using direct immunofluoresce (DIF) technique. METHODS: Twenty patients (10 with LPP and 10 with FFA) and eleven healthy controls underwent 4mm-punch biopsies and blood extraction. Patients collected samples from affected and normal-appearing scalp areas, and controls collected from anterior and posterior scalp areas. Patients samples were sent to histopathologic examination, DIF and ELISA tests for SP and CGRP detection. Control samples were sent to histopathologic examination and to the same ELISA tests. Symptoms (pain, burning, itching and tingling) and signs of inflammation (diffuse erythema, perifollicular erythema and perifollicular scale) were also assessed. This study was done at the Universities of São Paulo (Brazil) and Minnesota (USA), between 2012 and 2014. RESULTS: Normal-appearing scalp areas from patients with LPP and FFA showed lymphocytic perifollicular typical inflammation in 70% of the cases, as well as perifollicular fibrosis and mucin deposits. DIF test was positive in 50% of the affected areas and in 40% of normalappearing areas from patients with LPP, comparing to 40% and 20% in the FFA group, respectively. In SP ELISA test, affected areas from patients with LPP that had histopathologic moderate or intense infiltrate showed more expression of SP in the affected scalp, comparing to normal-appearing areas (P=0,046). However, affected areas from patients with FFA that showed the same degree of histopathologic infiltrate had higher expression of SP in normalappearing scalp, comparing to affected scalp (P=0.050). In CGRP ELISA test, affected scalp from patients with LPP that had histopathologic mild or irrelevant infiltrate showed increased CGRP expression in normal-appearing scalp areas, comparing to affected scalp (P=0,048). Althought, affected areas with the same degree of histopathologic inflammation from patients with FFA had more CGRP, comparing to normal-appearing scalp (P=0,050). All serum samples and scalp samples from controls had undetectable results in SP and CGRP ELISA tests. No clinical relationship was found among symptoms, signs of inflammation, and neuropeptide expression. CONCLUSION: Normal-appearing scalp areas can show histopathologic inflammation suggesting that both LPP and FFA can be more generalized processes affecting the scalp. Although both diseases share similar histopathologic findings, the opposite results in the ELISA test point that these diseases may have diverse pathogenic mechanisms. Neurogenic inflammation possibly play an important role in the pathogenesis of both LPP and FFA and may explain the symptomatic scalp some patients refer

Estudos realizados na última década mostram que a substância P (SP) é um neuromediador importante de estados emocionais e afetivos. A SP tem ação pró-aversiva quando microinjetada na substância cinzenta periaquedutal dorsal (SCPd) através da ativação de receptores neurocininérgicos do tipo NK-1, uma vez que o comportamento defensivo é bloqueado por antagonistas desses receptores. A ativação de receptores NK-1 na SCPd também produz antinocicepção, a qual é considerada parte da reação de defesa. Na sequência desses estudos, este projeto visa investigar o envolvimento dos receptores neurocininérgicos no núcleo central (CeA) e basolateral (BLA) da amígdala na mediação dos estados aversivos gerados e elaborados nessa estrutura prosencefálica que, junto com a SCPd, faz parte do sistema encefálico aversivo. O presente estudo mostrou que a SP e o agonista NK-1 (Sar-Met-SP) promoveram efeitos pró-aversivos no labirinto em cruz elevado somente no CeA, mas não no BLA. Ao contrário da SCPd, não obtivemos qualquer alteração no limiar nociceptivo com a microinjeção de antagonista de receptores NK-1 (Spantide) em ambos os núcleos. O Spantide sozinho não alterou os indicadores de nocicepção e ansiedade. Nenhum tipo de vocalização (audível ou ultrassônica) foi detectado no presente trabalho após a microinjeção de SP ou Sar-Met-SP em ambos núcleos amigdalóides, apesar de relatos de vocalizações ultrassônicas (VUS) após o mesmo tipo de tratamento na SCPd. Os resultados obtidos no presente estudo mostraram que o CeA, mas não o BLA, modula a expressão de comportamentos relacionados ao medo inato através de receptores neurocininérgicos do tipo NK-1. VUS e antinocicepção não parecem participar da reação de defesa elaborada no CeA. A ausência da emissão de VUS nesses núcleos pode indicar que somente estruturas mais antigas do neuroeixo (mesencéfalo e hipotálamo) são responsáveis pela produção de VUS. / A substantial body of evidence obtained in the last decade demonstrated that the Substance