CD55 e CD59 são proteínas de membrana ancoradas pela glicosilfosfatidilinositol que apresentam propriedades reguladoras da ativação da cascata do complemento. Esta regulação ocorre através da inibição da C3 convertase e prevenção da etapa final de polimerização do complexo de ataque à membrana, respectivamente. Pacientes com Lúpus Eritematoso Sistêmico com anemia hemolítica e linfopenia parecem apresentar uma deficiência adquirida de CD55 e CD59. Contudo, os mecanismos que modulam essa diminuída expressão continuam desconhecidos e o seu impacto nas manifestações do Lúpus Eritematoso Sistêmico necessita ser melhor estudado. / CD55 and CD59 are glycosylphosphatidylinositos-anchored proteins with complement inhibitory properties, which inhibit formation of the C3 convertases and prevent the terminal polymerization of the membrane attack complex, respectively. Systemic Lupus erythematosus patients seem to have an acquired deficiency of CD55 and CD59 proteins associated with secondary autoimmune hemolytic anemia and lymphopenia. But the mechanisms remain unknown and its impact on the clinical manifestation of Systemic Lupus erythematosus needs to be more explored.

OBJETIVO: Avaliar a expressão dos perfis de citocinas Th1, Th2 e Th17 em pacientes com LES e verificar possíveis associações com os níveis séricos de vitamina D. MÉTODOS: Estudo transversal com inclusão de 172 pacientes acompanhados no ambulatório de reumatologia do Hospital de Clínicas de Porto Alegre. Os níveis de vitamina D foram medidos por quimiluminescência. Níveis séricos <20 ng/ml foram considerados como deficiência de vitamina D e níveis ≥20 ng/ml foram considerados normais. As citocinas foram medidas no soro após o descongelamento das amostras em uma única ocasião, usando Kit CBA (cytometric beads array) Th1/Th2/Th17. RESULTADOS: Cento e sessenta e um (94%) pacientes eram mulheres e 128 (74,4%) foram classificados como euro-descendentes. A idade média foi de 40,5±13,8 anos e a idade média no momento do diagnóstico foi de 31,5±13,4 anos. Na entrada do estudo, os pacientes tiveram mediana (intervalo interquartil) de atividade da doença (SLEDAI- systemic lupus erythematosus disease activity index) de 2 (1-4) e cronicidade (SLICC damage index- systemic lupus international collaborating clinics) de 0 (0-1). O nível médio de vitamina D foi de 25,4±11,04 ng/ml. Cinquenta e nove (34,3%) pacientes apresentavam deficiência de vitamina D e 113 (65,7%) tinham níveis considerados normais. Nenhuma associação e correlação estatisticamente significativa foram encontradas. Os níveis de INF-α e SLEDAI mostraram uma correlação positiva fraca (rs=0,22, p=0,04). Análise de regressão linear foi realizada para controlar possíveis fatores de confusão. CONCLUSÃO: A deficiência de vitamina D é prevalente em pacientes com LES, entretanto, não foram encontradas correlações e associações entre níveis de vitamina D e perfil de citocinas. Confirmamos a correlação existente entre o IFN-α e SLEDAI, conforme a literatura. Efeito in vitro de vitamina D no perfil de citocinas não foi reproduzido no presente estudo. Estudos longitudinais podem ajudar a esclarecer a influência da vitamina D na fisiopatogenia do LES. / OBJECTIVES: To evaluate the expression of Th1, Th2 and Th17 cytokine profiles in SLE patients and verify possible associations with serum vitamin D levels. METHODS: Cross-sectional study with 172 SLE patients, followed at the outpatient clinic of rheumatology at Hospital de Clínicas de Porto Alegre were included. The levels of vitamin D were measured by chemiluminescence. Serum levels <20 ng/ml were considered as vitamin D deficiency. Normal vitamin D levels were defined as ≥20ng/ml. Cytokines were measured in serum after thawing the samples on a single occasion, using Kit CBA (cytometric beads array) Th1/Th2/Th17. RESULTS: One hundred sixty one (94%) patients were women and 128 (74.4%) were classified as European derived. The mean age of patients was 40.5±13.8 years and the mean age at diagnosis was 31.5±13.4 years. At the time of study entry, patients had median (IQR) of active disease (SLEDAI- systemic lupus erythematosus disease activity index) of 2 (1-4) and chronicity (SLICC damage index- systemic lupus international collaborating clinics) of 0 (0-1). Mean vitamin D levels were 25.4±11.04 ng/ml. Fifty-nine (34.3%) patients had vitamin D deficiency and 113 (65.7%) had normal levels. No association and statistically significant correlations was found. The levels of INF-α and SLEDAI showed a weak positive correlation (rs=0.22, p=0.04). Linear regression analysis was performed to control for possible confounding factors. CONCLUSION:Vitamin D deficiency is prevalent in patients with SLE, however, no statistically significant correlations and associations between vitamin D levels and cytokine profile were found. We confirm the correlation between IFN-α and SLEDAI, according to the literature. In vitro effect of vitamin D on the cytokine profile was not reproduced in this study. Longitudinal studies may help clarify the influence of vitamin D in the pathogenesis of SLE.

