A Artrite idiopática juvenil (AIJ) é a artropatia crônica mais prevalente na infância e adolescência. A prevalência da síndrome metabólica, assim como da obesidade, vem apresentando um rápido aumento, atingindo todas as faixas etárias, incluindo a infância. A síndrome metabólica é caracterizada por um conjunto de riscos para doença cardiovascular e diabetes melito tipo 2, incluindo adiposidade abdominal, resistência à insulina, dislipidemias e hipertensão arterial sistêmica. Além destes componentes, a inflamação tem sido reconhecida cada vez mais como um fator importante na síndrome metabólica e obesidade, e pacientes com doenças caracterizadas por processos inflamatórios crônicos, como a AIJ, poderiam representar grupos de risco especiais. Os glicocorticoides são utilizados rotineiramente no controle da inflamação da artrite idiopática juvenil, em doses elevadas e com uso prolongado. O uso crônico do glicocorticoide pode induzir resistência à insulina, hipertensão arterial sistêmica e obesidade, aumentando o risco de desenvolver síndrome metabólica. O presente trabalho tem como objetivo avaliar a prevalência de obesidade e síndrome metabólica em pacientes com AIJ. Em pacientes acompanhados no Serviço de Reumatologia do Hospital de Clínicas de Porto Alegre (HCPA) e Hospital da Criança Santo Antônio (complexo Santa Casa) foram observados uma prevalência de 19,7% de síndrome metabólica e 22,7% de obesidade, sem diferença entre os subtipos da doença. A obesidade foi associada com tempo de duração da doença, obesidade abdominal, pressão arterial elevada, resistência à insulina e presença de síndrome metabólica. O IMC, circunferência da cintura, triglicerídeos, baixos níveis de HDL-c, pressão arterial sistólica e diastólica, níveis séricos de insulina e resistência a insulina (HOMA-ir) mostraram associação com a SM (p<0,05). Não houve associação entre a presença de SM e dose cumulativa de glicocorticoide, atividade da doença e tempo de duração da doença. Os resultados mostram uma alta frequência de obesidade e síndrome metabólica em pacientes com AIJ, sugerindo um aumento do risco de futuras complicações cardiovasculares. e parecem ser independentes do uso de glicocorticoide. Ações de intervenção são necessárias entre os pacientes com AIJ para reduzir o excesso de peso, evitar as complicações metabólicas e fatores de risco cardiovasculares na vida adulta. / Juvenile idiopathic arthritis is the most prevalent chronic arthropathy in childhood and adolescence. The prevalence of metabolic syndrome, as well as obesity, is increasing fast, in all age groups, including the childhood. Metabolic syndrome is defined as a cluster of risk factors for cardiovascular and type 2 diabetes, including abdominal obesity, insulin resistance, dyslipidaemia and hypertension. Besides these components, inflammation has been increasingly considered as a significant component in metabolic syndrome and obesity, and patients with diseases characterized by the presence of chronic inflammation, such as JIA, could represent special groups of risk. Glucocorticoids are used routinely in the management of the inflammation of JIA, in high doses and long-term. Long-term use of the glucocorticoids can cause insulin resistance, hypertension and obesity, increasing the risk for the metabolic syndrome. The aim of the present study was to evaluate prevalence of the obesity and metabolic syndrome in patients with juvenile idiopathic arthritis (JIA). In patients followed in the Hospital de Clínicas de Porto Alegre (HCPA) and Hospital da Criança Santo Antônio (Santa Casa Complex) service of reumatology were observed a prevalence of 19.7% of metabolic syndrome and 22.7% of obese, without difference between the subtypes of the disease. Obesity was associated with disease duration, abdominal obesity, arterial hypertension, insulin resistance and presence of metabolic syndrome. BMI, waist circunference, triglycerides, low HDL-c level, systolic and diastolic BP, fasting insulin serum levels and insulin resistance (HOMA-ir) showed significant association with MetS (p<0,05). There was no correlation between the presence of metabolic syndrome and cumulative glucocorticoid dose, disease activity and duration of disease. The results showed that there were high frequencies of obesity and metabolic syndrome in JIA patients and use appears to be indeoendent of the use glucocorticoid. Intervation actions are needed among JIA patients, to decrease excess weight, metabolic complications and cardiovascular risk factors in adulthood.

