No description available.

Introdução: A dermatite atópica (DA) é uma doença cutânea inflamatória de caráter crônico, recidivante, em que o prurido intenso e a xerose cutânea são frequentes. A etiopatogenia da DA é multifatorial, envolvendo fatores genéticos, ambientais e imunológicos. Eosinófilos são leucócitos polimorfonucleares multifuncionais que estão implicados na patogênese de diversos processos inflamatórios, incluindo a DA. Além da produção e secreção de diversas proteínas presentes nos grânulos citoplasmáticos, os eosinófilos também apresentam potencial para secretar metaloproteinases, enzimas proteolíticas que degradam vários componentes da matriz extracelular, e estão presentes em diversos processos fisiológicos e patológicos. Objetivo: Avaliar: 1) o perfil fenotípico dos eosinófilos na dermatite atópica do adulto, através da expressão das moléculas CCR3, CD23, CD38, CD69 e CD62L; 2) o perfil funcional, a partir da secreção de metaloproteinases, inibidores teciduais de metaloproteinases e RANTES por eosinófilos purificados. Métodos: Foram incluídos 41 adultos diagnosticados com DA, de acordo com os critérios de Hanifin & Rajka e 45 controles adultos sadios. A gravidade da doença foi mensurada através do escore de gravidade EASI (Eczema Area and Severity Index). Eosinófilos (LIN 1- CCR3+) do sangue periférico foram analisados para os marcadores CCR3, CD38, CD69, CD23 e CD62L através da citometria de fluxo (LSRFortessa, BD Biosciences) a análise foi realizada com o FlowJo 7.5.6 software. Eosinófilos purificados de indivíduos com DA e indivíduos controles foram estimulados com enterotoxina de Staphylococcus aureus B (SEB) e FSL-1 (agonista de receptores Toll-like 2 e 6), e os sobrenadantes foram coletados para dosagem de metaloproteinases (MMPs), inibidores teciduais de metaloproteinases 1 e 2 (TIMP-1 e TIMP-2) e RANTES por ELISA e por Cytometric bead array. Resultados: Indivíduos com DA apresentaram maior frequência de eosinófilos (LIN1- CCR3+), relacionada à gravidade da doença. Observou-se também, que a frequência de CD62L (L-selectina) e de CD23 (receptor de baixa afinidade para IgE) em eosinófilos (LIN1- CCR3+) diminui em pacientes com DA. Os receptores de ativação precoce (CD69) e tardio (CD38) não mostraram diferença estatística entre os grupos analisados. Os níveis séricos de MMPs e de TIMPs foram similares entre os controles e pacientes. Ao analisarmos a secreção de MMPs e de (TIMPs), a partir de eosinófilos purificados de pacientes com dermatite atópica, observamos diminuição dos níveis basais de TIMP-1 e TIMP-2 e de RANTES. Conclusões: Na DA do adulto, o perfil fenotípico e funcional dos eosinófilos mostrou: perfil de ativação da fase aguda, com expressão aumentada de CCR3; potencial de migração elevado, em decorrência da diminuição da expressão de CD62L; falhas no processo de ativação dos eosinófilos via CD23, bem como, no remodelamento tecidual mediado por TIMP-1 e TIMP-2 e na quimotaxia mediada por RANTES / Introduction: Atopic dermatitis (AD) is an inflammatory, chronic and recurrent skin disease characterized by intense pruritus and xerosis. AD has a complex etiopathogenesis, which involves the influence of genetics, environment, and immunological disorders, among others. Eosinophils are multifunctional polymorphonuclear leukocytes that contribute to the pathogenesis of several inflammatory processes, such as AD. In addition to the production and secretion of diverse proteins of the cytoplasmic granules, eosinophils have also the potential to secrete metalloproteinases (MMPs), proteolytic enzymes with a primary role for degrading several extracellular matrix components, present in distinct physiological and pathological processes. Objective: To evaluate:1) the phenotypic profile of eosinophils in adults with atopic dermatitis through the expression of CCR3, CD23, CD38, CD69 and CD62L molecules; 2) the functional profile through secretion of MMPs, tissue inhibitors of metalloproteinases 1 and 2 ( TIMP-1 and TIMP-2) and RANTES by purified eosinophils. Methods: This work enrolled 41 patients with AD, diagnosed according to Hanifin & Rajka\'s criteria) and 45 healthy controls. Severity of the disease was established