P (SP) is an important mediator of the affective and emotional behaviors. SP is a pro-aversive compound when microinjected within the dorsal periaqueductal gray (dPAG). These effects are mediated by the type 1 neurokininergic receptors (NK-1), since the defensive behavior was inhibited by antagonists of these receptors. The activation of NK-1 receptors in the dPAG also produced antinociception and ultrasonic vocalizations (USV). In the sequence of these studies, this study investigated the involvement of neurokinin receptors of the central (CeA) and basolateral (BLA) nuclei of the amygdala in the mediation of the defense reaction. The amigdala together with the dPAG and the medial hypothalamus comprise the encephalic aversive system. The results showed that SP and the NK-1 agonist (Sar-Met-SP) promoted pro-aversive effects in the elevated plus maze test only when microinjected into the CeA, without effect in the BLA. Although SP and the activation of NK-1 receptors induce antinociception in the dPAG, we did not observe any alteration of the nociceptive threshold in the tail-flick test with the NK-1 antagonist (Spantide) injected into both nuclei and any changes of the anxiety parameters in the EPM. No vocalizations (audible or ultrasonic) were detected after treatment with SP or Sar-Met-SP in both amygdaloid nuclei. The lack of emissions of USVs after activation of these nuclei could indicate that only older structures (PAG and hypothalamus) of the neuroaxis are responsible for the production of USVs. The results obtained in the present study show that NK-1 receptors within CeA, but not BLA, modulate the expression of defensive behaviors related to the innate fear. Apparentely USVs and antinociception are not involved in the defensive reactions indiced by activation of NK-1 mechanisms in the CeA.

Les peptides appartenant à la famille des tachykinines telle que la substance P (SP) sont des acteurs essentiels contribuant à l’hyperalgésie primaire et secondaire. La SP libérée par les neurones afférents primaires, ne provoque pas à elle seule des décharges nociceptives, mais elle potentialise l’effet de divers neurotransmetteurs tel que le glutamate. Pour ces différentes raisons, de nombreuses recherches ont été effectuées avec des antagonistes des récepteurs neurokinines et en particulier des récepteurs NK1. Cependant, malgré des études pré-cliniques prometteuses, les antagonistes du récepteur NK1 n’ont pas montré d’effet significatif chez l’Homme. La biosynthèse des neuropeptides actifs passe par la maturation protéolytique des pro-neuropeptides. La compréhension des mécanismes de la maturation enzymatique des précurseurs des tachykinines, ainsi que l’étude de la stabilité métabolique de la substance P (SP) permettraient d’élucider des stratégies de traitement innovateur en favorisant l’inhibition du processus de maturation ou la production de fragments peptidiques moins actifs ou inactifs. Le premier objectif de cette étude était d’élucider le rôle de la Proproteine convertase 1 (PC1) et de la Proproteine convertase 2 (PC2) dans la maturation de la protachykinine en utilisant des fractions S9 de la moelle épinière des souris du type sauvage (WT), PC1-/+ et PC2-/+. La caractérisation et la quantification des neuropeptides ont été réalisées à l’aide de la chromatographie liquide à haute performance et de la spectrométrie de masse. Les résultats montrent que PC1 et PC2 interviennent dans la maturation de la protachykinine et ces deux enzymes sont essentielles pour la biosynthèse de la Tachykinine58-71, le précurseur de la SP. Une réduction de plus de 50% de la vitesse de formation dans les fractions S9 de la moelle épinière de souris mutantes PC1 et PC2 a été observée. Les résultats obtenus révèlent que PC1 et PC2 sont impliquées dans la protéolyse de la protachykinine et suggèrent un rôle important de ces enzymes dans la maturation de la protachykinine-1. La protéolyse régule probablement les concentrations extracellulaires de la SP, mais peu d'études ont été menées sur le métabolisme des tachykinines. Dans ce présent travail, nous démontrons que la protéolyse contrôle le niveau de la SP dans la moelle épinière menant à la formation de fragments C-terminaux actifs. La stabilité métabolique de la β-tachykinine58-71 et de la SP était très courte, avec une demi-vie de 5.7 et 3.5 min, respectivement. Plusieurs fragments C-terminaux ont été identifiés, y compris la SP3-11, la SP5-11 et la SP8-11, qui conservent leurs affinités vis-à-vis des récepteurs neurokinines. La stabilité métabolique des fragments C-terminaux était significativement supérieure à celle