Puumala hantavirus (PUUV) causes hemorrhagic fever with renal syndrome in Europe. After inhalation of virus shed by bank voles, the virus systemically targets the vascular endothelium leading to vascular dysfunction and leakage. Many patients with PUUV infection experience cardiopulmonary manifestations but the underlying mechanisms have not been determined. The aims of the studies presented were to describe cardiopulmonary manifestations, investigate pathogenetic mechanisms including presence of virus in the lungs and the local immune response in PUUV infection. The results showed cardiopulmonary involvement of varying severity in almost all studied patients. High-resolution computed tomography frequently revealed vascular leakage into the lungs or pleural cavities. Pulmonary function tests generally showed reduced gas diffusing capacity, evidenced in patients as dyspnea, poor oxygenation and frequent need of oxygen treatment. Among patients who were not fully recovered at 3 months follow-up, remaining decreased gas diffusing capacity was highly common. Echocardiography revealed mainly right heart dysfunction which was related to manifestations within the lungs, in terms of increased estimated pulmonary vascular resistance, mild to moderate pulmonary hypertension, and reduced right ventricular systolic function in patients with more pronounced lung involvement, as indicated by need of oxygen treatment. Analyses on bronchoalveolar lavage (BAL) and bronchial biopsies revealed a highly activated cytotoxic T cell (CTL) response in the lungs. The CTL response was not balanced by the expansion of regulatory T cells and high numbers of CTLs were associated with more severe disease. PUUV RNA was detected in almost all patients’ BAL samples and the viral load was inversely correlated to the number of CTLs. Three patients presenting with severe and fatal cardiopulmonary distress were also described. Autopsies revealed PUUV protein in vascular endothelium in all investigated organs, including the heart and lungs, along with a massive CTL response mainly in the lungs. In conclusion, cardiopulmonary involvement of varying severity was present in almost all patients with PUUV infection. Cytotoxic immune responses could contribute to disease development but also help in clearing the infection. Long lasting fatigue after hantavirus infection may be explained by remaining manifestations within the lungs.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Submitted by Karina Calciolari null (karinaveterinaria@hotmail.com) on 2016-04-18T19:09:55Z No. of bitstreams: 1 Dissertação_Karina Calciolari.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-04-19T17:12:27Z (GMT) No. of bitstreams: 1 calciolari_k_me_jabo.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) / Made available in DSpace on 2016-04-19T17:12:27Z (GMT). No. of bitstreams: 1 calciolari_k_me_jabo.pdf: 3537872 bytes, checksum: 25bdb76342a16861139075d0c9e32394 (MD5) Previous issue date: 2016-02-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As afecções do sistema respiratório são a segunda causa de queda de desempenho e afastamento dos equinos do esporte ou trabalho, as quais estão atrás somente das desordens musculoesqueléticas. A estabulação e alimentação a base de fenos predispõe os equinos a inalação de grande número de agentes irritantes as vias aéreas. No intuito de mensurar a influência dos tipos de cama utilizado em baias de equinos nas respostas alérgicas das vias aéreas estudou-se 3 grupos com 5 equinos cada sendo dois mantidos em cocheiras com diferentes tipos de forração à base de madeira (maravalha de pinus autoclavada-MA e serragem-SE) e por último um grupo controle à pasto por 45 dias com avaliações quinzenais (D0, D15, D30 e D45). Foi realizado nestes momentos o exame físico, coleta de amostras de sangue venoso e arterial para realização de hemograma e hemogasometria respectivamente, lavado broncoalveolar com análise citológica e mensuração de fosfatase alcalina, além de amostras das camas (limpa e suja) e feno pré-secado para análise micológica. No exame físico foi notado tosse e espirros em maior intensidade e número nos equinos do grupo SE. A análise hematológica permaneceu dentro dos padrões de normalidade. Já nos achados hemogasométricos os maiores valores de pH foram observados nos equinos à pasto (7,47 ± 0,02). Nos grupos embaiados foi observado valores de pressão parcial de dióxido, de D15 à D45, inferiores (valores entre 38,3 a 43,7 mmHg) ao grupo a pasto (valores entre 43,7 a 46,5 