utilizing EASI (Eczema Area and Severity Index). Eosinophils (Lineage cocktail 1- CCR3+) from peripheral blood were analyzed for CCR3, CD38, CD69, CD23 and CD62L by flow cytometry (LSRFortessa, BD Biosciences), and analysis was performed using the FlowJo 7.5.6 software. Purified eosinophils were stimulated with Staphylococcus aureus enterotoxin B (SEB) FSL-1 (Toll-like receptor 2/6 agonist), and supernatants were collected for MMPs, TIMPs and RANTES secretion, evaluated by ELISA and cytometric bead array (CBA). Results: Patients with AD have a higher frequency of eosinophils (LIN1- CCR3+), related to disease severity. Moreover, the frequency of CD62L (L-selectin) and CD23 (low-affinity receptor for IgE) in (LIN1- CCR3+) eosinophils was reduced in individuals with AD. CD69 and CD38 (early and late activation receptors) did not show significant difference in the studied groups. Serum levels of MMPs and of TIMP-1 and TIMP-2 were similar in healthy controls and AD patients. When analyzing secretion of MMPs and TIMPs by purified eosinophils from AD individuals, we detected a decrease in baseline levels of TIMP-1, TIMP-2, and reduced RANTES-mediated chemotaxis. Conclusions: Eosinophils in AD exhibit an activation profile of acute phase, with enhanced CCR3 expression, high potential for migration due to reduced expression of CD62, defective activation mechanisms via CD23, altered tissue remodeling process mediated by TIMP-1 and TIMP-2 and reduced RANTES-mediated chemotaxis

No description available.

Introdução: A dermatite atópica (DA) é uma doença cutânea inflamatória de caráter crônico, recidivante, em que o prurido intenso e a xerose cutânea são frequentes. A etiopatogenia da DA é multifatorial, envolvendo fatores genéticos, ambientais e imunológicos. Eosinófilos são leucócitos polimorfonucleares multifuncionais que estão implicados na patogênese de diversos processos inflamatórios, incluindo a DA. Além da produção e secreção de diversas proteínas presentes nos grânulos citoplasmáticos, os eosinófilos também apresentam potencial para secretar metaloproteinases, enzimas proteolíticas que degradam vários componentes da matriz extracelular, e estão presentes em diversos processos fisiológicos e patológicos. Objetivo: Avaliar: 1) o perfil fenotípico dos eosinófilos na dermatite atópica do adulto, através da expressão das moléculas CCR3, CD23, CD38, CD69 e CD62L; 2) o perfil funcional, a partir da secreção de metaloproteinases, inibidores teciduais de metaloproteinases e RANTES por eosinófilos purificados. Métodos: Foram incluídos 41 adultos diagnosticados com DA, de acordo com os critérios de Hanifin & Rajka e 45 controles adultos sadios. A gravidade da doença foi mensurada através do escore de gravidade EASI (Eczema Area and Severity Index). Eosinófilos (LIN 1- CCR3+) do sangue periférico foram analisados para os marcadores CCR3, CD38, CD69, CD23 e CD62L através da citometria de fluxo (LSRFortessa, BD Biosciences) a análise foi realizada com o FlowJo 7.5.6 software. Eosinófilos purificados de indivíduos com DA e indivíduos controles foram estimulados com enterotoxina de Staphylococcus aureus B (SEB) e FSL-1 (agonista de receptores Toll-like 2 e 6), e os sobrenadantes foram coletados para dosagem de metaloproteinases (MMPs), inibidores teciduais de metaloproteinases 1 e 2 (TIMP-1 e TIMP-2) e RANTES por ELISA e por Cytometric bead array. Resultados: Indivíduos com DA apresentaram maior frequência de eosinófilos (LIN1- CCR3+), relacionada à gravidade da doença. Observou-se também, que a frequência de CD62L (L-selectina) e de CD23 (receptor de baixa afinidade para IgE) em eosinófilos (LIN1- CCR3+) diminui em pacientes com DA. Os receptores de ativação precoce (CD69) e tardio (CD38) não mostraram diferença estatística entre os grupos analisados. Os níveis séricos de MMPs e de TIMPs foram similares entre os controles e pacientes. Ao analisarmos a secreção de MMPs e de (TIMPs), a partir de eosinófilos purificados de pacientes com dermatite atópica, observamos diminuição dos níveis basais de TIMP-1 e TIMP-2 e de RANTES. Conclusões: Na DA do adulto, o perfil fenotípico e funcional dos eosinófilos mostrou: perfil de ativação da fase aguda, com