de la β-Tachykinine58-71 et de la SP. Deux inhibiteurs de Prolyl endopeptidase spécifiques ont été utilisés et ont montré une réduction significative de la vitesse de formation de SP3-11 et de SP5-11. Ainsi, nous avons démontré que le Prolyl endopeptidase est impliqué dans le traitement N-terminal de la SP dans la moelle épinière et dans la formation de la SP3-11 et la SP5-11. Étant donné que la régulation des niveaux endogènes de peptides opioïdes (DynA, Leu-Enk, Met-Enk) et des tachykinines (Tach58-71, SP) dépend fondamentalement de l'activité de PC1 et de celle de PC2, l'analyse des tachykinines et des neuropeptides opioïdes ont été réalisées. Les résultats obtenus révèlent une diminution significative des neuropeptides pro nociceptifs la Tach58-71 (p <0,05), de la SP (p <0,01) et du NKA (P <0,001)), et des neuropeptides opioïdes DynA (p <0,01), de Leu-Enk (p <0,001), de Met-Enk (p <0,001), dans la moelle épinière de souris PC1 - / + et PC2 - / +. Par conséquent, la modulation de l'activité des PCs a un impact important sur les peptides pro-nociceptifs, mais également sur le système opioïde endogène et par conséquent elle affectera significativement les voies modulatrices de la douleur. Ces résultats suggèrent également que la réduction significative des concentrations de peptides pro-nociceptifs peut altérer la réponse du système opioïde endogène. Les analyses des concentrations des peptides opioïdes chez les souris Tac1-/- ont montré spécifiquement que les concentrations en Endomorphine-2 (EM2), en Leu-Enk et en Dyn A sont significativement inférieures que celles obtenues dans la moelle épinière chez les souris WT. Par conséquent, l’absence de la SP a un impact sur les mécanismes endogènes de modulation de la douleur. Mots clés : Tachykinines, substance P, proprotéines convertases, protéolyse, peptides opioïdes, moelle épinière, douleur, chromatographie liquide à haute performance, spectrométrie de masse. / SP is a major proteolytic product of the protachykinin-1 primarily synthesized in neurons and plays a central role in nociceptive transmission. The SP does not acte alone to cause nociceptive discharges, but it potentiates the effect of various neurotransmitters such as glutamate. For these various reasons, much research has been carried out with antagonists of neurokinin receptors and in particular NK1 receptors. However, despite promising pre-clinical studies, NK1 receptor antagonists have not shown significant effect in Humans. The proteolysis control of endogenous protachykinins has a profound impact on pain perception. Proprotein convertases (PCs) are extensively expressed in the central nervous system and specifically cleave at C-terminal of either a pair of basic amino acids, or a single basic residue but the role of PCs remains unclear. The first objective of this study was to decipher the role of PC1 and PC2 in the proteolysis of protachykinins using cellular fractions of spinal cords from wild type (WT), PC1 -/+ and PC2 -/+ mices and mass spectrometry. The results clearly demonstrate that both PC1 and PC2 mediate the formation of SP and β-Tachykinin58-71, an important SP precursor, with over 50 % reduction of the rate of formation in mutant PC1 and PC2 mouse S9 spinal cord fractions. The results obtained revealed that PC1 and PC2 are involved in the C-terminal processing of protachykinin peptides and suggest a major role in the maturation of the protachykinin-1 protein. The proteolysis is suspected to regulate extracellular SP concentrations but few studies were conducted on the metabolism of proneuropeptides and neuropeptides. In the present study, we provide evidence that proteolysis controls SP levels in the spinal cord leading to the formation of active C-terminal fragments. The metabolic stability of β-Tachykinin58-71 and SP were very short resulting in half-life of 5.7 and 3.5 min, respectively. Several C-terminal fragments were identified, including SP3-11, SP5-11 and SP8-11, which conserve affinity for the neurokinin receptors. Interestingly, the metabolic stability of C-terminal fragments were significantly superior. Two specific Prolyl endopeptidase inhibitors were used and showed a significant reduction in the rate of formation of SP3-11 and SP5-11 providing strong evidence that Prolyl endopeptidase is involved into N-terminal processing of SP in the spinal cord. The role of proprotein convertases (PCs) in the proteolysis of proneuropeptides was previously established but few studies have shown the direct impact of PCs on the regulation of specific tachykinin and opioid peptides in the central nervous system. This study