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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Influência da condição bucal, hábitos e fatores socioedemográficos no padrão citológico da mucosa bucal normal / Influence of oral condition, behaviours and sociodemographic factors on the cytologic pattern of the normal oral mucosa

Baumgart, Cristina da Silva January 2013 (has links)
Proposição: Avaliar a associação entre as condições de saúde bucal, fatores comportamentais e sociodemográficos e o padrão citopatológico da mucosa bucal de homens adultos. Correlacionando o padrão citopatológico quantitativo e qualitativo com as variáveis bucais e sociodemográficas. Materiais e Métodos: A partir de dois esfregaços, um da borda da língua e outro do assoalho bucal de 117 homens com mais de 25 anos, foram quantificadas cem células de cada. As células foram coradas pelo método Papanicolaou modificado e classificadas em: Escamas, células superficiais com núcleo, células intermediárias e células parabasais. Variáveis sociodemográficas e comportamentais foram coletadas a partir de um questionário estruturado. Índice CPO-D e uso de próteses foram registradas a partir de um exame clínico intra-oral.As análises foram conduzidas utilizando o pacote estatístico Stata versão 10. O indivíduo foi considerado a unidade analítica. O nível de significância foi estabelecido em 5%. Resultados: No total das células na borda da língua, 75% eram intermediárias, 20% superficiais com núcleo e 5% escamas, sendo que células parabasais foram raramente observadas. Não foram observadas diferenças significativas para todas as variáveis em estudo em todos os tipos celulares, com exceção da ingestão de bebidas alcoólicas.Observou-se percentual significativamente maior de escamas e células superficiais com núcleo nos indivíduos que ingeriam de álcool comparados aos que não ingerem. Para as células intermediárias, o percentual foi significativamente menor nos indivíduos que bebem comparados aos que não bebem. Um padrão semelhante de distribuição celular foi observado no assoalho de boca. O consumo de álcool foi o único fator comportamental que influenciou significativamente no padrão citológico da mucosa bucal dos indivíduos analisados nos modelos multivariados. Conclusões: Foi encontrada associação entre um dos fatores comportamentais (o álcool) e o padrão citopatológico da mucosa bucal de homens adultos. As demais variáveis estudadas não apresentaram associação significativa com o padrão de descamação da mucosa bucal normal com a técnica utilizada. / Proposition: To evaluate the association between oral health status, socio- demographic and behavioral factors and standard cytology of the oral mucosa of adult men. Correlating the standard cytopathology quantitative and qualitative with oral and sociodemographic variables. Materials and Methods: From two smears, one edge of the tongue and other oral floor of 117 men over 25 years old, were quantified hundred cells each. Cells were stained with modified Papanicolaou method and classified into: Scales, superficial cells with nuclei, intermediate and parabasal cells. Sociodemographic and behavioral variables were collected from a structured questionnaire. DMFT index and use of prostheses were recorded from a clinical intra - oral.As analyzes were conducted using Stata version 10. The individual was considered the analytical unit. The level of significance was set at 5 %. Results: In total cells at the edge of the tongue 75% were intermediate, 20% core surface scales and 5%, and parabasal cells were rarely observed. No significant differences were observed for all study variables in all cell types, with the exception of beverage intake alcoólicas.Observou is significantly greater percentage of scales and superficial cells in the core subjects ingestores alcohol compared to those who do not drink. For intermediate cells, the percentage was significantly lower in individuals who drink compared to those who do not drink. A similar pattern of cell distribution was observed in the floor of mouth. Alcohol consumption was the only factor that significantly influenced the behavioral cytology of the oral mucosa of individuals analyzed in the multivariate models. Conclusions: An association between a behavioral factor (alcohol) and standard cytology of the oral mucosa of adult men. The other variables were not significantly associated with the default scaling of normal oral mucosa with the technique used.
12

Identifcation of serum biomarkers in patients of exfoliative glaucoma in Scandanavian population. : Autoimmune profiling by microarray technology. / Biomarker detection in exfoliative glaucoma. : none