expressão aumentada de CCR3; potencial de migração elevado, em decorrência da diminuição da expressão de CD62L; falhas no processo de ativação dos eosinófilos via CD23, bem como, no remodelamento tecidual mediado por TIMP-1 e TIMP-2 e na quimotaxia mediada por RANTES / Introduction: Atopic dermatitis (AD) is an inflammatory, chronic and recurrent skin disease characterized by intense pruritus and xerosis. AD has a complex etiopathogenesis, which involves the influence of genetics, environment, and immunological disorders, among others. Eosinophils are multifunctional polymorphonuclear leukocytes that contribute to the pathogenesis of several inflammatory processes, such as AD. In addition to the production and secretion of diverse proteins of the cytoplasmic granules, eosinophils have also the potential to secrete metalloproteinases (MMPs), proteolytic enzymes with a primary role for degrading several extracellular matrix components, present in distinct physiological and pathological processes. Objective: To evaluate:1) the phenotypic profile of eosinophils in adults with atopic dermatitis through the expression of CCR3, CD23, CD38, CD69 and CD62L molecules; 2) the functional profile through secretion of MMPs, tissue inhibitors of metalloproteinases 1 and 2 ( TIMP-1 and TIMP-2) and RANTES by purified eosinophils. Methods: This work enrolled 41 patients with AD, diagnosed according to Hanifin & Rajka\'s criteria) and 45 healthy controls. Severity of the disease was established utilizing EASI (Eczema Area and Severity Index). Eosinophils (Lineage cocktail 1- CCR3+) from peripheral blood were analyzed for CCR3, CD38, CD69, CD23 and CD62L by flow cytometry (LSRFortessa, BD Biosciences), and analysis was performed using the FlowJo 7.5.6 software. Purified eosinophils were stimulated with Staphylococcus aureus enterotoxin B (SEB) FSL-1 (Toll-like receptor 2/6 agonist), and supernatants were collected for MMPs, TIMPs and RANTES secretion, evaluated by ELISA and cytometric bead array (CBA). Results: Patients with AD have a higher frequency of eosinophils (LIN1- CCR3+), related to disease severity. Moreover, the frequency of CD62L (L-selectin) and CD23 (low-affinity receptor for IgE) in (LIN1- CCR3+) eosinophils was reduced in individuals with AD. CD69 and CD38 (early and late activation receptors) did not show significant difference in the studied groups. Serum levels of MMPs and of TIMP-1 and TIMP-2 were similar in healthy controls and AD patients. When analyzing secretion of MMPs and TIMPs by purified eosinophils from AD individuals, we detected a decrease in baseline levels of TIMP-1, TIMP-2, and reduced RANTES-mediated chemotaxis. Conclusions: Eosinophils in AD exhibit an activation profile of acute phase, with enhanced CCR3 expression, high potential for migration due to reduced expression of CD62, defective activation mechanisms via CD23, altered tissue remodeling process mediated by TIMP-1 and TIMP-2 and reduced RANTES-mediated chemotaxis

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-15T12:35:53Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Trabalho e Artigo. BIBLIOTECA.pdf: 1144641 bytes, checksum: 49381fb9cd2af1b7f9dccd4c30011139 (MD5) / Made available in DSpace on 2016-04-15T12:35:53Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Trabalho e Artigo. BIBLIOTECA.pdf: 1144641 bytes, checksum: 49381fb9cd2af1b7f9dccd4c30011139 (MD5) Previous issue date: 2015-09-11 / CAPEs / O câncer de colo uterino é o terceiro câncer mais comum em mulheres. A infecção e persistência do papilomavirus humano (HPV) tem papel fundamental no surgimento e evolução das lesões cervicais, promovendo alterações no ciclo celular e proliferação celular descontrolada através das oncoproteínas E6 e E7. Entretanto, fazem-se necessários diversos outros fatores para o desenvolvimento de neoplasias. Entre estes, encontram-se as metaloproteinases de matriz (MMP), endopeptidases capazes de digerir matriz extracelular, membrana basal e induzir fatores de crescimento, que participam dos processos de invasão, metástase, angiogênese e recidiva tumorais. Em lesões neoplásicas, a síntese de MMPs encontra-se aumentada. Sua atividade normalmente é contrarregulada por