has determined the relative concentration of targeted neuropeptides in the spinal cord of WT, PC1- / + and PC2- /+ mice to establish the impact of a restricted PCs activity on the regulation of specific neuropeptides. The results revealed a significant decrease of Dyn A (p < 0.01), Leu-Enk (p < 0.001), Met-Enk (p < 0.001), Tach58-71 (p < 0.05), SP (p < 0.01) and NKA (p < 0.001) spinal cord concentrations in both, PC1 -/+ and PC2 -/+ mice. Therefore, the modulation of PCs activity has an important impact on specific pronociceptive peptides (SP and NKA), but the results also showed that endogenous opioid system is hindered and consequently it will affect significantly the pain modulatory pathways. Tachykinin and opioid peptides play a central role in pain transmission, modulation and inhibition. Recent investigations suggest that both pronociceptive tachykinins and the analgesic opioid systems are important for normal pain sensation. The analysis of opioid peptides in Tac1-/- spinal cord tissues offers a great opportunity to verify the influence of the tachykinin system on specific opioid peptides. Our results reveal that Endomorphin-2 (EM2), Leu-Enk and Dyn A were down regulated in Tac1-/- spinal cord tissues that strongly suggest a significant impact on the endogenous pain-relieving mechanisms. These results may have insightful impact on future analgesic drug developments and therapeutic strategies. Key words: Tachykinins, substance P, proprotein convertases, proteolysis, opioid peptides, spinal cord, pain, high performance liquid chromatography, mass spectrometry.

No description available.

Die bakterielle Meningitis (BM) ist trotz antibiotischer Therapie eine Erkrankung mit einer hohen Mortalität und Morbidität. Kopfschmerzen und Meningismus sind Hauptsymtome und ein klinischer Hinweis für die Aktivierung trigeminaler Fasern. Ziel dieser Arbeit war es zu prüfen ob die freigesetzten Neuropeptide einen proinflammatorischen Effekt auf zerebrale Endothelzellen, einen wesentlichem Bestandteil der Blut-Hirn-Schranke haben. Wir verwendeten primär kultivierte zerebrale Kapillarendothelzellen (BMEC) der Ratte und als Stimulus Neuropeptide und/oder Pneumokokkenzellwände (PCW). Beide Neuropeptide, CGRP mehr als SP, verstärken den Effekt von PCW auf die mRNA Expression und Freisetzung von TNF-alpha, IL-1beta, IL-6, IL-10 und MIP-2 aus den BMEC. CGRP und SP haben nur eine geringe Wirkung. PCW regulieren die Dichte der CRLR (CGRP1-R) bzw. NK-1 Rezeptoren und erklären damit die kostimulatorische Wirkung. Zudem untersuchten wir den Effekt von PCW und/oder CGRP auf die Adrenomedullin (AM)- Synthese. AM ist ein vasodilatorisch wirkendes Peptid, dass vorwiegend in Endothelzellen konstitutiv gebildet wird und am CRLR Rezeptor wirkt. PCW und CGRP verstärken die Synthese von AM. Mit dieser Arbeit konnte gezeigt werden, dass PCW zur Hochregulation von Neuropeptidrezeptoren führt und CGRP und SP über diese Rezeptoren einen modulatorischen Effekt auf die Zytokinproduktion in BMEC haben. Ein genaues Verständnis dieser Interaktionen könnte die Entwicklung immunmodulatorischer Interventionen und damit eine Verbesserung der Prognose der bakteriellen Meningitis bewirken. / Despite antibiotic treatment bacterial meningitis is still associated with a high mortality and morbidity. Headache and meningismus as key symptoms, provide clear evidence for the activation of trigeminal nerve fibers. Aim of the study was to test whether the released neuropeptides have a proinflammatory effect in cerebral endothelial cells the major compartment of the blood brain barrier. We used primary brain microvascular endothelial cells of the rat (BMEC) which were stimulated with CGRP, SP and/or pneumococcal cell walls (PCW). Both neuropeptides CGRP more than SP enhanced PCW-induced mRNA expression and the release of TNF-alpha, IL-1-beta, IL-6, IL-10 and MIP-2. Neuropeptides alone were not able to induce these cytokines. PCW upregulate the density of CRLR receptor and regulate the NK-1 receptor and therefore may explain the costimulatory effect. Furthermore the effect of PCW and/or CGRP on adrenomedullin synthesis in BMEC was investigated. Adrenomedullin is a vasodilatatory peptide, which is constitutivly produced by endothelial cells and act on the CRLR receptor. PCW as well as CGRP enhance the synthesis of AM. Our data suggest that PCW upregulate neuropeptide receptors and modulate via these specific receptors the cytokine production. A detailed understanding of these interactions may open new immunmodulatory interventions and therefore may contribute to a better prognosis of bacterial meningitis.