INTRODUÇÃO: A urticária crônica é caracterizada pelo aparecimento de placas eritêmato-edematosas, pruriginosas, que perduram por mais de seis semanas. A etiologia é desconhecida na maioria dos pacientes sendo definida como idiopática (UCI). A desregulação imunológica na UCI pode ser devido a distúrbios na produção de citocinas e quimiocinas. OBJETIVOS: Avaliar o perfil citocinas e quimiocinas em pacientes submetidos ao teste de soro autólogo (ASST) avaliando os soros, a expressão de RNAm e a expressão intracelular de células mononucleares do sangue periférico (CMN) induzidas por estímulos policlonais. METODOLOGIA: Pacientes com UCI (n=37) foram selecionados do Ambulatório de Dermatologia do HC-FMUSP e submetidos ao ASST. O grupo controle foi constituído por indivíduos saudáveis (n=33). Os níveis séricos de citocinas e quimiocinas foram determinados por citometria de fluxo ou por ELISA e a expressão de RNAm de citocinas foi determinada por Real-Time PCR. RESULTADOS: Uma elevação dos níveis séricos de TNF-, IL-6, IL-1, IL-12p70 e IL-10 foi detectada nos pacientes com UCI comparados ao grupo controle, independente da resposta ao ASST. A secreção in vitro de citocinas por CMN estimuladas por fitohemaglutinina (PHA) mostrou aumento da produção de IL-2 nos pacientes com UCI e de IL-17A e IL-10 no grupo ASST positivo em relação ao grupo controle. A expressão de RNAm para IL-10 em CMN, foi diminuída no grupo ASST negativo comparado ao grupo controle. Além disto, um aumento da capacidade linfoproliferativa ao mitógeno Pokeweed foi observado nos pacientes ASST positivo em relação aos indivíduos controles. Os níveis séricos de CXCL8, CCL2, CXCL10 e CXCL9 foram encontrados elevados nos pacientes com UCI em relação aos controles. A secreção de quimiocinas in vitro, foi observado aumento dos níveis basais de CCL2 pelas CMN dos pacientes em relação aos controles, que se elevaram em resposta a enterotoxina A de Staphylococcus aureus (SEA). Já o estímulo com PHA promoveu aumento na produção de CXCL8 e CCL5 pelas CMN dos pacientes. A expressão intracelular de CXCL8 foi detectada principalmente nas células CD14+. A intensidade média de fluorescência (MFI) e a porcentagem da expressão de CXCL8 em CD14+ nos níveis basais e estimulados com SEA encontram-se diminuídos nos pacientes com UCI comparado ao grupo controle. A expressão intracelular de CCL2 em células CD14+ mostrou uma queda na porcentagem dos níveis basais somente nos pacientes ASST negativo em relação ao grupo controle. Além disto, em condições basais de cultura houve um aumento na porcentagem da expressão de CCR5 em células T CD8+ de pacientes com UCI, em função do aumento no grupo ASST positivo. CONCLUSÕES: Os resultados enfatizam o conceito de desequilíbrio imunológico na UCI, independente da resposta ao ASST, evidenciado pelo aumento na secreção de quimiocinas e citocinas pró-inflamatórias. Estes dados sugerem que na UCI, os linfócitos e monócitos estão ativados, os quais podem contribuir para a imunopatogênese da doença / INTRODUCTION: Chronic urticaria is skin disorder characterized by recurrent and transitory itchy weals occurring regularly for more than 6 weeks. The aetiology is not identified in most patients being considered as idiopathic (CIU). The immunological dysregulation in CIU could be due to a disturbed cytokines and chemokines production. OBJECTIVES: To evaluate the pattern of cytokine and chemokine in CIU patients who undergone autologous serum skin test (ASST), assessing sera, mRNA expression and intracellular expression of peripheral blood mononuclear cells (PBMC) through the secretion upon induced by policlonal stimuli. METHODS: CIU patients (n=37) were selected from the Dermatological Outpatient Clinic of the Hospital das Clínicas de São Paulo (HC-FMUSP) and submitted to the ASST. The control group consisted of healthy subjects (n=33). Cytokine and chemokine levels were assessed by flow cytometer and ELISA and mRNA expression was analyzed by Real-Time PCR. RESULTS: Elevated levels of TNF-, IL-6, IL-1, IL-12p70 and IL-10 were observed in sera from CIU patients compared to healthy control group. CIU patients also showed increased IL-2 production by PBMC stimulated with phytohemagglutinin (PHA). Moreover, it was observed higher IL-17A and IL-10 levels in the ASST+ group compared to control group. The IL-10 mRNA expression was diminished in the ASST- group compared to control group. Furthermore, an increased lymphoproliferative response to