mmHg), sendo os valores de pressão parcial de oxigênio inversamente proporcionais (MA e SE: valores entre 103,6 a 127,78 mmHg e à pasto: 88,2 a 103,6 mmHg). Os principais achados no lavado broncoalveolar basearam-se na contagem de células nucleadas totais no que apresentou maiores valores em todos os momentos nos animais à pasto (251,0 a 336,8 x 103/ µL), seguido do grupo SE (197,0 a 248,6 x 103/ µL) e por último o MA (140,6 à 270,2 x 103/ µL). Dentre as células nucleadas os macrófagos representaram maior porcentagem seguidos dos linfócitos (51,2 a 80,8% e 6,6 a 33,2% respectivamente). Um padrão inesperado foi observado na população de neutrófilos, os quais com os passar dos momentos houve decréscimo, com excessão do grupo MA que apresentou um pico no D30 (35%), relacionado ao pico de fosfatase alcalina (27,6 ± 14,98 UI/L) neste mesmo momento. Foram identificados cerca de 12 gêneros fúngicos em ambas camas e 17 no alimento volumoso, sendo neste último encontrado gêneros patogênicos como Aspergillus (0,85 ± 2,2%), Fusarium (5,35 ± 9,23%) e Penicílium (4,81 ± 9,53%), porém em baixas porcentagens. A principal diferença entre as camas baseou-se na capacidade da produção e dispersão de partículas finas passíveis de inalação, a qual foi maior para a serragem (MA: 15,29 % e SE: 18,28%). Concluiu-se que a cama de maravalha além de ter manejo mais fácil, apresentou menor capacidade irritativa das vias aéreas superiores do que a serragem. As condições de manejo e estabulações utilizadas foram ideais, servindo de modelo quanto a ventilação e higienização das baias. / Horse respiratory diseases is second most commom cause of poor performance and premature retirement, which the one are musculoskeletal disorders. The stabling and poor quality feedings may the favor predispose of diseases in airways. In order we measure the influence of the types of bedding used in the horse stalls about responses allergic airway. Three groups of five horses each are formated, two groups kept in stables but each group with a different type of bedding (autoclaved wood- MA shaving and sawdust-SE) . The third group is the control and stays at pasture. The groups remained in this condition for 45 days with biweekly reviews (D0, D15, D30 and D45). It was realize the physical examination, venous and arterial blood samples collection to realize hemogram and hemogasometry analysis, the bronchoalveolar lavage samples was colected to realize the cytological analysis and to measure alkaline phosphatase. In addition, samples of the beds (clean and dirty) and haylage was collected to realize mycological analysis. In the physical examination was noticed higher intensity of coughing and sneezing at SE group. Hematological analysis remained within the normal standards. Findings of hemogasometric analysis were observed the biggest pH values at horses to pasture (7.47 ± 0.02). At stables horses was observed smaller values of partial pressure dioxide (D15 to D45), (values between 38.3 to 43.7 mmHg) to horses to pasture (values between 43.7 to 46.5 mmHg). The values oxygen partial pressure it was inversely proportional to partial pressure dioxide (MA and SE: values between 103.6 to 127.78 mmHg and pasture: 88.2 to 103.6 mmHg). It was observate higher values of nucleated cells of bronchoalveolar lavage, at all times, in animals to pasture (251.0 to 336.8 x 103 / mL), followed by the SE group (197.0 to 248.6 x 103 / mL) and finally MA group (140.6 to 270.2 x 103 / mL). The macrophages cells represented the biggest percentage of nucleates cells on bronchoalveolar lavage followed by lymphocytes (51.2 to 80.8% and 6.6 to 33.2% respectively). An unexpected pattern was observed in percentange of neutrophils cells, that it was a decrease over the time. One exception it was with MA group that had the biggest percentage values in D30 (35%), it was related to alkaline phosphatase peak at same time (27.6 ± 14.98 IU / L). Were identified about 12 fungi genres in both beds and 17 fungi genres at haylage. We indentified pathogenic genres in haylage as Aspergillus (0.85 ± 2.2%), Fusarium (5.35 ± 9.23%) and Penicillium (4 , 81 ± 9.53%), however in lower percentages. It was observate a difference production capacity and fine particle dispersion between the bed, that the biggest it was notice at sawdust (MA: 15.29% and SE: 18.28%). It was concluded that wood shavings bed is easier to use and showed less irritative capacity upper airway to que sawdust. As management and stabling conditions used were ideals and it was a ideal model of stables.