INTRODUÇÃO: A toxina botulínica tipo A (TXB-A) tem sido testada no tratamento da rinite, principalmente nos casos de rinite idiopática. Sugere-se que um estado de hiper-reatividade do nervo trigêmeo esteja envolvido na fisiopatologia da rinite idiopática. O nervo trigêmeo possui fibras sensitivas não mielinizadas tipo C (FSNMT-C) que contém os neuropeptídeos substância P (SP) e peptídeo relacionado ao gene da calcitonina (CGRP). O óxido nítrico (NO) produzido pelas enzimas óxido nítrico sintase (NOS) também está envolvido nesse processo de neurorregulação nasal. O transporte mucociliar, mecanismo primário de defesa do sistema respiratório, é formado pelo batimento ciliar e muco nasal, e esses componentes podem ser influenciados por diferentes neuropeptídeos e neurotransmissores presentes na mucosa nasal. OBJETIVO: O objetivo deste estudo foi avaliar o efeito da TXB-A sobre a expressão da SP, CGRP e óxido nítrico sintase neural (nNOS), além de sua influência sobre o transporte mucociliar nasal em coelhos. MÉTODOS: Coelhos machos saudáveis da linhagem Nova Zelândia foram divididos em dois grupos: o grupo tratamento recebeu TXB-A (25UI) na concha nasomaxilar (CNM) do lado direito e soro fisiológico a 0,9% (SF0,9%) na CNM esquerda. O grupo controle recebeu SF0,9% na CNM direita e nenhuma intervenção na CNM esquerda. Foram investigados os efeitos da TXB-A sobre a expressão da SP, CGRP e nNOS no tecido de CNM por meio da imuno-histoquímica. Para esta análise, dividiu-se o tecido em camada externa (CE, acima da membrana basal) e camada interna (CI, abaixo da membrana basal). Avaliou-se também a presença de apoptose celular, a frequência de batimento ciliar (FBC), o perfil histoquímico do muco nasal (glicoproteínas ácidas e neutras) e a espessura do epitélio (ESP-CE). RESULTADOS: Foi observado um aumento significativo na quantidade de células apoptóticas na CNM do grupo tratamento que recebeu TXB-A em comparação aos controles (p <= 0,001). A CNM do grupo tratamento que recebeu SF0,9% exibiu um aumento na quantidade de células apoptóticas na CI ao comparar com os controles (CNM SF0,9%, p=0,035) (CNM sem intervenção, p=0,022), e também um aumento da expressão de SP na CE em comparação aos controles (CNM SF0,9%, p=0,021) (CNM sem intervenção, p=0,040). A expressão de CGRP apresentou um aumento na CNM do grupo tratamento que recebeu TXB-A em comparação à CNM sem intervenção (p=0,008). A FBC, expressão de nNOS, perfil histoquímico do muco nasal e ESP-CE não apresentaram diferenças significativas. DISCUSSÃO: O aumento da expressão de CGRP e SP pode ter sido causado por inibição de sua exocitose vesicular pela TXB-A, levando ao seu acúmulo intracelular. Não foram observadas diferenças significativas na FBC ou perfil histoquímico do muco nasal, indicando que o aumento da expressão de CGRP e SP não foi associado à inflamação. O aumento da quantidade de células apoptóticas e da expressão de SP na CNM SF0,9% do grupo tratamento pode ter sido causado por um efeito central da TXB-A. CONCLUSÃO: A administração nasal de TXB-A aumentou a expressão de CGRP e SP, possivelmente por acúmulo intracelular por causa da inibição da sua exocitose, mas sem alterar a FBC e o perfil histoquímico do muco nasal / INTRODUCTION: Botulinum toxin type A (BoNT-A) has been assessed in the treatment of rhinitis, especially in cases of idiopathic rhinitis. Trigeminal hyper-responsiveness appears to be involved in the pathological process of idiopathic rhinitis. Trigeminal nociceptive type C unmyelinated sensory fibers contain the neuropeptides calcitonin gene-related peptide (CGRP) and substance P (SP). Nitric oxide (NO) produced by the enzyme nitric oxide synthase (NOS) are also involved in this nasal neurorregulation process. The mucociliary clearance, primary defense system of the respiratory system, is composed by the ciliary beat and nasal mucus. These components can be influenced by different nasal neuropeptides and neurotransmitters. OBJECTIVE: The aim of this study was to evaluate the effect of BoNT-A on the expression of SP, CGRP and neural nitric oxide synthase (nNOS), and its influence on nasal mucociliary clearance in rabbits. METHODS: Healthy New Zealand male rabbits were divided into two groups: the treatment group was challenged with BoNT-A (25UI) in the right nasomaxillary turbinate (NMT) and saline (SF0.9%) in the left NMT. The control group received SF0.9% in the right NMT and no-intervention in the left NMT. We investigated the effects of BoNT-A on SP, CGRP and nNOS expression in the NMT tissue by immunohistochemistry. Each area of interest was subdivided into an internal layer (IL: below the basement membrane) and outer layer (OL: above the basement membrane) for analysis. It was also assessed signs of cellular apoptosis, ciliary beat frequency (CBF), mucus histochemical profile (acidic and neutral glycoproteins) and epithelial thickness (EP-TH). RESULTS: It was observed a significant increase in the amount of apoptotic cells in the BoNT-A-challanged NMT compared with controls (p <= 0.001). The NMT of treatment group which received only SF0.9% showed an increase in the amount of apoptotic cells in the IL compared with controls (NMT SF0.9%, p = 0.035) (NMT no-intervention, p = 0.022), and also an increase in the SP expression in the OL compared with controls (NMT SF0.9%, p = 0.021) (NMT no-intervention, p = 0.040). CGRP expression showed higher expression in the BoNT-A-challanged NMT compared with no-intervention NMT (p=0.008). The CBF, nNOS expression, mucus histochemical profile and EP-TH did not show significant differences. DISCUSSION: The increased CGRP and SP expression could be due to inhibition of vesicular exocytosis by BoNT-A, leading to CGRP and SP intracellular accumulation. No significant differences in CBF or mucus histochemical profile were observed, indicating that the increased CGRP and SP expression was not associated with inflammation. The increase in the amount of apoptotic cells and SP expression in the SF0.9% NMT of treatment group may be due to a central effect of BoNT-A. CONCLUSION: Nasal administration of BoNT-A increased SP and CGRP expression, possibly via inhibition of their release, but did not change the CBF or mucus profile

Anxiety disorders are very common and the primary feature is abnormal or inappropriate anxiety. Fear and anxiety is often mediated by the amygdala, a brain structure rich in substance P (SP) and neurokinin 1 (NK1) receptors. To learn more about how the human amygdala is modulated by fear and anxiety in event-triggered anxiety disorders and to investigate if the SP/NK1 receptor system is affected, regional cerebral blood flow (rCBF) ([15O]-water; Study I and II) and the SP/NK1 receptor system ([11C]GR205171; Study III and IV) were studied with positron emission tomography (PET). In Study I we investigated the neural correlates of affective startle modulation in persons with specific phobia by measuring rCBF during exposure to fearful and non-fearful pictures, paired and unpaired with acoustic startle stimuli. Fear-potentiated startle was associated with activation of the affective part of the anterior cingulate cortex and the left amygdaloid–hippocampal area. In Study II short-term drug treatment effects on rCBF in patients diagnosed with social phobia was evaluated, comparing the NK1 receptor antagonist GR205171 to the selective serotonin reuptake inhibitor citalopram and placebo. Social anxiety and neural activity in the medial temporal lobe including the amygdala was significantly reduced by both drugs but not placebo. In Study III we investigated if activity in the SP/NK1 receptor system in the amygdala would be affected by fear provocation in individuals with specific snake or spider phobia. Fear provocation was associated with a decreased uptake of the NK1 antagonist [11C]GR205171 in the amygdala, possibly explained by an increase in endogenous SP release occupying the NK1 receptors. Study IV was conducted to explore the resting state NK1 receptor availability in PTSD patients as compared to healthy controls. Increased resting state binding of the tracer [11C]GR205171 in the amygdala of patients with PTSD suggested an increased amount of available receptors. In summary, fear and fear-potentiated startle modulates the human amygdala, possibly through the SP/NK1 receptor system.