Objetivos: A reserva ovariana de pacientes com lúpus eritematoso sistêmico (LES) pode ser afetada pela atividade de doença e pelo tratamento medicamentoso. Estudos realizados até o momento mostram que pacientes com LES têm taxas de fertilidade semelhantes às de mulheres hígidas da mesma idade. Este trabalho tem como objetivo estudar a reserva ovariana de pacientes com LES e compará-la com a de controles saudáveis através da dosagem do hormônio anti-Mülleriano (HAM). Métodos: Estudo de caso-controle no qual foram incluídas 80 mulheres prémenopáusicas, sendo 40 pacientes com diagnóstico de LES segundo critérios de classificação do American College of Rheumatology (ACR) de 1997 e 40 controles hígidos pareados pelo uso de anticoncepcional oral. Foi utilizado o kit Human AMH ELISA (CUSABIO, Wuhan, China) para a determinação quantitativa da concentração sérica do HAM em sangue venoso. Resultados: Não houve diferença significativa entre os níveis séricos de HAM nas pacientes com LES e nos controles (22,79 ± 17,32 ng/ml versus 21,41 ± 16,22 ng/ml, respectivamente; p=0,7), mesmo após ajuste para a idade (21,03 ± 2,74 ng/ml versus 23,97 ± 2,71 ng/ml; p=0,5). Não foi identificada correlação do HAM com tempo de doença (r=0,2; p=0,3), índice de massa corporal (IMC) (r=0,2; p=0,2) e índices de atividade [SLEDAI (r=0,1; p=0,7)] e cronicidade de doença [SLICC (r=0,1; p=0,7)]. Não houve associação do HAM com etnicidade, tabagismo ativo e uso prévio de ciclofosfamida ou outros imunossupressores. Conclusão: Neste estudo transversal, mulheres com LES apresentaram níveis de HAM semelhantes aos de controles saudáveis, indicando reserva ovariana preservada nessa população. / Objective: The ovarian reserve of patients with systemic lupus erythematosus (SLE) may be affected by disease activity and medication use. Studies have found that patients with SLE have similar fertility rates to healthy women of the same age. The goal of the present study was to investigate the ovarian reserve of patients with SLE by measuring anti-Müllerian hormone (AMH) levels, and compare it to that of healthy controls. Method: This was a case-control study performed on 80 premenopausal women, of whom 40 fulfilled the 1997 American College of Rheumatology (ACR) criteria for SLE and 40 healthy controls paired by hormonal contraceptive use. Serum concentrations of AMH in peripheral venous blood were measured using a Human AMH ELISA kit (CUSABIO, Wuhan, China). Results: AMH serum levels did not differ between patients with SLE and controls (22.79 ± 17.32 ng/ml versus 21.41 ± 16.22 ng/ml, respectively, p=0.7), even after adjusting for age (21.03 ± 2.074 ng/ml versus 23.97 ± 2.71 ng/ml; p=0.5). AHM levels were not significantly correlated with disease duration (r=0.2; p=0.3), body mass index (BMI) (r=0.2; p=0.2) and disease activity [SLEDAI (r=0.1; p=0.7)] and damage indices [SLICC (r=0.1; p=0.7)]. No associations were found between AMH and ethnicity, current smoking, as well as current or prior use of cyclophosphamide and other immunosuppressants. Conclusion: In this cross-sectional study, women with SLE demonstrated similar AMH levels to healthy controls, suggesting preserved ovarian reserve in this population.