Há diversas evidências epidemiológicas de correlações positivas entre indicadores de morbidade e mortalidade pulmonar e cardiovascular e aumentos na concentração atmosférica de MP2,5 (material particulado fino). O objetivo deste trabalho foi avaliar os efeitos da exposição subcrônica de MP2,5 sobre o tônus cardíaco autonômico, a inflamação pulmonar e sistêmica; o estresse oxidativo e a homeostase sanguínea, após oito semanas de repetidas instilações nasais de suspensão aquosa de MP2,5 da cidade de São Paulo em concentração ambiental. Dividiram-se os animais em dois grupos: salina e MP2,5 e avaliaram-se os seguintes parâmetros: frequência cardíaca (FC), variabilidade da frequência cardíaca (VFC), pressão arterial sistólica (PA), hemograma, contagem de plaquetas e reticulócitos, fibrinogênio plasmático, tempo de protrombina (TP), tempo de tromboplastina parcialmente ativada (TTPA), mielograma, citologia do lavado broncoalveolar (LBA), análise histopatológica e imuno-histoquímica (15-F2tisoprostano e -actina) de pequenas arteríolas pulmonares e coronarianas. Não houve alterações na FC e na PA (p > 0,05). Houve interação estatisticamente significante entre grupos e semanas em relação à VFC. O SDNN (desvio padrão dos intervalos R-R normais), a r-MSSD (raiz quadrada da média dos quadrados das diferenças sucessivas entre intervalos R-R normais adjacentes) e a AF (alta frequência) do grupo MP2,5 aumentaram significativamente na 7ª semana em comparação à 1ª semana (p < 0,05), enquanto a BF (baixa frequência) não se alterou (p > 0,05). A porcentagem de macrófagos no LBA do MP2,5 diminuiu significativamente (p < 0,05). Não se observaram alterações no sangue, mielograma e análise histopatólogica e imuno-histoquímica dos vasos (p > 0,05). Concluiu-se que a exposição subcrônica pela instilação nasal de suspensão aquosa de MP2,5 em concentração ambiental causou inflamação pulmonar tênue e alterou o equilíbrio cardíaco autonômico / There are several epidemiological evidences of positive correlation between indicators of pulmonary and cardiovascular morbidity and mortality and increases of PM2.5 (fine particulate matter) air concentration. The aim of this experiment was to evaluate the effects of subchronic exposure of PM2.5 on cardiac autonomic tone, pulmonary and systemic inflammation, oxidative strees and blood homeotasis of healthy rats after eight weeks of repeated nasal instillations of suspended PM2.5 from Sao Paulo city in environmental concentration. Rats were divided in two groups: saline and PM2.5. The following parameters were evaluated: heart rate (HR), heart rate variability (HRV), systolic blood pressure (BP), hemogram, platelets and reticulocytes count, plasmatic fibrinogen, prothrombin time (PT), activated partial thromboplastin time (APTT), bone marrow cells, bronchoalveolar lavage cells (BAL), histopathological and immunohistochemical analysis (15-F2tisoprostane and -actin) of pulmonary and coronary small arterioles. No changes were detected in HR and BP (p > 0.05). There were a statistically significant interaction between groups and weeks in relation to HRV. SDNN (standard deviation of normal RR intervals), r-MSSD (square root of the mean of the squared differences between adjacent normal RR intervals) and HF (high frequency) of PM2.5 group significantly increased on 7th week compaired to 1st week (p < 0.05), while LF (low frequency) did not alter (p > 0.05). BAL macrophages porcentage of PM2.5 group significantly decreased (p < 0.05). No alterations were observed in blood, bone marrow cells, histopathological and immunohistochemical analysis of vessels (p > 0.05). We concluded that subchronic exposure by nasal instillation of aquous suspension of PM2.5 in environmental concentration caused tenuous pulmonary inflammation and altered cardiac autonomic balance

A constant flow of various pathogens enters the respiratory system on daily basis through the involuntary mechanism of breathing. Respiratory viral infections are common yet can be fatal in vulnerable populations. Respiratory syncytial virus (RSV) is one of the first and most common viruses that the human population acquire in the first two years of life. Despite the ability of most infants to recover from a RSV infection, many require hospitalization and, in few cases, die from such an infection. The pattern of seasonality of respiratory viruses also applies to RSV. In this work the temperature dependence of infectivity was studied in Hep-2 cells infected with RSV that had been incubated with bronchoalveolar lavage (BAL) fluid. The results indicate a temperature dependence of infectivity. Inhibition of the viral infectivity was observed at three different temperatures 37 ̊C, 40 ̊C and 42 ̊C. The inhibition appears to be linked to the appearance of large agglutinates that appear to reduce the infectivity of RSV. Such a study found that viral neutralization is dependent on a temperature-dependent agglutination reaction. The causality of agglutination formation requires further investigation in order to conclusively confirm the immunological component(s) of this reaction, and how temperature is contributing to this reaction.