Pokeweed mitogen was observed in the ASST+ patients compared to healthy subjects. Seric levels of CXCL8, CCL2, CXCL10 and CXCL9 were higher in CIU patients. Regarding the in vitro chemokines secretion, it was detected higher basal levels of CCL2 in CIU patients, which was increased by Staphylococcus aureus enterotoxin A (SEA). Stimulation with PHA increased the CXCL8 and CCL5 production by CIU mononuclear cells. The main source of CXCL8 was the CD14+ cells. CIU CD14+ cells showed decreased mean fluorescence intensity and percentage of CXCL8 expression with and without SEA stimuli. The percentage of CD14+ producing CCL2 was lower in ASST- patients compared to healthy control subjects. Furthermore, in the absence of stimuli the percentage of CCR5-expressing CD8+ T cells was higher in CIU patients, mainly due to an increased expression by the ASST+ group. CONCLUSIONS: These results indicate an immunological dysregulation in CIU, without association to ASST response, which was evidenced by the increased production of pro-inflammatory cytokines and chemokines. The data suggest a higher activation of monocytes and lymphocytes in CIU, which may contribute to its immunopathogenesis

Orientador: Marcelo Addas Carvalho / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T03:08:54Z (GMT). No. of bitstreams: 1 Vilela_JosieFadul_M.pdf: 1739915 bytes, checksum: ea1d6c47907a49ccd0e00255b01d3dee (MD5) Previous issue date: 2012 / Resumo: A Púrpura Trombocitopênica Imune (PTI) é uma doença autoimune caracterizada pela presença de autoanticorpos contra as glicoproteínas de membrana plaquetária, tais como GPIIb/IIIa e GPIb/IX. O processo patogênico da PTI envolve uma destruição acelerada das plaquetas pelo sistema retículo-endotelial e a presença de sangramentos mucocutâneos. A reação inflamatória em doenças infecciosas e autoimune é regulada por um balanço entre as citocinas pró e anti-inflamatórias e a PTI tem sido associada com a desregulação das respostas e atividades de citocinas. Uma associação entre os polimorfismos de genes de citocinas que afetam sua produção e secreção foram relatadas em doenças infecciosas, alérgicas, autoimunes, e malignas, tanto na fase de formação quanto no decurso da doença e nas suas respostas ao tratamento. Neste estudo, o objetivo foi avaliar a importância dos polimorfismos IL1B -511C/T, IL1B +3953C/T, IL1RN intron 2 VNTR, IL4 -590C/T, IL4 intron 3 VNTR, IL6 -174G/C, IL10 -1082G/A, IL10 -819C/T e IL10 -592 A/C em pacientes portadores de PTI na região de Campinas, SP e investigar a associação entre os genótipos identificados e a resposta clínica do paciente ao tratamento. Utilizamos o método PCR e digestão com enzima de restrição (PCR-RFLP) ou PCR em Tempo real (RT-PCR) para identificação dos polimorfismos. No total, 216 pacientes adultos diagnosticados com PTI foram pareados com 119 controles saudáveis constituídos por doadores voluntários do Centro de Hematologia e Hemoterapia da UNICAMP. Os dados clínicos como contagem de plaquetas ao diagnóstico, tipo de tratamento e resposta, foram obtidos através dos prontuários médicos. A análise de frequências dos alelos e genótipos dos polimorfismos IL1B - 511C/T, IL1B +3953C/T, IL6 -174G/C, IL10-1082G/A, IL10 -819C/T e IL10 -592A/C de pacientes portadores de PTI comparadas ao grupo controle não mostrou diferenças significativas entre os dois grupos. No entanto, para os polimorfismos IL1RN intron 2 VNTR, IL4 -590C/T, IL4 intron 3 VNTR e para os haplótipos de IL10 houve uma diferença significativa ao compararmos as frequências polimórficas entre os dois grupos. Analisando-se os polimorfismos associados com parâmetros clínicos, este estudo mostrou que o genótipo IL1B -511CC estava mais presente em indivíduos com boa resposta à esplenectomia. Pode-se concluir que o estudo de características genéticas dos pacientes portadores de PTI na região de Campinas, SP pode ajudar a esclarecer o perfil de pacientes acometidos pela doença nesta região, identificando grupos de maior risco e a entender qual polimorfismo pode estar associado a uma melhor resposta clínica, projetando uma nova linha de investigação / Abstract: The immune thrombocytopenic purpura (ITP) is an autoimmune disease characterized by the presence of autoantibodies against the platelet membrane glycoproteins such as GPIIb/IIIa and GPIb/IX. The pathogenic process of ITP involves an accelerated destruction of platelets by reticuloendothelial system and the presence of mucocutaneous bleeding. The