The biological half-life of several pro-inflammatory mediators involved in the pathogenesis of rheumatoid arthritis (RA) is controlled by molecules exhibiting dipeptidyl peptidase-IV (DPP-IV)-like enzymatic activity (Dipeptidyl peptidase-IV activity and/or structure homologues- DASH). The aim of this thesis was to identify the molecular source of the DPP-IV-like enzymatic activity in the peripheral blood and synovial fluid in patients with rheumatoid arthritis as compared to control patients with osteoarthritis (OA), and to evaluate the association of DPP-IV with the disease activity. We found that the main source of the DPP-IV-like enzyme activity in the plasma and in the synovial fluid in patients with RA is the canonical DPP-IV. DPP-IV-like enzymatic activity and canonical DPP-IV were also detected on the cell surface of blood and synovial fluid mononuclear cells. Significantly lower DPP-IV-like enzymatic activity and DPP-IV expression in the synovial fluid mononuclear cells was found in RA as opposed to OA patients. In the synovial fluid of RA patients there was also a negative correlation between the concentration of the pro-inflammatory DPP-IV substrate SDF (stromal cell-derived factor-1 and the proportion of the DPP-IV+ T cells. The blood plasma DPP-IV-like enzymatic activity and...

INTRODUÇÃO: A toxina botulínica tipo A (TXB-A) tem sido testada no tratamento da rinite, principalmente nos casos de rinite idiopática. Sugere-se que um estado de hiper-reatividade do nervo trigêmeo esteja envolvido na fisiopatologia da rinite idiopática. O nervo trigêmeo possui fibras sensitivas não mielinizadas tipo C (FSNMT-C) que contém os neuropeptídeos substância P (SP) e peptídeo relacionado ao gene da calcitonina (CGRP). O óxido nítrico (NO) produzido pelas enzimas óxido nítrico sintase (NOS) também está envolvido nesse processo de neurorregulação nasal. O transporte mucociliar, mecanismo primário de defesa do sistema respiratório, é formado pelo batimento ciliar e muco nasal, e esses componentes podem ser influenciados por diferentes neuropeptídeos e neurotransmissores presentes na mucosa nasal. OBJETIVO: O objetivo deste estudo foi avaliar o efeito da TXB-A sobre a expressão da SP, CGRP e óxido nítrico sintase neural (nNOS), além de sua influência sobre o transporte mucociliar nasal em coelhos. MÉTODOS: Coelhos machos saudáveis da linhagem Nova Zelândia foram divididos em dois grupos: o grupo tratamento recebeu TXB-A (25UI) na concha nasomaxilar (CNM) do lado direito e soro fisiológico a 0,9% (SF0,9%) na CNM esquerda. O grupo controle recebeu SF0,9% na CNM direita e nenhuma intervenção na CNM esquerda. Foram investigados os efeitos da TXB-A sobre a expressão da SP, CGRP e nNOS no tecido de CNM por meio da imuno-histoquímica. Para esta análise, dividiu-se o tecido em camada externa (CE, acima da membrana basal) e camada interna (CI, abaixo da membrana basal). Avaliou-se também a presença de apoptose celular, a frequência de batimento ciliar (FBC), o perfil histoquímico do muco nasal (glicoproteínas ácidas e neutras) e a espessura do epitélio (ESP-CE). RESULTADOS: Foi observado um aumento significativo na quantidade de células apoptóticas na CNM do grupo tratamento que recebeu TXB-A em comparação aos controles (p <= 0,001). A CNM do grupo tratamento que recebeu SF0,9% exibiu um aumento na quantidade de células apoptóticas na CI ao comparar com os controles (CNM SF0,9%, p=0,035) (CNM sem intervenção, p=0,022), e também um aumento da expressão de SP na CE em comparação aos controles (CNM SF0,9%, p=0,021) (CNM sem intervenção, p=0,040). A expressão de CGRP apresentou um aumento na CNM do grupo tratamento que recebeu TXB-A em comparação à CNM sem intervenção (p=0,008). A FBC, expressão de nNOS, perfil histoquímico do muco nasal e ESP-CE não apresentaram diferenças significativas. DISCUSSÃO: O aumento da expressão de CGRP e SP pode ter sido causado por inibição de sua exocitose vesicular pela TXB-A, levando ao seu acúmulo intracelular. Não foram observadas diferenças significativas na FBC ou perfil histoquímico do muco nasal, indicando que o aumento da expressão de CGRP e SP não foi associado à inflamação. O aumento da quantidade de células apoptóticas e da expressão de SP na CNM SF0,9% do grupo tratamento pode ter sido causado por um efeito central da TXB-A. CONCLUSÃO: A administração nasal de TXB-A aumentou a expressão de CGRP e SP, possivelmente por acúmulo