Multiple biomarkers of oxidative stress have been measured and used in human medicine to diagnose and monitor airway disease. The purpose of the study was to determine if similar relationships existed between inflammatory and oxidative stress biomarkers in exhaled breath condensate (EBC), bronchoalveolar lavage fluid (BALF), red blood cells, white blood cells, and plasma; and cytokine expression in airway inflammatory cells and mucosal biopsies of RAO-affected horses and their controls. Sixteen horses in pairs were used: 8 non-RAO-affected (controls) and 8 RAO-affected horses. Samples from all horses were collected at remission (S1), during environmental challenge (S2) and at recovery (S3). RAO-affected horses had significant alterations in cellular glutathione peroxidase (cGPx) activity, ascorbic acid and pH in a number of biological samples. Concentrations of 8-isoprostanes, isofurans, amino acids and mRNA expression of interleukin 4 (IL4), gamma interferon (INFγ), inducible nitric oxide synthase (iNOS), extracellular glutathione peroxidase (GPx-3), and cytosolic superoxide dismutase (SOD-1) were not significantly different or were at the limits of detection. Conductivity was measured and assessed as a potential correctional factor for respiratory fluid dilution. The alterations in biomarker concentrations demonstrate that oxidative stress is an important component of airway inflammation in RAO-affected horses. Further research is warranted in the use of biomarkers and the effects of dietary interventions. / Master of Science

Este trabalho teve por objetivo avaliar as alterações respiratórias e neurológicas resultantes da infecção por via intranasal das diferentes estirpes nacionais do herpesvírus equino tipo 1 (EHV-1) em hamsters comparando sua susceptibilidade com estudos sobre infecção do EHV-1 em camundongos e equinos. Para isso, hamsters sírios machos, três semanas de idade, foram infectados por via intranasal com as estirpes do EHV-1 obtidas a partir de fetos abortados e potro neonato infectados (A4/72, A9/92, A3/97 e Iso/72). Os animais foram pesados e examinados diariamente em busca de sinais clínicos e neurológicos. Conforme os sintomas neurológicos apareceram, grupos de cinco hamsters foram eutanasiados por overdose de isoflurano na primeira etapa do projeto, e, de cetamina/xilazina por via intraperitoneal na segunda etapa. Na necropsia, sistema nervoso central (SNC), pulmão, fígado, baço e timo foram coletados para isolamento viral em cultura de células E-dermal e para análise histopatológica. Na segunda etapa do projeto, a lavagem broncoalveolar (LBA) com 3 ml de PBS por hamsters foi realizada para determinar a resposta inflamatória pulmonar através da contagem total e diferencial de leucócitos. Similar aos experimentos com camundongos, hamsters desafiados com as estirpes virais A4/72 e A9/92 apresentaram manifestações clínicas severas no terceiro dia pós-inoculação (dpi), tais como perda de peso aguda, dispnéia, desidratação, decúbito e morte. Observou-se também sinais neurológicos como hiperexcitabilidade, paralisia, espasmos, perda de propriocepção, andar em círculos e convulsões. Ao contrário dos camundongos, que não desenvolveram a doença; hamsters inoculados com as estirpes virais A3/97 e Iso/72 manifestaram sintomas respiratórios e neurológicos agudos entre quarto e quinto dpi, sendo as alterações respiratórias as mais evidentes, principalmente hemoptise e conjuntivite. O isolamento do vírus a partir do SNC foi positivo em todos os animais infectados; no entanto, todas as amostras de pulmões foram positivas apenas nos grupos infectado pelas estirpes virais A9/92 e A4/72. Todas as estirpes do EHV-1 foram isoladas a partir do baço, no entanto, a partir do timo foram isoladas apenas as estirpes A9/92 e A4/72, e, de fígado somente a estirpe viral Iso/72 não foi isolada. No LBA, a contagem total de leucócitos não demonstrou diferenças de valores significativas entre os grupos experimentais, sendo apenas evidente a presença de eritrócitos, macrófagos e neutrófilos na maioria dos esfregaços dos hamsters infectados. Porém, na contagem diferencial de leucócitos observou-se um aumento significativo de neutrófilo com consequente diminuição significativa de macrófagos nos hamsters infectados pelas estirpes virais A3/97, Iso/72 e A4/72 quando comparados ao grupo controle. Os hamsters infectados pela estirpe viral A9/92 mantiveram valores próximos aos do grupo controle. Ao avaliar microscopicamente o SNC, fígado e pulmão dos hamsters infectados foi observado infiltrado inflamatório, necrose e manguito perivascular em SNC; leucocitose e necrose no parênquima hepático com discreta pericolangite e proliferação de ducto biliar; e em pulmão observou inflamação, necrose, edema e hemorragia em bronquíolos e alvéolos. Concluindo, os resultados apontaram o hamster como a espécie mais susceptível à infecção pelo EHV-1 servindo como um modelo experimental complementar para estudos de doenças respiratória e neurológica provocadas por este agente em equinos / This study aimed to evaluate the respiratory and neurological disorders resulting from intranasal infection with different