inflammatory reaction in infectious and autoimmune diseases is regulated by a balance between pro and anti-inflammatory cytokines and ITP has been associated with dysregulation of cytokine responses and activities. An association between cytokine gene polymorphisms that affect their production and secretion have been reported in infectious, allergic, autoimmune, and malignant diseases, both during training and during the illness and its response to treatment. The aim of this study was to evaluate the importance of IL1B -511C/T, IL1B +3953 C/T, IL1RN intron 2 VNTR, IL4 -590C/T IL4 intron 3 VNTR, IL6 -174G/C, IL10 -1082G/A, IL10 -819C/T and IL10 -592A/C polymorphisms in patients with ITP in the region of Campinas, SP, and investigate the association between different genotypes and clinical responses to treatment. We used the PCR method and digestion with restriction enzyme (PCR-RFLP) or real-time PCR (RT-PCR) to identify polymorphisms. In total, 216 adult patients diagnosed with ITP were matched with 118 healthy controls. The clinical data such as platelet count at diagnosis, type of treatment and response were obtained from medical records. Analysis of allele and genotypes frequencies of IL1B -511C/T, IL1B +3953C/T, IL6 -174G/C, IL10 - 1082G/A, IL10 -819C/T and IL10 -592A/C polymorphisms in patients with ITP compared to the control group showed no significant differences between the two groups. However, for IL1RN intron 2 VNTR polymorphisms, IL4 -590C/T, IL4 intron 3 VNTR and IL10 haplotypes there were a significant difference when comparing polymorphic frequencies between the two groups. Analyzing the polymorphisms associated with clinical parameters, this study showed that IL1B -511CC genotype was more frequent in individuals with good response to splenectomy. It can be concluded that the study of genetic characteristics of patients with ITP in the region of Campinas, SP should help clarify the profile of patients affected, identifying groups at higher risk and understanding which polymorphism may be associated with better clinical response / Mestrado / Clinica Medica / Mestra em Clínica Médica

Abstract Interstitial lung diseases (ILD), including interstitial pneumonias (IP), represent disorders with variable degrees of parenchymal inflammation and/or fibrosis offer an ideal model to investigate the histopathological features in relation to the course of these diseases. The most common IP is idiopathic pulmonary fibrosis (IPF) with the histological pattern of usual interstitial pneumonia (UIP) exhibiting the histological hallmark of fibroblast foci (FF). Surgical lung biopsy (SLB) is not usually needed for diagnosis of IPF, but the lung biopsy samples taken by SLB confers the diagnosis in atypical cases. The safety of SLB in IPF/UIP has been a controversial issue. The acute exacerbation occasionally occurs during the course of IPF/UIP, but pathological features related to this event are poorly understood. Recent studies suggest that one important determinant in the pathogenesis of ILDs, as in IPF, is oxidant stress and an imbalance of the redox-state in the lung. Thiol containing redox-regulated proteins which paticipate in the antioxidant defence of the lung include thiorexin (Trx) and gamma-glutamylcysteine synthetase (γGCS), also called glutamate-cysteine ligase (GLCL), the rate-limiting enzyme of glutathione (GSH) synthesis. The goal of this research was to evaluate the safety of SLB and the relationships between the histological findings and the course of IPF/UIP, and to investigate the above mentioned defense mechanisms in a variety of ILDs by means of immmunohistochemical analyses, Western Blotting and immunoelectronmicroscopy. No deaths occurred in the following 30 days after 34 video-assisted thoracoscopic lung biopsy (VATS). The number of FF in the lung sample predicted the survival, but it was not associated with acute exacerbation of IPF/UIP before death. Diffuse alveolar damage was a common feature in autopsy samples. The studied redox regulated defense enzymes were expressed in bronchial epithelium, metaplastic alveolar epithelium and alveolar macrophages, but the fibrotic areas generally showed no expression. In IPF/UIP VATS is a safe diagnostic method and counting the number of FF represents a reproducible and reliable method for predicting patient survival. Alterations in the redox regulated defense enzymes further point to the importance of oxidant burden in the fibrotic lung.