intracelular por causa da inibição da sua exocitose, mas sem alterar a FBC e o perfil histoquímico do muco nasal / INTRODUCTION: Botulinum toxin type A (BoNT-A) has been assessed in the treatment of rhinitis, especially in cases of idiopathic rhinitis. Trigeminal hyper-responsiveness appears to be involved in the pathological process of idiopathic rhinitis. Trigeminal nociceptive type C unmyelinated sensory fibers contain the neuropeptides calcitonin gene-related peptide (CGRP) and substance P (SP). Nitric oxide (NO) produced by the enzyme nitric oxide synthase (NOS) are also involved in this nasal neurorregulation process. The mucociliary clearance, primary defense system of the respiratory system, is composed by the ciliary beat and nasal mucus. These components can be influenced by different nasal neuropeptides and neurotransmitters. OBJECTIVE: The aim of this study was to evaluate the effect of BoNT-A on the expression of SP, CGRP and neural nitric oxide synthase (nNOS), and its influence on nasal mucociliary clearance in rabbits. METHODS: Healthy New Zealand male rabbits were divided into two groups: the treatment group was challenged with BoNT-A (25UI) in the right nasomaxillary turbinate (NMT) and saline (SF0.9%) in the left NMT. The control group received SF0.9% in the right NMT and no-intervention in the left NMT. We investigated the effects of BoNT-A on SP, CGRP and nNOS expression in the NMT tissue by immunohistochemistry. Each area of interest was subdivided into an internal layer (IL: below the basement membrane) and outer layer (OL: above the basement membrane) for analysis. It was also assessed signs of cellular apoptosis, ciliary beat frequency (CBF), mucus histochemical profile (acidic and neutral glycoproteins) and epithelial thickness (EP-TH). RESULTS: It was observed a significant increase in the amount of apoptotic cells in the BoNT-A-challanged NMT compared with controls (p <= 0.001). The NMT of treatment group which received only SF0.9% showed an increase in the amount of apoptotic cells in the IL compared with controls (NMT SF0.9%, p = 0.035) (NMT no-intervention, p = 0.022), and also an increase in the SP expression in the OL compared with controls (NMT SF0.9%, p = 0.021) (NMT no-intervention, p = 0.040). CGRP expression showed higher expression in the BoNT-A-challanged NMT compared with no-intervention NMT (p=0.008). The CBF, nNOS expression, mucus histochemical profile and EP-TH did not show significant differences. DISCUSSION: The increased CGRP and SP expression could be due to inhibition of vesicular exocytosis by BoNT-A, leading to CGRP and SP intracellular accumulation. No significant differences in CBF or mucus histochemical profile were observed, indicating that the increased CGRP and SP expression was not associated with inflammation. The increase in the amount of apoptotic cells and SP expression in the SF0.9% NMT of treatment group may be due to a central effect of BoNT-A. CONCLUSION: Nasal administration of BoNT-A increased SP and CGRP expression, possibly via inhibition of their release, but did not change the CBF or mucus profile

The biological half-life of several pro-inflammatory mediators involved in the pathogenesis of rheumatoid arthritis (RA) is controlled by molecules exhibiting dipeptidyl peptidase-IV (DPP-IV)-like enzymatic activity (Dipeptidyl peptidase-IV activity and/or structure homologues- DASH). The aim of this thesis was to identify the molecular source of the DPP-IV-like enzymatic activity in the peripheral blood and synovial fluid in patients with rheumatoid arthritis as compared to control patients with osteoarthritis (OA), and to evaluate the association of DPP-IV with the disease activity. We found that the main source of the DPP-IV-like enzyme activity in the plasma and in the synovial fluid in patients with RA is the canonical DPP-IV. DPP-IV-like enzymatic activity and canonical DPP-IV were also detected on the cell surface of blood and synovial fluid mononuclear cells. Significantly lower DPP-IV-like enzymatic activity and DPP-IV expression in the synovial fluid mononuclear cells was found in RA as opposed to OA patients. In the synovial fluid of RA patients there was also a negative correlation between the concentration of the pro-inflammatory DPP-IV substrate SDF (stromal cell-derived factor-1 and the proportion of the DPP-IV+ T cells. The blood plasma DPP-IV-like enzymatic activity and...