national strains of equine herpesvirus type 1 (EHV-1) in hamsters comparing their susceptibility to studies about EHV-1 infection in mice and horses. Therefore, male Syrian hamsters, three weeks of age, were infected via intransal with EHV-1 strains obtained from aborted fetuses and neonatal foal infected (A4/72, A9/92, A3/97 and Iso/72). The animals were weighed and examined daily for clinical search and neurological signs. As neurological symptoms appeared five hamsters groups were euthanized by isoflurane overdose in the first stage of the project, and ketamine/xylazine via intraperitoneal in the second stage. At necropsy, central nervous system (CNS), lung, liver, spleen and thymus were collected for virus isolation in E-dermal cell culture and histopathological analysis. In the second stage of the project, bronchoalveolar lavage (BAL) with 3 ml of PBS per hamsters was performed to determine the pulmonary inflammatory response through the total and differential leukocyte count. Similar to the experiments with mice, hamsters challenged with viral strains A4/72 and A9/92 had severe clinical manifestations in the third day post-inoculation (dpi), such as acute weight loss, dyspnea, dehydration, recumbency, and death. It was also observed neurological signs such as hyperexcitability, paralysis, spasms, loss of proprioception, circling and convulsions. Unlike mice, which did not develop disease; hamsters inoculated with viral strains A3/97 and Iso/72 showed acute respiratory and neurological symptoms between fourth and fifth dpi, and the most evident respiratory distress was hemoptysis and conjunctivitis. The virus isolation from CNS was positive in all infected animals; however, all lung samples were positive only in groups infected by A9/92 and A4/72 viral strains. All EHV-1 strains were recovered from spleen, however, only A9/92 and A4/72 viral strains were recovered from thymus, but only Iso/72 viral strain was not recovered from liver. BAL total leukocyte count showed no significant differences in values between the experimental groups but the presence of erythrocytes, macrophages and neutrophils were evident in most smears of infected hamsters. However, in the leukocyte differential count it was observed a significant increase in neutrophils with consequent significant reduction of macrophages in hamsters infected by viral strains A3/97, Iso/72 and A9/92 when compared with the control group. Hamsters infected with the A9/92 viral strain maintained values similar to the control group. When evaluating microscopically the CNS, liver and lungs of infected hamsters it was observed inflammatory infiltrate, necrosis and perivascular cuff in CNS; leukocytosis and necrosis in the liver parenchyma with discrete pericholangitis and bile duct proliferation; and inflammation, necrosis, edema and hemorrhage in the bronchioles and alveoli. Concluding, the results showed the hamster as the most susceptible species to EHV-1 infection serving as a complementary experimental model for studies of respiratory and neurological diseases caused by this agent in horses

Estudamos o efeito do tratamento com salbutamol em dois regimes: diário (DS) e administrado a intervalos de 96 horas (IS) em camundongos balb/c sensibilizados com injeções intraperitoneais de uma solução de ovoalbumina (OVA) adsorvida em hidróxido de alumínio, e desafiada com inalações de ovoalbumina a 1%. O grupo controle SAL recebeu injeções i.p. de salina e desafios inalatórios de sallina. A partir do 34o dia, os animais OVA foram tratados com salbutamol via inalatória 10 mg/ml durante 15 minutos nos dois regimes descritos. Os animais foram sacrificados no 60o dia, que corresponde a 48 horas após o último desafio antigênico. Após os camundongos serem anestesiados com pentobarbital sódico via i.p., eles foram traqueostomizados e entubados e sacrificados com secção da Aorta abdominal. Então, procedeu-se com a coleta do lavado broncoalveolar para a quantificação de leucócitos. Coletamos os tecidos pulmonares para a avaliação do processo inflamatório por quantificação de células linfomononucleares (LMN) e eosinófilos EPO+, essa última com marcação citoquímica. Além disso, estudamos a influência do tratamento adrenérgico sobre o IgE anafilático. O modelo de inflamação (grupo OVA) produziu significativo aumento do número de células totais, de eosinófilos e de neutrófilos observados na avaliação de lavado broncoalveolar. Além disso, houve nesse grupo processo inflamatório na parede de vias aéreas, caracterizada por um infiltrado linfomononuclear e com presença de eosinófilos. O nosso processo de indução de inflamação também recrutou eosinófilos para o septo alveolar. O tratamento com salbutamol diário produziu uma queda significativa do processo inflamatório no BAL, principalmente de neutrófilos e eosinófilos, enquanto que o tratamento intermitente produziu redução significativa apenas de neutrófilos. O tratamento com salbutamol a cada 96 horas (IS) promoveu uma queda significativa de células LMN quantificadas no septo alveolar, mas não atingindo valores do grupo salina (NS). Ambos os tratamentos com salbutamol produziu redução