Khan, Sabeen Asad January 2019 (has links)
Glaucoma is the leading cause of irreversible blindness, estimated to affect more than 79 million people by the year 2020. It is a group of optic neuropathies that is found to be associated with autoimmunity. One of its types is exfoliative glaucoma which is more prevalent in certain areas of the world including Scandinavia. It is more aggressive and often resistant to conventional therapy. The best treatment options for glaucoma lies at the early detection of the disease. The aim of the study was to identify serum biomarkers in patients of exfoliative glaucoma in the Scandinavian population. Serum samples of 30 patients of exfoliative glaucoma and 10 control subjects were profiled on epoxy coated protein microarrays expressing immobilized His-tagged human antigens. 3072 antigens were selected after a literature review which included the ones expressed in eye and retina. Protein-microarrays were incubated with sera, and occurring immunoreactivities were visualized with fluorescence labelled secondary antibodies. To detect changes, spot intensities were digitized and analysed with different statistical methods. Binary logistic regression was used to classify diseased and controls. A significant increase of antibodies against IRAK4 antigen was detected among serum samples of the controls (p = 0.002) as compared to the exfoliative glaucoma patients. Antibodies against four other antigens were found to be more prevalent in serum samples of exfoliative glaucoma patients although not significantly. These included FUT2, VAV2, and GPATCH8 and PFKFB1. The logistic regression was able to classify diseased and controls with 100 percent accuracy depending on 11 selected reactive antigens. Out of the 3072 antigens, IRAK4 was found to be the only significant antigen with increased reactivity in controls as compared to exfoliative glaucoma patients. IRAK4 has a role in innate immunity and signal transduction, antibodies against it may have a neuroprotective effect in glaucoma. However, this is an initial exploratory study based on only 40 samples and further experiments with a larger sample size needs to be performed. / None
13

An in vivo model to study mucin-bacterial interactions during early post-hatch development of broiler chickens.

Forder, Rebecca Edith Anne January 2007 (has links)
Mucins, synthesised and secreted by goblet cells, possess potential binding sites for both commensal and pathogenic organisms, and may perform a defensive role during establishment of the intestinal barrier in newly hatched chickens. Increasing interest has been directed toward bacterial interactions within the mucus layer, and the mechanisms by which bacterial colonisation can influence mucus composition during early development. This is important, firstly, as a means to understand initiation of infection and secondly, to optimise the gut microflora for enhanced animal production. Currently, information on mucosal-bacterial interactions in poultry is limited. In order to observe the effects of bacterial exposure on intestinal goblet cell mucin production during early development, differences in the small intestine of conventionally-raised (CV) and low bacterial load (LBL) broiler chicks were examined during the first 7 days post-hatch. The initial aim of the study was to construct a small-scale, economical isolator system to hatch and raise chicks in a bacterial-free environment as a means to observe bacterial interactions with the intestinal mucosa in chickens exposed to normal environmental conditions. The design and construction of flexible plastic isolators for incubation and brooding are described, along with methodologies for preparation of eggs for entry into the isolators, incubation and hatching. Two trials were conducted, the first in August 2005 and the second in March 2006. It was found that the isolator system was successful in producing low bacterial load chicks for comparative studies with conventionally raised chicks, without compromising body weight. A histological study was then conducted whereby ileal and jejunal goblet cells were stained with either periodic acid-Schiff or high iron diamine/alcian blue pH 2.5 to discriminate between neutral, sulphated and sialyated acidic mucins. Total goblet cell numbers and goblet cell and villous/crypt morphology were also examined. Bacterial colonisation of CV animals induced an increase in sialic acid moieties in both ileal and jejunal goblet cell such that initiation of these changes occurred at day 3-4 post-hatch. Differences in intestinal morphology were also consistent with other germ-free animal studies. In order to further understand the extent to which bacteria affected mucin composition, purified, isolated oligosaccharide fractions from ileal mucin at d 4 and 7 post-hatch were collected and analysed using mass spectrometry techniques to determine any structural differences in chain length or chain number between LBL and CV animals. No differences in chain length or number were observed between CV and LBL animals at either d 4 or 7 post-hatch with both groups equally displaying chain lengths of both low and high molecular weights. Although structural differences in mucin oligosaccharides were not observed between LBL and CV animals, bacterial binding assays utilising whole ileal sections were employed to determine whether or not the differences in mucin composition between LBL and CV animals during early development may have deterred or enhanced binding of certain bacterial species. Escherichia coli and Lactobacillus salivarius were selected for the experiment. Binding of L. salivarius to ileal sections was very low whereas E. coli binding was greater, and more pronounced in LBL animals, especially at d 7 post-hatch. No statistically significant differences were observed in binding of E. coli to purified ileal mucin from LBL and CV animals at either d 4 or d 7 post-hatch. Correlations between E. coli and L. salivarius adherence to ileal tissue and mucin samples, and goblet cell parameters, were not statistically significant when fitted as co-variates. It was concluded that the changes in mucin composition played a minor role in bacterial adhesion of L. salivarius and this E. coli serotype. In summary, this thesis explores the physiological changes in goblet cell mucin production in response to bacterial exposure post-hatch. The thesis outlines the complexity of mucosal-bacterial interactions which would benefit from the employment of specialised techniques such as nuclear magnetic resonance spectroscopy and microarray technologies to examine a greater range of mucin structures and gene expression. This thesis provides support for future investigations into the influence of intestinal microflora on mucosal and mucin dynamics of poultry and the potential development of prebiotics for use in animal production. / http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1297640 / Thesis (Ph.D.) -- School of Agriculture, Food and Wine, 2007
14