inibidores endógenos, sendo muito comum que haja desequilíbrio nesta relação em lesões tumorais. A despeito de muito estudo sobre sua relação com o câncer cervical, sabe-se pouco sobre o papel das MMPs e seus inibidores na progressão de lesões cervicais causadas por HPV. Este estudo procura correlacionar a expressão de TIMP2 e RECK às lesões cervicais causadas por HPV. Foram utilizadas 115 amostras teciduais, obtidas por conização de lesões cervicais uterinas entre 2011 e 2015 no Hospital das Clínicas de Recife, nas quais foi realizado estudo histopatológico e imunohistoquímico. Foi observada reatividade fraca no citoplasma de células do tecido escamoso de 28,5% dos controles, sem nenhuma lâmina demonstrar reatividade moderada ou forte. Quanto ao núcleo, a quase totalidade das amostras não apresentou TIMP-2, enquanto 28,5% dos controles o fez. No epitélio glandular nenhuma amostra do Grupo Controle, NIC I ou NIC II foi positiva para TIMP2 no citoplasma e núcleo. Das amostras de NIC III, 6% demonstraram positividade no citoplasma. Os resultados de RECK no citoplasma do epitélio escamoso mostraram que a expressão de RECK no citoplasma de células epiteliais escamosas é significativamente maior quanto maior o grau de lesão do tecido, exceto no CC, onde a expressão é menor que a das lesões NIC III (p = 0,019). Os resultados demonstraram que a expressão nuclear de RECK em células epiteliais escamosas é significativamente menor nos tecidos displásicos (p < 0,001). Nas análises de citoplasma do epitélio glandular , nenhuma amostra do Grupo Controle, NIC I e NIC II foi positiva, havendo 3,6% de positividade nas lesões de NIC III, todas com reatividade fraca ou moderada, e 10% de positividade moderada nas amostras de CC. Nenhuma das amostras apresentou positividade nuclear. Os resultados obtidos demonstram menor expressão nuclear de TIMP2 e RECK na presença de displasia e maior expressão citoplasmática de RECK nas células escamosas. Esta foi maior quanto mais alto o grau de displasia, mas foi menor nas amostras de carcinoma do que nas de NIC III. Conclui-se que os inibidores de MMPs podem ter utilidade como marcadores imunohistológicos nas lesões cervicais, sendo necessários mais estudos para sua validação prática. / Cervical cancer is the third most common cancer in women. The infection and persistence of human papillomavirus (HPV) plays a key role in the emergence and evolution of cervical lesions, promoting changes in the cell cycle and uncontrolled cell proliferation through the oncoproteins E6 and E7. However, make up several other factors required for the development of malignancies. Among these are the matrix metalloproteinases (MMPs), endopeptidases capable of digesting the extracellular matrix, basement membrane and induce growth factors, that participate in the processes of invasion, metastasis, angiogenesis and tumor recurrence. In neoplastic lesions, MMPs synthesis is increased. Its activity is usually contrarregulada by endogenous inhibitors, being very common there is imbalance in this relationship in tumor lesions. Despite much study on its relationship with cervical cancer, little is known about the role of MMPs and their inhibitors in the progression of cervical lesions caused by HPV. This study tries to correlate the expression of RECK and TIMP2 the cervical lesions caused by HPV. 115 tissue samples were used, obtained by conization to uterine cervical lesions between 2011 and 2015 at the Hospital das Clinicas of Recife, in which was conducted histopathological and immunohistochemical study. Weak reactivity was observed in the cytoplasm of the squamous tissue cells of 28.5% of controls, with no slide show moderate or strong reactivity. As for the core, almost all of the samples showed no TIMP-2, while 28.5% of controls did. Glandular epithelium in any sample of the control group, CIN I or CIN II was positive for TIMP2 in the cytoplasm and nucleus. Samples of CIN III, 6% showed positivity in the cytoplasm. The results of RECK in the cytoplasm of squamous epithelium showed that RECK expression in the cytoplasm of squamous epithelial cells is significantly higher the higher the degree of tissue injury, except DC, where expression