significativa de células EPO+ no parênquima pulmonar (P < 0,05). Apesar das alterações no processo celular, o salbutamol não influenciou na expressão de anticorpos IgE anafiláticos a OVA. Assim, podemos concluir que o salbutamol apresenta atividade imunomoduladora, observada por redução de eosinófilos no BAL e no parênquima pulmonar, apesar de não atingir valores semelhantes aos animais do grupo salina / We studied the effects of salbutamol treatment in two regimen: diary (DS) and at interval of 96 hours (IS) in ovalbumin sensitized (OVA) balb/c mice. The control group (NS) received i.p. injections and aerosol challenge with normal saline. Starting at day 34 the OVA animals were treated with 10mg/ml salbutamol by inhalation during 15 minutes per day in both regimen: DS and IS. The mice were sacrificed at day 60 that corresponded the fourthly eight hours after last OVA and/or salbutamol exposure. At experimental day, mice were anesthetized with i.p. injection of sodium pentobarbital, tracheostomized, entubed and the abdominal aorta sectioned. We followed with collecting of bronchoalveolar lavage (BAL) and lungs to histopathology studies. In the BAL, total cells and differential leukocytes were quantified, while in the lung sections, the EPO+ and LMN in airways wall and parenchyma septa were evaluated. Also, we sampled the blood to evaluate the effects of salbutamol on anaphylactic IgE antibodies expression. The inflammatory model (OVA animals) produced a significant increase of BAL total cells, BAL eosinophils and neutrophils, and LMN cells and EPO+ eosinophils in the airways and in the parenchyma. Diary salbutamol treatment decrease significantly BAL eosinophils and neutrophils, while the IS group showed a diminution of BAL neutrophils and LMN cells in the alveolar septum. Both salbutamol treatments produced significant decline of EPO+ cells in the lung parenchyma. Despite the changes in the cellular patterns, the salbutamol did not affect the IgE antibodies expression. So, we can concluded that salbutamol present an immunomodulatory activity observed by reduction of eosinophils in the BAL and lung parenchyma, but did not achieve the values of saline control group

Introdução: A tuberculose (TB) é uma das infecções mais prevalentes na humanidade, sendo o comprometimento pulmonar a principal causa de morbimortalidade. A cultura é o padrão de referência para diagnóstico, porém apresenta baixa sensibilidade. Das formas extrapulmonares, a TB pleural é a mais comum e apresenta diagnóstico confirmatório difícil por ser paucibacilar e conter interferentes intrínsecos na amostra. A reação em cadeia da polimerase (PCR), por amplificar o DNA da micobactéria, apresenta-se como teste mais sensível que a cultura, sendo positivo em amostras que apresentam a partir de 102 UFC/mL (unidades formadoras de colônia por mL) de M. tuberculosis (MTB). Entretanto, quando utilizada em amostras de escarro, lavado broncoalveolar e/ou líquido pleural pode ter seu desempenho comprometido pela presença de inibidores intrínsecos da amostra (variáveis pré-analíticas) e pelas técnicas de amplificação e detecção (variáveis analíticas) utilizadas na reação. Objetivo: Avaliar a influência de variáveis pré-analíticas (concentração de células, hemácias e proteínas) na detecção do DNA do M. tuberculosis em amostras de escarro, lavado broncoalveolar (LBA) e líquido pleural (LP), utilizando combinações de métodos de extração/detecção. Métodos: Amostras de escarro, lavado broncoalveolar e líquido pleural de pacientes não infectados pelo M. tuberculosis foram obtidas através de indução à expectoração, broncoscopia respiratória e/ou toracocentese, respectivamente, em volumes suficientes para o estudo. Para testar o limiar de detecção do M. tuberculosis, as amostras foram preparadas \"in vitro\" de maneira a conter concentrações variadas dos interferentes pré-analíticos e de UFC/mL da micobactéria. Para a técnica de PCR, o DNA foi extraído pelo método de extração QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) e pelo AMPLICOR® Respiratory Specimen Preparation (Roche Molecular Systems, Inc., Branchburg, NJ, USA) e amplificado e detectado por três métodos: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) e 3) \"in-house\" ou caseiro. Desta maneira, foram testadas as seguintes combinações: Extração Roche/detecção Roche (R/R); Extração Roche/detecção Nanogen (R/N); Extração Roche/detecção \"in house\" (R/IH); Extração Qiagen/detecção Roche (Q/R); Extração Qiagen/detecção Nanogen (Q/N) e Extração Qiagen/detecção \"in house\" (Q/IH). Resultados: Em amostras de escarro, a quantidade de células e de hemácias não interferiu na detecção do M. tuberculosis, com exceção do método de extração/detecção Roche. Nas amostras de LBA, médias e altas concentrações de células e altas concentrações de hemácias contribuíram para menor detecção do MTB quando utilizado o método de detecção Roche, enquanto que no líquido pleural, a concentração de hemácias foi a variável que mais interferiu na detecção do agente. Em ambas as situações a menor detecção foi obtida com a combinação Q/N. Conclusão: A qualidade pré-analítica das amostras