Identification and characterization of M cells in the mammalian conjunctiva

Petris, Carisa Kay, January 2007 (has links)
Thesis (Ph. D.)--University of Missouri-Columbia, 2007. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on December 12, 2007) Vita. Includes bibliographical references.
15

Effect of entactin and other extracellular matrix molecules on the adhesion and migration of mouse thymocytes and a thymocyte cell line

Schroen, Daniel J. Cheung, H. Tak. January 1994 (has links)
Thesis (Ph. D.)--Illinois State University, 1994. / Title from title page screen, viewed March 21, 2006. Dissertation Committee: H. Tak Cheung (chair), Herman E. Brockman, Lynne A. Lucher, Philip D. Morse, Anthony J. Otsuka. Includes bibliographical references (leaves 101-111) and abstract. Also available in print.
16

Influência da condição bucal, hábitos e fatores socioedemográficos no padrão citológico da mucosa bucal normal / Influence of oral condition, behaviours and sociodemographic factors on the cytologic pattern of the normal oral mucosa

Baumgart, Cristina da Silva January 2013 (has links)
Proposição: Avaliar a associação entre as condições de saúde bucal, fatores comportamentais e sociodemográficos e o padrão citopatológico da mucosa bucal de homens adultos. Correlacionando o padrão citopatológico quantitativo e qualitativo com as variáveis bucais e sociodemográficas. Materiais e Métodos: A partir de dois esfregaços, um da borda da língua e outro do assoalho bucal de 117 homens com mais de 25 anos, foram quantificadas cem células de cada. As células foram coradas pelo método Papanicolaou modificado e classificadas em: Escamas, células superficiais com núcleo, células intermediárias e células parabasais. Variáveis sociodemográficas e comportamentais foram coletadas a partir de um questionário estruturado. Índice CPO-D e uso de próteses foram registradas a partir de um exame clínico intra-oral.As análises foram conduzidas utilizando o pacote estatístico Stata versão 10. O indivíduo foi considerado a unidade analítica. O nível de significância foi estabelecido em 5%. Resultados: No total das células na borda da língua, 75% eram intermediárias, 20% superficiais com núcleo e 5% escamas, sendo que células parabasais foram raramente observadas. Não foram observadas diferenças significativas para todas as variáveis em estudo em todos os tipos celulares, com exceção da ingestão de bebidas alcoólicas.Observou-se percentual significativamente maior de escamas e células superficiais com núcleo nos indivíduos que ingeriam de álcool comparados aos que não ingerem. Para as células intermediárias, o percentual foi significativamente menor nos indivíduos que bebem comparados aos que não bebem. Um padrão semelhante de distribuição celular foi observado no assoalho de boca. O consumo de álcool foi o único fator comportamental que influenciou significativamente no padrão citológico da mucosa bucal dos indivíduos analisados nos modelos multivariados. Conclusões: Foi encontrada associação entre um dos fatores comportamentais (o álcool) e o padrão citopatológico da mucosa bucal de homens adultos. As demais variáveis estudadas não apresentaram associação significativa com o padrão de descamação da mucosa bucal normal com a técnica utilizada. / Proposition: To evaluate the association between oral health status, socio- demographic and behavioral factors and standard cytology of the oral mucosa of adult men. Correlating the standard cytopathology quantitative and qualitative with oral and sociodemographic variables. Materials and Methods: From two smears, one edge of the tongue and other oral floor of 117 men over 25 years old, were quantified hundred cells each. Cells were stained with modified Papanicolaou method and classified into: Scales, superficial cells with nuclei, intermediate and parabasal cells. Sociodemographic and behavioral variables were collected from a structured questionnaire. DMFT index and use of prostheses were recorded from a clinical intra - oral.As analyzes were conducted using Stata version 10. The individual was considered the analytical unit. The level of significance was set at 5 %. Results: In total cells at the edge of the tongue 75% were intermediate, 20% core surface scales and 5%, and parabasal cells were rarely observed. No significant differences were observed for all study variables in all cell types, with the exception of beverage intake alcoólicas.Observou is significantly greater percentage of scales and superficial cells in the core subjects ingestores alcohol compared to those who do not drink. For intermediate cells, the percentage was significantly lower in individuals who drink compared to those who do not drink. A similar pattern of cell distribution was observed in the floor of mouth. Alcohol consumption was the only factor that significantly influenced the behavioral cytology of the oral mucosa of individuals analyzed in the multivariate models. Conclusions: An association between a behavioral factor (alcohol) and standard cytology of the oral mucosa of adult men. The other variables were not significantly associated with the default scaling of normal oral mucosa with the technique used.
17