Introdução: As alopecias cicatriciais são subdivididas em primárias e secundárias. Nas alopecias cicatriciais primárias o folículo piloso é o alvo principal da destruição; diferentemente das secundárias onde a destruição folicular não é o evento patológico primário. Objetivo: Revisar os achados histológicos de pacientes com diagnóstico de alopecia cicatricial primária, em uma fase tardia e reclassificá-los em seus respectivos subtipos. Casuística e Métodos: Os espécimes de biópsia de pacientes com diagnóstico histológico prévio de alopecia cicatricial foram revisados e submetidos a colorações por hematoxilina e eosina (HE), ácido periódico-Schiff (PAS) e Weigert, a fim de reclassificá-los de acordo com os diferentes subtipos de alopecia. Foram utilizados para a revisão histológica critérios de infiltrado inflamatório acrescidos de coloração para fibra elástica. Resultados: Os 37 casos de alopecia cicatricial primária foram reclassificados em: lupus eritematoso discóide (16), líquen plano pilar (4), pseudopelada de Brocq (12), foliculite decalvante (3), foliculite abscedante/dessecante (1), e alopecia não-específica (1). Conclusão: Mesmo em uma fase tardia, pauci ou não inflamatória, o exame histológico, utilizando colorações de rotina, PAS e coloração para fibra elástica, permitiu o diagnóstico mais acurado das alopecias cicatriciais primárias / BACKGROUND: Scarring alopecias are classified into primary and secondary according to the initial site of inflammation. In primary scarring alopecias, the hair follicle is the main target of destruction. The term secondary cicatricial alopecia implies that follicular destruction is not the primary pathologic event. AIMS: To review the histopathologic diagnoses of cases of cicatricial alopecia in order to classify them according to the North American Hair Research Society. PATIENTS AND METHODS: Patients with biopsy specimens diagnosed as cicatricial alopecia seen from 2000 to 2005 at the Dermatologic Department of Hospital das Clínicas, São Paulo University Medical School had hematoxylin and eosin, Periodic Acid-Schiff (PAS) and Weigert stained slides reevaluated and sub-typed into different primary cicatricial alopecias. RESULTS: Thirty-seven cases of primary cicatricial alopecias were reclassified as: discoid lupus erythematosus (16), lichen planus pilaris (4), pseudopelade of Brocq (12), folliculitis decalvans (3), dissecting folliculitis (1), and non-specific scarring alopecia (1). CONCLUSIONS: Even in late, pauci or noninflammatory phases, an approach with systematic evaluation of a constellation of criteria in routine hematoxylin and eosin stain, PAS and Weigert stain permitted an accurate diagnosis of cicatricial alopecias