biológicas recebidas no laboratório clínico pode interferir no desempenho diagnóstico dos testes moleculares. A escolha dos métodos de extração e detecção é de fundamental importância na sensibilidade analítica do teste, para garantia de melhores resultados, especialmente quando trabalhamos com amostras paucibacilares que contém potenciais inibidores da reação / Introduction: Tuberculosis (TB) is one of the most prevalent infections in humanity, and pulmonary compromise is the leading cause of morbidity and mortality. Culture is the reference standard for diagnosis, but has low sensitivity. Of the extrapulmonary forms, pleural TB is the most common and presents difficult confirmatory diagnosis due to be paucibacillary and to contain intrinsic interfering in the sample. The polymerase chain reaction (PCR), for amplifying DNA of the mycobacterium, appears as more sensitive test than the culture, with positive results from 102 CFU/ml (colony forming units per ml) of M. tuberculosis (MTB). However, when used in sputum samples, bronchoalveolar lavage and/or pleural fluid, this test can also have its performance compromised by the presence of intrinsic sample inhibitors (pre-analytical variables) and by the amplification and detection techniques (analytical variables) used in the reaction. Objective: To evaluate the influence of pre-analytical variables (concentration of cells, red blood cells and proteins) in DNA detection of M. tuberculosis from sputum, bronchoalveolar lavage (BAL) and pleural fluid (PF) samples by using combinations of extraction/detection methods. Methods: Samples of sputum, bronchoalveolar lavage and pleural fluid of patients not infected with M. tuberculosis were obtained by inducing sputum, respiratory bronchoscopy and/or thoracentesis, respectively, in sufficient volumes for the study. To test the detection threshold of M. tuberculosis, samples were prepared \"in vitro\" to contain variable concentrations of pre-analytical interfering and CFU/mL of mycobacteria. For PCR, DNA was extracted by two methods: the QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) and Respiratory Specimen Preparation Amplicor (Roche Molecular Systems, Inc., Branchburg, NJ, USA) and amplified and detected by three methods: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) and 3) \"in-house\". Thus, the following combinations were tested: Roche extraction and detection (R/R); Roche extraction and Nanogen detection (R/N); Roche extraction and \"in house\" detection (R/IH); Qiagen extraction and Roche detection (Q/R); Qiagen extraction and Nanogen detection (Q/N) and Qiagen extraction and \"in house\" detection (Q/IH). Results: In sputum samples, the amount of cells and red blood cells did not interfere with M. tuberculosis detection, an exception for Roche extraction/detection method. In BAL samples, medium and high cell concentrations and high concentrations of red blood cells contributed to lower detection of MTB when using the Roche detection method, while in the pleural fluid, the concentration of red blood cells was the variable that most interfered with the MTB detection. In both situations, the smallest detection was obtained with the combination Q/N. Conclusion: The pre-analytical quality of biological samples received in the clinical laboratory can interfere with the performance of molecular diagnostic tests. The choice for the extraction/detection methods is of fundamental importance in the analytical sensitivity of PCR, in order to guarantee better results, especially when working with paucibacillary samples containing potential reaction inhibitors

Este trabalho teve por objetivo avaliar as alterações respiratórias e neurológicas resultantes da infecção por via intranasal das diferentes estirpes nacionais do herpesvírus equino tipo 1 (EHV-1) em hamsters comparando sua susceptibilidade com estudos sobre infecção do EHV-1 em camundongos e equinos. Para isso, hamsters sírios machos, três semanas de idade, foram infectados por via intranasal com as estirpes do EHV-1 obtidas a partir de fetos abortados e potro neonato infectados (A4/72, A9/92, A3/97 e Iso/72). Os animais foram pesados e examinados diariamente em busca de sinais clínicos e neurológicos. Conforme os sintomas neurológicos apareceram, grupos de cinco hamsters foram eutanasiados por overdose de isoflurano na primeira etapa do projeto, e, de cetamina/xilazina por via intraperitoneal na segunda etapa. Na necropsia, sistema nervoso central (SNC), pulmão, fígado, baço e timo foram coletados para isolamento viral em cultura de células E-dermal e para análise histopatológica. Na segunda etapa do projeto, a lavagem broncoalveolar (LBA) com 3 ml de PBS por hamsters foi realizada para determinar a resposta inflamatória pulmonar através da contagem total e diferencial de leucócitos. Similar aos experimentos com camundongos, hamsters desafiados com as estirpes virais A4/72 e A9/92 apresentaram manifestações clínicas severas no terceiro dia pós-inoculação (dpi), tais como perda de peso aguda, dispnéia, desidratação, decúbito e morte. Observou-se também sinais neurológicos como hiperexcitabilidade, paralisia, espasmos, perda