Influência da condição bucal, hábitos e fatores socioedemográficos no padrão citológico da mucosa bucal normal / Influence of oral condition, behaviours and sociodemographic factors on the cytologic pattern of the normal oral mucosa

Baumgart, Cristina da Silva January 2013 (has links)
Proposição: Avaliar a associação entre as condições de saúde bucal, fatores comportamentais e sociodemográficos e o padrão citopatológico da mucosa bucal de homens adultos. Correlacionando o padrão citopatológico quantitativo e qualitativo com as variáveis bucais e sociodemográficas. Materiais e Métodos: A partir de dois esfregaços, um da borda da língua e outro do assoalho bucal de 117 homens com mais de 25 anos, foram quantificadas cem células de cada. As células foram coradas pelo método Papanicolaou modificado e classificadas em: Escamas, células superficiais com núcleo, células intermediárias e células parabasais. Variáveis sociodemográficas e comportamentais foram coletadas a partir de um questionário estruturado. Índice CPO-D e uso de próteses foram registradas a partir de um exame clínico intra-oral.As análises foram conduzidas utilizando o pacote estatístico Stata versão 10. O indivíduo foi considerado a unidade analítica. O nível de significância foi estabelecido em 5%. Resultados: No total das células na borda da língua, 75% eram intermediárias, 20% superficiais com núcleo e 5% escamas, sendo que células parabasais foram raramente observadas. Não foram observadas diferenças significativas para todas as variáveis em estudo em todos os tipos celulares, com exceção da ingestão de bebidas alcoólicas.Observou-se percentual significativamente maior de escamas e células superficiais com núcleo nos indivíduos que ingeriam de álcool comparados aos que não ingerem. Para as células intermediárias, o percentual foi significativamente menor nos indivíduos que bebem comparados aos que não bebem. Um padrão semelhante de distribuição celular foi observado no assoalho de boca. O consumo de álcool foi o único fator comportamental que influenciou significativamente no padrão citológico da mucosa bucal dos indivíduos analisados nos modelos multivariados. Conclusões: Foi encontrada associação entre um dos fatores comportamentais (o álcool) e o padrão citopatológico da mucosa bucal de homens adultos. As demais variáveis estudadas não apresentaram associação significativa com o padrão de descamação da mucosa bucal normal com a técnica utilizada. / Proposition: To evaluate the association between oral health status, socio- demographic and behavioral factors and standard cytology of the oral mucosa of adult men. Correlating the standard cytopathology quantitative and qualitative with oral and sociodemographic variables. Materials and Methods: From two smears, one edge of the tongue and other oral floor of 117 men over 25 years old, were quantified hundred cells each. Cells were stained with modified Papanicolaou method and classified into: Scales, superficial cells with nuclei, intermediate and parabasal cells. Sociodemographic and behavioral variables were collected from a structured questionnaire. DMFT index and use of prostheses were recorded from a clinical intra - oral.As analyzes were conducted using Stata version 10. The individual was considered the analytical unit. The level of significance was set at 5 %. Results: In total cells at the edge of the tongue 75% were intermediate, 20% core surface scales and 5%, and parabasal cells were rarely observed. No significant differences were observed for all study variables in all cell types, with the exception of beverage intake alcoólicas.Observou is significantly greater percentage of scales and superficial cells in the core subjects ingestores alcohol compared to those who do not drink. For intermediate cells, the percentage was significantly lower in individuals who drink compared to those who do not drink. A similar pattern of cell distribution was observed in the floor of mouth. Alcohol consumption was the only factor that significantly influenced the behavioral cytology of the oral mucosa of individuals analyzed in the multivariate models. Conclusions: An association between a behavioral factor (alcohol) and standard cytology of the oral mucosa of adult men. The other variables were not significantly associated with the default scaling of normal oral mucosa with the technique used.
18