is lower than that of CIN III lesions (p = 0.019). The results showed that nuclear RECK expression in squamous epithelial cells is significantly lower in dysplastic tissues (p <0.001). In the cytoplasm analysis of glandular epithelium, no sample of the control group, CIN I and CIN II was positive, with 3.6% of positivity in CIN III lesions, all with low or moderate reactivity, and 10% moderate positivity in the samples DC. None of the samples showed nuclear positivity. The results showed lower nuclear expression TIMP2 and RECK in the presence of dysplasia and increased cytoplasmic expression of RECK in squamous cells. This was greater the higher the degree of dysplasia, but was lower in carcinoma samples than in CIN III. We conclude that MMP inhibitors may have utility as immunohistological markers in cervical lesions, more research is needed to validate your practice.

Chronic obstructive pulmonary disease (COPD) is characterized by a non-fully reversible airflow limitation and a chronic inflammatory response accompanied by the development of emphysema. The β2-adrenoceptor agonists and anticholinergic agents are widely used in patients with COPD due to their bronchodilator properties. Today, many studies in vitro and in vivo in experimental animal models have shown that these bronchodilators also exert anti-inflammatory effects, but their protective roles against lung inflammation and the development of emphysema in patients with COPD remain to be determined. The imbalance between the activity of matrix metalloproteinases (MMPs) and their specific tissue inhibitors (TIMPs) is considered to play a key role in the pathogenesis of COPD, especially in the development of pulmonary emphysema. The modulation of inflammatory responses and emphysema via the inhibition of the MMPs activity induced by the use of synthetic inhibitors of MMPs suggests that MMPs may be therapeutic targets for COPD patients. However, very few studies have demonstrated the regulation exerted by β2-adrenoceptor agonists and anticholinergic agents on the activity of MMPs. The combination of β2-adrenoceptor agonists with anticholinergic agents has been found to exert an additive and even synergistic bronchodilator effect, but nothing is known about their combination on the inflammatory pathogenesis and the development of emphysema. Thus, a better knowledge of the activities of β2-adrenoceptor agonists and anticholinergic agents on controlling pulmonary inflammation and emphysema in COPD could provide a new therapeutic approach in this area. The first goal of the present work was to investigate the effects of formoterol, a β2-adrenoceptor agonist and/or ipratropium bromide, an anticholinergic agent, on acute pulmonary inflammation induced by cadmium inhalation in rats. In addition, we examined whether the expected anti-inflammatory effects of formoterol and/or of ipratropium bromide were associated with a modulation of the gelatinase A (MMP-2), gelatinase B (MMP-9) and macrophage metalloelastase (MMP-12) activity. Compared with the data observed in rats exposed to a single dose of cadmium, the pre-administration of formoterol or ipratropium bromide inhibited the cadmium-induced increase in airway resistance. Formoterol significantly reduced the total cell, neutrophil and macrophage counts in bronchoalveolar lavage fluid (BALF), whereas, ipratropium bromide only reduced the neutrophil number. Both bronchodilators administrated alone attenuated significantly the lung lesions associated with parenchyma inflammatory cell influx and congestion observed in cadmium-group. The increased MMP-9 activity was significantly attenuated. A reduction of pulmonary edema was also detected by measuring the lung wet-to-dry weight ratio. However, no additive or synergistic effect was obtained when formoterol was administrated in combination with ipratropium bromide. In conclusion, formoterol and ipratropium bromide partially protect the lungs against inflammation by reducing the neutrophilic infiltration. This protective effect may be related to the reduction of MMP-9 activity which plays an important role in the acute inflammation. Up to now, the impact of a long-term administration of