Ménière’s disease is the third most common inner ear disorder. The individual course of Ménière’s disease in different patients makes it difficult to diagnose on the basis of symptomatology alone. The impact of Ménière’s disease on quality of life has highlighted the importance of an additional tool to support the diagnosis of Ménière’s disease. Apart from the patient’s history, audiological data provide the most relevant information for confirming the diagnosis. The aim of this study was to analyse and describe the clinical and audiological features of a cohort of subjects diagnosed with Ménière’s disease, in order to develop understanding of the pathophysiology of the disease and to facilitate the diagnostic process. The research is based on a retrospective study of the medical records of 135 subjects with Ménière’s disease which were selected according to a non-probability sample. Descriptive statistics were used to organize, analyse and interpret the data. Sixty one percent of subjects presented with definite Ménière’s disease, 14 % with probable Ménière’s disease and 25 % with possible Ménière’s disease. The results showed a higher incidence of Ménière’s disease in females especially in the vestibular type. Three percent of subjects indicated a family history of Ménière’s disease. Bilateral Ménière’s disease presented in 39 % of subjects. The results confirmed that vertigo was the most debilitating symptom in Ménière’s disease. Correlating the clinical features of subjects with audiometric and vestibular tests highlighted the clinical value of an audiological test battery including the following tests: Pure tone audiometry, Speech discrimination, Oto-acoustic emissions, Electronystagmography and Electrocochleography. This confirms the role of the audiologist in the diagnostic and rehabilitation process in patients with Ménière’s disease. / Dissertation (Communication Pathology)--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted

The purpose of this study was to investigate whether there is an association between developmental milestones of babies and the prevalence of spinal deformities in adolescents in Middelburg, Mpumalanga. The relationship between spinal deformities in a cross-sectional group of adolescents and parental recall was the focus of the study. One hundred and four adolescents were evaluated to determine if a spinal deformity was present. The subjects were then allocated to either the case (those with spinal deformities) or the control (subjects without spinal deformities) groups. The mothers of the subjects were then interviewed with regard to some of the developmental milestones of their offspring, and other factors which may have had an influence on the development of adolescent spinal deformities. The results showed that a perfectly "normal spine" was seldom found and that even in the control group some minor deviations, within normal limits, were present. Most of the mothers of subjects from the case group did not realise that their offspring had a deformity. There was a non¬significant trend for more crawlers to be present in the control group. Subjects who did not crawl, and who were also late walkers appeared to have an increased tendency to develop adolescent spinal deformities. Despite the fact that the schools approached were multi-racial, only white parents responded to the request for participation in this trial. The possible reasons for this should be investigated and a trial comparing the prevalence of spinal deformities amongst adolescents from all ethnic groups in South Africa should be conducted. Due to the possible recall bias of this study, it is recommended that a longitudinal study, commencing with the babies attending baby clinics in South Africa (representative of the South Africa population), be conducted to determine the influence of developmental milestones on the prevalence of spinal deformities in adolescence. / Dissertation (MPhysiotherapy)--University of Pretoria, 2010. / Physiotherapy / unrestricted

There is little head-to-head evidence comparing interventions available for juvenile idiopathic arthritis (JIA). This review involved a series of systematic reviews and network meta-analyses (NMAs) to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological interventions among patients with JIA. Outcomes were the American College of Rheumatology Pediatric 30 (ACR Pedi 30) (disease response), its six composite outcomes, pain relief, health-related quality of life, and physical and emotional functioning. There was some evidence that etanercept had greater reduction in the number of joints with active arthritis compared to abatacept for polyarticular-course JIA and that canakinumab had improved ACR Pedi 30 over rilonacept. Non-pharmacological interventions showed no significant results for efficacy but were safe overall. Most included studies were low-quality and many were excluded from analysis because of unclear reporting or no results for outcomes of interest. As more studies are conducted this will improve the estimates from the NMAs.