A Severe Case of Cutaneous Adverse Drug Reaction Secondary to a Novice Drug: Idelalisib

Gabriel, Joseph Gabriel, Kapila, Aaysha, Gonzalez-Estrada, Alexei 01 May 2017 (has links)
Phosphatidylinositol 3-kinase δ (PIK3δ) is a tyrosine kinase essential for B cell survival, making it an important target in the treatment of chronic lymphocytic leukemia. Idelalisib is an inhibitor of PIK3δ demonstrating initial success in disease response, but is now shown to have a decreased overall survival and life-threatening serious adverse events. The following is an unfortunate case of a grade III adverse skin reaction secondary to idelalisib with the likely complication of methicillin-resistant Staphylococcus aureus bacteremia.
19

Immuncytokemi på ThinPrep™-preparerat cytologiskt material : Validering av antikroppar och jämförelse av post-fixeringsmedel / Immunocytochemistry on ThinPrep™-prepared cytological material : Validation of antibodies and comparison of post-fixation agents

Rosén, Helena January 2024 (has links)
Immunhistokemi (IHC) och immuncytokemi (ICC) är viktiga verktyg inom cancerdiagnostik för att fastställa diagnoser. Både histologiskt och cytologiskt material kan användas för immunokemisk analys men kräver olika förberedelser. Den preanalytiska fasen påverkar epitop och antigenens tillgänglighet samt immunoreaktivitet, vilket gör valet av pre- och postfixering och hur de påverkar cytologiskt material, viktiga att förstå. ICC tillämpas vanligen på cytologiskt material som preparerats enligt cellblockteknik (CBT) men ibland saknas extraherat material för analys. Antikroppar kan användas för att differentiera tumörursprung, tumörsubtyper och inflammatoriska tillstånd, vilket är avgörande för klinisk diagnostik och behandlingsbeslut för individen. Vid klinisk patologi och cytologi i Kalmar är ett återkommande problem bristen på cellmaterial för CBT-preparering vid punktionscytologi. Syftet med denna studie var att validera antikroppar (kalretinin, CD45, CK5, CK7, SOX-10, EpCAM och TTF-1) på cytologiskt material (pleuraexsudat från 10 patienter) som preparerats enligt ThinPrep™- metoden (TP-metoden). Studien syftade även till att undersöka effekterna av post-fixering i 4 % formalin, 96% etanol eller ingen post-fixering inför ICC-analys för att se om valet av post-fixeringsmedel påverkar antikropparnas färgningsmönster (nukleärt, cytoplasmatiskt eller membranöst). CD45, CK5, CK7 och TTF-1 kunde valideras i studien. Det fanns inte någon signifikant skillnad (p > 0,05) i bedömningskategorierna (bakgrund, inmärkning och cellantal) mellan olika post-fixeringsmedel. Det fanns heller inga indikationer som visade att en särskild post-fixering gynnande ett särskilt färgningsmönster. Fler studier behövs för att förstå den preanalytiska fasens påverkan på ICC- analys av cytologiskt material. I samband med punktionscytologi skulle preparering enligt TP-metoden säkerställa tillgången på cellmaterial för ICC-analys. / Immunohistochemistry (IHC) and immunocytochemistry (ICC) are crucial tools in cancer diagnostics for establishing diagnosis. Both histological and cytological materials can be used for immunochemical analysis, but they require different preparations. The pre-analytical phase affects the epitope and antigen availability as well as immunoreactivity, making the choice of pre- and post-fixation and their impact on cytological material important to understand. ICC is usually applied to cytological material prepared using the cell block technique (CBT), but sometimes there is a lack of extracted material for analysis. Antibodies can differentiate tumor origins, subtypes, and inflammatory conditions, which is essential for clinical diagnostics and treatment decisions. In clinical pathology and cytology in Kalmar, a recurring issue is the lack of cell material for CBT preparation in fine-needle aspiration cytology. This study aimed to validate antibodies (calretinin, CD45, CK5, CK7, SOX-10, EpCAM, and TTF-1) on cytological material (n=10 pleural effusions) prepared using the ThinPrep™ method (TP method). The study also aimed to study the effects of post-fixation in 4% formalin, 96% ethanol, or without fixation medium before ICC analysis to see if the choice of post-fixation medium affects the staining patterns of the antibodies (nuclear, cytoplasmic, or membranous). CD45, CK5, CK7, and TTF-1 were validated in the study. There was no significant difference (p > 0.05) in the assessment categories (background, staining, and cell count) between different post-fixation media. There were also no indications that a particular post-fixation medium favored a specific staining pattern. Further studies are needed to understand the pre-analytical phase's impact on ICC analysis of cytological material. In fine-needle aspiration cytology, preparation using the TP method would ensure the availability of cell material for ICC analysis.
20