de propriocepção, andar em círculos e convulsões. Ao contrário dos camundongos, que não desenvolveram a doença; hamsters inoculados com as estirpes virais A3/97 e Iso/72 manifestaram sintomas respiratórios e neurológicos agudos entre quarto e quinto dpi, sendo as alterações respiratórias as mais evidentes, principalmente hemoptise e conjuntivite. O isolamento do vírus a partir do SNC foi positivo em todos os animais infectados; no entanto, todas as amostras de pulmões foram positivas apenas nos grupos infectado pelas estirpes virais A9/92 e A4/72. Todas as estirpes do EHV-1 foram isoladas a partir do baço, no entanto, a partir do timo foram isoladas apenas as estirpes A9/92 e A4/72, e, de fígado somente a estirpe viral Iso/72 não foi isolada. No LBA, a contagem total de leucócitos não demonstrou diferenças de valores significativas entre os grupos experimentais, sendo apenas evidente a presença de eritrócitos, macrófagos e neutrófilos na maioria dos esfregaços dos hamsters infectados. Porém, na contagem diferencial de leucócitos observou-se um aumento significativo de neutrófilo com consequente diminuição significativa de macrófagos nos hamsters infectados pelas estirpes virais A3/97, Iso/72 e A4/72 quando comparados ao grupo controle. Os hamsters infectados pela estirpe viral A9/92 mantiveram valores próximos aos do grupo controle. Ao avaliar microscopicamente o SNC, fígado e pulmão dos hamsters infectados foi observado infiltrado inflamatório, necrose e manguito perivascular em SNC; leucocitose e necrose no parênquima hepático com discreta pericolangite e proliferação de ducto biliar; e em pulmão observou inflamação, necrose, edema e hemorragia em bronquíolos e alvéolos. Concluindo, os resultados apontaram o hamster como a espécie mais susceptível à infecção pelo EHV-1 servindo como um modelo experimental complementar para estudos de doenças respiratória e neurológica provocadas por este agente em equinos / This study aimed to evaluate the respiratory and neurological disorders resulting from intranasal infection with different national strains of equine herpesvirus type 1 (EHV-1) in hamsters comparing their susceptibility to studies about EHV-1 infection in mice and horses. Therefore, male Syrian hamsters, three weeks of age, were infected via intransal with EHV-1 strains obtained from aborted fetuses and neonatal foal infected (A4/72, A9/92, A3/97 and Iso/72). The animals were weighed and examined daily for clinical search and neurological signs. As neurological symptoms appeared five hamsters groups were euthanized by isoflurane overdose in the first stage of the project, and ketamine/xylazine via intraperitoneal in the second stage. At necropsy, central nervous system (CNS), lung, liver, spleen and thymus were collected for virus isolation in E-dermal cell culture and histopathological analysis. In the second stage of the project, bronchoalveolar lavage (BAL) with 3 ml of PBS per hamsters was performed to determine the pulmonary inflammatory response through the total and differential leukocyte count. Similar to the experiments with mice, hamsters challenged with viral strains A4/72 and A9/92 had severe clinical manifestations in the third day post-inoculation (dpi), such as acute weight loss, dyspnea, dehydration, recumbency, and death. It was also observed neurological signs such as hyperexcitability, paralysis, spasms, loss of proprioception, circling and convulsions. Unlike mice, which did not develop disease; hamsters inoculated with viral strains A3/97 and Iso/72 showed acute respiratory and neurological symptoms between fourth and fifth dpi, and the most evident respiratory distress was hemoptysis and conjunctivitis. The virus isolation from CNS was positive in all infected animals; however, all lung samples were positive only in groups infected by A9/92 and A4/72 viral strains. All EHV-1 strains were recovered from spleen, however, only A9/92 and A4/72 viral strains were recovered from thymus, but only Iso/72 viral strain was not recovered from liver. BAL total leukocyte count showed no significant differences in values between the experimental groups but the presence of erythrocytes, macrophages and neutrophils were evident in most smears of infected hamsters. However, in the leukocyte differential count it was observed a significant increase in neutrophils with consequent significant reduction of macrophages in hamsters infected by viral strains A3/97, Iso/72 and A9/92 when compared with the control group. Hamsters infected with the A9/92 viral strain maintained values similar to the control group. When evaluating microscopically the CNS, liver and lungs of infected hamsters it was observed inflammatory infiltrate, necrosis and perivascular cuff in CNS; leukocytosis and necrosis in the liver parenchyma with discrete pericholangitis and bile duct proliferation; and inflammation, necrosis, edema and hemorrhage in the bronchioles and alveoli. Concluding, the results showed the hamster as the most susceptible species to EHV-1 infection serving as a complementary experimental model for studies of respiratory and neurological diseases caused by this agent in horses