bronchodilators aiming to control the chronic inflammation and the development of emphysema in experimental animal models and in patients with COPD has been poorly investigated. In this context, it was rational to investigate whether the protective role of formoterol and ipratropium bromide identified in acute conditions persists in a rat model of subacute neutrophilic pulmonary inflammation with an enlargement of airspaces. In the second part of this study, we also intended to determine whether these anti-inflammatory effects are related to the modulation of imbalance between MMPs and TIMPs. Though ipratropium induced no effect on the subacute pulmonary inflammation and the airspace enlargement induced by repeated cadmium inhalations during 5 weeks in rats, formoterol elicited marked anti-inflammatory effects on the increase of total cell and neutrophil counts as well as the activity of MMP-9 mainly expressed in alveolar macrophages and epithelial cells. This drug also prevented the inflammatory infiltration in alveoli and in interstitial tissue and significantly inhibited the airspace enlargement as demonstrated by the significant decrease in the mean linear intercept (Lm). The combination of both bronchodilators at inefficient concentrations induced synergistic inhibitory effects on the total cell and neutrophil counts and on the cadmium-induced increased Lm associated with a reduction of MMP-9 activity in BALF. These data suggest that formoterol alone or combined with ipratropium could protect lungs against subacute pulmonary inflammation and the airspace enlargement by inhibiting neutrophilic infiltration via the reduction of MMP-9 activity. To the best of our knowledge, this is the first report which reveals the anti-inflammatory effects of β2-adrenoceptor agonists and anticholinergic agents in an animal model which mimics the main features of COPD. The data obtained in this work contribute to identify new therapeutic targets in COPD for drugs currently used in clinical practice./ La broncho-pneumopathie chronique obstructive (BPCO) est caractérisée essentiellement par une limitation du débit aérien qui n'est pas entièrement réversible et une inflammation chronique pulmonaire accompagnée dun développement demphysème. Les agonistes β2-adrénergiques et les anticholinergiques sont largement utilisés chez les patients atteints de BPCO en raison de leurs propriétés bronchodilatatrices. Aujourdhui, de nombreuses études expérimentales in vitro et in vivo, utilisant des modèles animaux, ont montré que ces bronchodilatateurs exerçaient également des effets anti-inflammatoires. Leur rôle protecteur contre linflammation pulmonaire et le développement d'emphysème chez des patients souffrant de BPCO reste à déterminer. Le déséquilibre entre les métalloprotéinases de la matrice (MMPs) et leurs inhibiteurs tissulaires (TIMPs) est considéré comme un mécanisme clé dans lévolution de la maladie et surtout dans le développement d'emphysème pulmonaire. La modulation des réactions inflammatoires et de lemphysème obtenue grâce à la réduction de lactivité des MMPs induite par des inhibiteurs synthétiques suggère que les MMPs pourraient être des cibles thérapeutiques importantes dans le traitement de la BPCO. Mais jusquà ce jour, très peu détudes ont été consacrées à la régulation de lactivité des MMPs par les agonistes β2-adrénergiques et les anticholinergiques. Lassociation dun agoniste β2-adrénergique avec un anticholinergique donne lieu à une amplification des effets bronchodilatateurs, mais il nest pas certain que leur combinaison débouche sur des effets additifs ou synergiques sur le plan dun meilleur contrôle de la réaction inflammatoire. Ainsi, une meilleure connaissance des activités des agonistes β2-adrénergiques et des anticholinergiques visant au contrôle de l'inflammation pulmonaire et de l'emphysème dans la BPCO pourrait fournir une nouvelle approche thérapeutique dans ce domaine. Lobjectif de la première partie de ce travail était donc d'étudier les effets du formotérol, un agoniste β2-adrénergique et / ou du bromure d'ipratropium, un anticholinergique, sur l'inflammation pulmonaire aiguë provoquée par linhalation de cadmium chez le rat. En