Avaliação da expressão do fator de crescimento endotelial vascular e da endoglina nos pacientes eritrodérmicos com pênfigo foliáceo / Vascular endothelial growth factor and endoglin expression in erythrodermic patients with pemphigus foliaceus

Miyamoto, Denise 07 June 2017 (has links)
INTRODUÇÃO: O pênfigo foliáceo (PF) caracteriza-se pela síntese de autoanticorpos contra a desmogleína 1 (Dsg1) com acantólise na epiderme superior. As lesões na face e tronco podem evoluir para eritrodermia (PFE), cuja patogênese é pouco conhecida. Estudos prévios sugerem a participação do fator de crescimento endotelial vascular (VEGF) e da endoglina (Eng). OBJETIVOS: Avaliar dados demográficos, expressão tecidual e níveis séricos do VEGF e Eng, bem como o perfil dos imunocomplexos no PFE. PACIENTES, MATERIAIS E MÉTODOS: Foram selecionados pacientes de PFE (n=31) e indivíduos controles com pênfigo vulgar (PV; n=10), psoríase (PSO; n=10) e saudáveis (CS; n=14) com amostras de soro e pele armazenadas. Os níveis séricos do VEGF, receptor solúvel do VEGF (sVEGFR-1), anti-Dsg1 e -Dsg3 foram avaliados por meio da técnica de ELISA, e a presença do VEGF, Eng, e imunocomplexos in situ foi determinada por imuno-histoquímica (IH) em plataforma automatizada (n=19). Após digitalização das lâminas, a reatividade aos anticorpos supracitados foi classificada manualmente em: 0 (ausente), 1 (discreta-moderada) e 2 (intensa), e analisada por software. RESULTADOS: PFE ocorreu no início da doença em 25/31 pacientes (80,6%), com média de idade de 42,7 anos e predomínio feminino (23/31; 74,2%). Os pacientes foram hospitalizados em média por 41,2 dias; infecção bacteriana foi a principal complicação (30/31; 96,8%), com bacteremia em 10/31 (32,3%) causada por Staphylococcus aureus em 7/10 (70%) dos pacientes. Infecção pelo vírus do herpes simples (HSV) em 11/31 (35,5%) doentes determinou internação prolongada. Valores de imunofluorescência indireta, e anti-Dsg1 e VEGF séricos (ELISA) foram superiores no PFE vs. PF não-eritrodérmico (PFNE) (p < 0,05). Níveis do sVEGFR-1 foram semelhantes no PFE e PFNE, e correlacionaram-se fracamente com a anti-Dsg1 no PFNE (p=0,034). A avaliação manual da IH com anti-VEGF no PFE foi estatisticamente diferente do PFNE (p=0,042) e CS (p=0,004), e similar ao PV (p=0,667) e PSO (p=0,667). Já no PFNE, a expressão do VEGF foi estatisticamente diferente do PV (p=0,049) e PSO (p=0,049) e semelhante ao CS (p=0,247). A contagem automatizada dos vasos marcados com anti-Eng no PFE foi similar ao PFNE (p=0,700) e PSO (p=0,133), e diferente do PV (p=0,0009) e CS (p=0,0009). A avaliação de 6 espécimes de PFE mostrou depósitos de imunocomplexos: intercelulares intraepidérmicos com IgG e C3 (n=6), IgA (n=5) e IgM (n=1); nas células inflamatórias com IgG e C3 (n=6), IgM e IgA (n=1); nos vasos com IgG, C3 e IgA (n=6), e IgM (n=5); e nos anexos com IgG e C3 (n=6), IgA (n=3) e IgM (n=1). CONCLUSÕES: O PFE predomina no início da doença e em mulheres, com maior risco de infecção. O aumento do VEGF sérico e tecidual sugere uma resposta reparadora ao dano tecidual causado pelos níveis elevados de autoanticorpos no PFE. A menor expressão de Eng no PFE indica uma desregulação da angiogênese na eritrodermia. De forma pioneira, a IH automatizada demonstrou a