Les virus sont les entités biologiques les plus abondantes et diversifiées sur Terre et leur diversité est encore très peu connue. Récemment, la métagénomique virale a facilité l'exploration de cette diversité. Néanmoins, la plupart des viromes environnementaux générés à ce jour proviennent de régions tempérées et la plupart des viromes humains proviennent d’échantillons de selles, sang ou de prélèvements oro-naso-pharyngés. L'objectif de mon travail de thèse était d’apporter de nouvelles connaissances sur les communautés virales d’environnements et d’échantillons humains les moins étudiés en utilisant une approche de métagénomique virale.La première partie de cette thèse est une revue des principaux outils d'analyse des métagénomes viraux. La deuxième partie présente la première étude de métagénomique virale dans le désert du Sahara. Dans la troisième partie de ma thèse, je présente de viromes associés a l'Homme: i) le premier métagénome viral issu d'un coprolithe humain du Moyen Âge; ii) la première étude de métagénomique virale sur de liquides péricardiques provenant de patients atteints d’une péricardite infectieuse d'origine inconnue; iii) une analyse fonctionnelle de métagénomes viraux précédemment publiés associés aux expectorations de patients atteints de mucoviscidose qui décrit les gènes de résistance aux antibiotiques portés par les bactériophages dans ces patients.Ce travail présente ainsi des données inédites sur certaines communautés virales peu étudiées et confirme le potentiel de la métagénomique virale pour étudier la diversité virale, révéler la présence de virus inattendus ou inconnus et comprendre leur rôle dans leur écosystème d’origine. / Viruses are the most abundant and diverse organisms but little is known about their diversity. Recently, viral metagenomics has allowed performing broad unselective exploration of uncultivated viral communities, bypassing the limits of classical viral detection tools. However, most viral metagenomes are generated from temperate regions (for environmental studies) or from modern stool samples, sera/blood and naso-/oro- pharyngeal samples (for human-associated studies). Therefore, the purpose of my thesis is to study viral communities in the least investigated environments or human samples, using viral metagenomics.The first part of my thesis is a review of the main computational tools for the analysis of viral metagenomes. The second part of my thesis presents the first viromes generated from the Sahara desert. In the third part, I investigate human-associated viral communities: i) the first virome from a human coprolite; ii) the first viromes generated from human pericardial fluids, in idiopathic pericarditis cases; ii) a functional-level investigation of previously described viral metagenomes from cystic fibrosis patient sputa that focuses on antimicrobial resistance genes carried by bacteriophages to better understand the emergence of multidrug-resistance bacteria in the airways of cystic fibrosis patients.This thesis work provides original data on unexplored viral communities and shows the potential of viral metagenomics to give insights on viral diversity, reveal the presence of expected and unexpected viruses and decipher their role in the ecosystem.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-05-25T17:34:07Z No. of bitstreams: 1 Paulo Rogerio Pereira.pdf: 773654 bytes, checksum: 098c4df44754fb146e1a3739b5cb13f0 (MD5) / Made available in DSpace on 2016-05-25T17:34:07Z (GMT). No. of bitstreams: 1 Paulo Rogerio Pereira.pdf: 773654 bytes, checksum: 098c4df44754fb146e1a3739b5cb13f0 (MD5) Previous issue date: 2014-12-15 / Background: Idiopathic pulmonary fibrosis (IPF) is characterized by decline of lung function, increased inflammation and fibrosis mainly in the pulmonary interstitium, with serotonin (5-HT) and Akt signaling presenting a role. Aerobic training (AT) reduces lung injury in different models of pulmonary diseases. However, the mechanisms underlying the effects of AT in a model of bleomycin-induced lung fibrosis is unknown. Thus, this study investigated the effects of AT in a model of bleomycin-induced pulmonary fibrosis, as well as the participation of 5HT/Akt signaling. Methods: Seventy-two C57Bl/6 male mice were distributed in Control (Co), Exercise (Ex), Fibrosis (Fi) and Fibrosis+Exercise (Fi+Ex) groups. Bleomycin (1.5UI/Kg) was administered on day 1 and treadmill AT began on day 14 during 4 weeks. Total and differential cells count in bronchoalveolar lavage (BAL), IL-1beta, IL-6, CXCL1/KC, IL-10, TNF-alpha and TGF-beta levels in BAL fluid, collagen content in the lung parenchyma, 5-HT levels in BAL fluid and in serum, and the expression of 5-HT2b receptor and Aktphosphorylation were evaluated. Results: AT reduced bleomycin-increased number of total cells (p<0.001), neutrophils (p<0.01), macrophages (p<0.01) and lymphocytes (p<0.05) in BAL. AT also reduced the levels of IL-1beta (p<0.01), IL-6 (p<0.05), CXCL1/KC (p<0.001), TNF-alpha (p<0.001) and TGF-beta (p<0.001), while increased the levels of IL-10 (p<0.001). Collagen fibers deposition was also reduced by AT (p<0.01). These findings were followed by AT-reduced bleomycin-increased 5-HT levels in BAL fluid (p<0.001) and in serum (p<0.05), as well as the expression of 5-HT2b receptor (p<0.01) and the Aktphosphorylation in lung tissue. Conclusions: We conclude that AT reduces lung inflammation and fibrosis in a model of bleomycin-induced lung fibrosis involving 5-HT/Akt signaling. / Introdução: A fibrose pulmonar idiopática (FPI) é uma doença devastadora com pobre prognóstico e nenhum tratamento efetivo disponível. Estudos recentes demonstram que a serotonina / 5-hidroxitriptamina (5-HT) desempenha um papel importante no processo de fibrose pulmonar. Entretanto, alguns estudos demonstram que o tratamento não farmacológico, como programas de reabilitação pulmonar para pacientes com FPI resulta em melhora da qualidade de vida e do manejo da doença, mas os efeitos sobre os pulmões e os possíveis mecanismos desses efeitos não são conhecidos. Objetivos: Portanto, o presente estudo investigou os efeitos do treinamento físico aeróbio na resposta pulmonar em um modelo de fibrose pulmonar induzida por bleomicina em camundongos, e os possíveis efeitos moduladores do exercício sobre os níveis de 5-HT. Materiais e métodos: Foram utilizados setenta e dois camundongos machos C57/Bl6, os quais foram distribuídos em Controle (Co), Exercício (Ex), Fibrose (Fi) e Fibrose + Exercício (Fi + Ex). Vinte e quatro horas após o último teste físico na esteira, a inflamação pulmonar foi avaliada através da avaliação do lavado broncoalveolar (contagem de células e medidas de citocinas: IL-1beta, IL-6, CXCL1/KC, IL-10, TNF-alfa, TGF-beta), e o remodelamento pulmonar através do acúmulo de fibras colágenas no parênquima pulmonar. Foram avaliados também os níveis de 5-HT no sobrenadante do lavado broncoalveolar e no soro. Além disso, a expressão do receptor para 5-HT (5-HT2B) também foi avaliado no tecido pulmonar. Por fim, a expressão da forma integral e fosforilada da Akt também foi avaliada no tecido pulmonar. Resultados: Os resultados demonstraram que o treinamento aeróbio reduziu o número de células totais (p<0.001), de neutrófilos (p<0.01), de macrófagos (p<0.01) e de linfócitos (p<0.05) no lavado broncoalveolar, assim como reduziu os níveis de IL-1beta (p<0.01), IL-6 (p<0.05), CXCL1/KC (p<0.001), TNF-alfa (p<0.001) e TGF-beta (p<0.001) no lavado broncoalveolar, enquanto aumentou os níveis da citocina anti-inflamatória IL-10 (p<0.001). O treinamento físico também reduziu a deposição de fibras de colágeno no parênquima pulmonar (p<0.001). Os níveis de 5-HT no sobrenadante do lavado broncoalveolar (p<0.001) e no soro (p<0.05) e a expressão do receptor 5HT2B (p<0.01) no tecido pulmonar demonstraram-se reduzidos no grupo submetido ao treinamento físico. A expressão de Akt na forma total não foi alterada pelo treinamento físico, enquanto que a forma fosforilada foi reduzida pelo treinamento físico (p<0.01). Conclusões: Os resultados do presente estudo demonstram claramente que o treinamento físico aeróbio é capaz de reduzir a inflamação e a fibrose pulmonar em um modelo experimental de fibrose pulmonar induzida pela bleomicina. Os resultados também demonstram que pelo menos em parte, esses efeitos benéficos do treinamento físico aeróbio pode ter sido mediado pelo aumento da liberação de IL-10, assim como pela redução da exacerbação dos níveis de serotonina, levando a uma redução da expressão do receptor de serotonina 5-HT2B, e também da redução da ativação da proteína Akt.

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