Les récepteurs du Fc des Immunoglobulines G (FcγR) sont impliqués dans de nombreuses réactions immunitaires. Deux groupes de faible affinité existent : les FcγRIIa/b/c et les FcγRIIIa/b, FcγRIIb étant le seul inhibiteur. Plusieurs polymorphismes, modifiant l’affinité au ligand et la réponse du récepteur, sont favorisés par une pression de sélection infectieuse et associés aux Maladies Auto-Immunes (MAI). Nous avons étudié l’association des polymorphismes FcγRIIa-R131H, FcγRIIb-I232T, FcγRIIIa-F158V, FcγRIIIb-Na1/Na2 aux Lupus érythémateux systémique (LES), la neuromyélite optique (NMO) et la sclérose en plaque (SEP) en Martinique. Nos résultats montrent une forte fréquence des allèles T232, V158 et des génotypes 232TT et 158VV dans la population générale, une augmentation de la fréquence de l’homozygote Na1, des allèles Na1 et 158F dans le LES, une augmentation du génotype 131RR ainsi que des allèles 131R et 158V dans le LES avec atteinte rénale, une augmentation du génotype 131RR et une diminution du NA2/NA2 dans la SEP ainsi qu’une augmentation de l’allèle 232T dans les NMO. L’étude de l’influence du FcγRIIb-I232T sur l’activation du récepteur à l’antigène des lymphocytes B (BCR) chez des lupiques et des témoins sains porteurs des formes IT, TT ou II montre que la régulation du BCR est effective même en présence de la forme TT. Ces résultats démontrent pour la première fois que la population martiniquaise possède un terrain génétique particulier qui faciliterait l’apparition de MAI avec pronostic plus sévère. / Receptors of Fc of Immunoglobulin G (FcγR) are involved in many immune responses. Two low affinity groups exist: FcγRIIa/b/c, and FcγRIIIa/b, FcγRIIb is the only inhibitor. Several polymorphisms, altering the affinity ligand and receptor response, are selected by an infectious pressure and associated with autoimmune diseases (AID). We studied the association of polymorphisms FcγRIIa-R131H, FcγRIIb-I232T, FcγRIIIa-F158V, FcγRIIIb-Na1/Na2 to systemic lupus erythematosis (SLE), neuromyelitis optica (NMO) and multiple scelrosis (MS) in Martinique. Our results show a high frequency of alleles T232, V158 and 232TT and 158VV genotypes in Martinican, an increase in the frequency of the homozygous Na1, Na1 and 158F alleles in SLE, an increase of 131RR genotype, the 131R and 158V alleles in SLE with kidney disease, an increase of 131RR genotype and a decrease of NA2 / NA2 in MS but an increase in the 232T allele in NMO. Study of the influence of FcγRIIb-I232T on the activation of the B cells receptor (BCR) in lupus and healthy controls controls exibiting IT, TT or II forms, shows that the regulation of BCR is effective even in the presence TT form. These results show for the first time Martinican population has a particular genetic background which would facilitate the appearance of MAI particularly serious.

A method for assaying poly (ADP-ribose) polymerase (PADPRP) activity in lymphocytes of systemic lupus erythematosus (SLE) patients has been developed. Using this method, PADPRP activity has been studied in lymphocytes from 15 patients and 13 controls. The mean activity in SLE lymphocytes was significantly lower than that in controls and 60% of the SLE patients demonstrated activities below the minimum of the control population. Possible mechanisms for this altered metabolism were investigated. The Km app of PADPRP for NAD; size distribution, branch frequency, and rates of turnover of polymers; competition for substrate; and number of PADPRP molecules were studied. The data demonstrated that SLE lymphocytes have a decreased synthetic capacity rather than alterations in the substrate or in turnover of the product.

No description available.

The purpose of the study was to determine the point prevalence of cognitive dysfunction in patients with systemic lupus erythematosus (SLE) and to investigate its association with corticosteroids and depression. The severity of dysfunction and the pattern of cognitive changes were examined. This study hypothesized that cognitive dysfunction is common in SLE and many previous studies have underestimated its prevalence, partially due to using limited neuropsychological batteries and insensitive test instruments. It was further hypothesized that the pattern of cognitive changes in SLE patients will resemble that observed in subcortical dementias.

No description available.

No description available.