presença de imunocomplexos intraepidérmicos e nas estruturas dérmicas / BACKGROUND: Pemphigus foliaceus (PF) is characterized by the production of autoantibodies against desmoglein 1 (Dsg1), triggering superficial acantholysis. Lesions on the face and trunk may evolve to erythroderma (PFE). The pathogenesis of PFE is not fully understood. Previous studies suggest the role of vascular endothelial growth factor (VEGF) and endoglin (Eng). OBJECTIVES: To evaluate demographic data, VEGF and Eng expression, and immune complexes deposition in patients with PFE. METHODS: This study included patients with PFE (n=31) and controls with pemphigus vulgaris (PV; n=10), psoriasis (PSO; n=10), and health individuals (CS; n=14) that had serum and skin samples stored. Serum levels of VEGF, soluble VEGF receptor (sVEGFR-1), anti-Dsg1 and Dsg3 were measured by ELISA, and the in situ expression of VEGF, Eng, and immune complexes was evaluated utilizing an automated immunohistochemistry (IH) platform (n=19). After digitalizing the slides, the reactivity was manually classified as 0 (negative), 1 (mild-to-moderate) and 2 (intense), and also analyzed by software. RESULTS: PFE occurred at the onset of the disease in 25/31 (80.6%) patients, with a mean age of 42.7 years and a female predominance (23/31; 74.2%). Patients were hospitalized with an average length of stay of 41.2 days. Bacterial infection was the main complication (30/31; 96.8%), with bacteremia in 10/31 (32.3%) due to Staphylococcus aureus in 7/10 (70%) patients. Herpes simplex virus infection in 11/31 (35.5%) PFE patients caused prolonged hospitalization. Indirect immunofluorescence titers and serum anti-Dsg1 and VEGF (ELISA) were increased in PFE vs. non-erythrodermic PF (PFNE) (p < 0.05). Serum levels of sVEGFR-1 were similar in PFE and PFNE, and weakly correlated with anti-Dsg1 in PFNE (p=0.0342). Manual analysis of anti-VEGF positivity in PFE was statistically different from PFNE (p=0.042) and CS (p=0.004), and similar to PSO (p=0.667) and PV (p=0.667). VEGF expression in PFNE was statistically different from PSO (p=0.049) and PV (p=0.049) and similar to CS (p=0.247). The automated positive vessel count with anti-Eng was similar between PFE and PFNE (p=0.700) and PSO (p=0.133), but different from PV (p=0.0009). Immune complex deposits were evaluated in 6 specimens obtained during PFE and exhibited: intraepidermal intercellular deposits with IgG and C3 (n=6), IgA (n=5) and IgM (n=1); reactivity to inflammatory cells with IgG e C3 (n=6), IgM and IgA (n=1); vascular deposits with IgG, C3 and IgA (n=6), and IgM (n=5); and adnexal positivity with IgG and C3 (n=6), IgA (n=3) and IgM (n=1). CONCLUSIONS: Erythroderma predominates at the onset of PF, especially in women, with higher infectious risk. Increased expression of serum and in situ VEGF suggests that healing processes are triggered in response to the tissue damage caused by high levels of circulating autoantibodies in PFE. The reduced expression of Eng in PFE demonstrates a dysregulated angiogenesis during erythroderma. To the best of our knowledge, this is the first study that showed intraepidermal and dermal deposits of multiple immune complexes utilizing automated IH analysis

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