outre, nous voulions aussi vérifier si ces effets anti-inflammatoires étaient associés à une modulation de lactivité de la gélatinase A (MMP-2), de la gélatinase B (MMP-9) et de la métallo-élastase du macrophage (MMP-12). Par rapport aux effets observés chez des rats exposés à une dose de cadmium, ladministration préventive de formotérol ou de bromure dipratropium a atténué laugmentation de la résistance des voies aériennes. Le formotérol a induit une diminution significative du nombre de cellules totales, des neutrophiles et des macrophages dans le liquide de lavage broncho-alvéolaire (BALF). Par contre, le bromure dipratropium na entraîné quune diminution du nombre de neutrophiles. Les lésions pulmonaires caractérisées par de la congestion et une réaction inflammatoire du parenchyme ont été significativement inhibées par ces deux bronchodilatateurs administrés séparément. Lélévation remarquable de lactivité de MMP-9 dans le BALF a été significativement atténuée par le prétraitement au formotérol ou au bromure dipratropium. Il en est de même pour ldème pulmonaire évalué par le biais du rapport entre le poids humide et le poids sec du parenchyme. Lorsque les deux principes actifs ont été combinés et administrés préventivement à laction du cadmium, aucun effet synergique ou additif na été constaté. En conclusion, le formotérol et le bromure dipratropium préviennent partiellement linflammation pulmonaire aiguë en réduisant linfiltration neutrophilique du parenchyme pulmonaire faisant suite à une exposition aiguë au cadmium. Cet effet protecteur pourrait être lié à une réduction de lactivité de MMP-9 qui joue un rôle pro-inflammatoire important dans linflammation aiguë. Jusquici, les effets potentiels des bronchodilatateurs contre linflammation chronique et lévolution de lemphysème pulmonaire chez des animaux et chez les patients atteints de BPCO restent mal connus. Il nous restait donc à vérifier si les effets protecteurs du formotérol et du bromure dipratropium révélés par nos premières études au cours desquelles les rats ont été exposés de manière aiguë au cadmium persistent dans un modèle dinflammation pulmonaire subaiguë accompagnée dun élargissement des espaces aériens. Nous voulions également déterminer si ces effets étaient liés à la modulation du déséquilibre entre les MMP-2/9/12 et les TIMP-1/2. Bien que le bromure dipratropium nait aucun effet sur linflammation subaiguë pulmonaire et lélargissement des espaces aériens induits par des inhalations répétées de cadmium chez le rat, le prétraitement par du formotérol a, quant à lui, inhibé significativement laugmentation du nombre de cellules totales et des neutrophiles ainsi que de lactivité de MMP-9 exprimée principalement dans les macrophages et les cellules épithéliales alvéolaires. En outre, une atténuation importante des lésions pulmonaires caractérisées par un élargissement des espaces aériens les plus distaux et une infiltration de cellules inflammatoires dans les alvéoles et le tissu ont été observées. La combinaison des deux bronchodilatateurs, à des concentrations pourtant inefficaces, a provoqué un effet synergique sur la plupart des paramètres étudiés, en particulier sur linfiltration par les neutrophiles et lactivité de MMP-9 dans le BALF. Ce travail suggère que le formotérol, seul ou combiné avec le bromure dipratropium, pourrait protéger partiellement les poumons contre linflammation pulmonaire et lélargissement des espaces aériens en réduisant l'infiltration neutrophilique éventuellement via l'inhibition de lactivité de MMP-9. A notre connaissance, il sagit du premier rapport montrant les effets anti-inflammatoires des agonistes β2-adrénergiques et des anticholinergiques dans un modèle animal mimant les principales caractéristiques physiopathologiques de la BPCO. Les données obtenues dans ce travail pourraient contribuer à identifier de nouvelles cibles thérapeutiques pour cette maladie.

Made available in DSpace on 2014-12-17T15:32:30Z (GMT). No. of bitstreams: 1 ValeriaSF_TESE.pdf: 1554906 bytes, checksum: 59273626aa3c7c32d790e22ae6dd68d4 (MD5) Previous issue date: 2011-02-24 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The balance between the expression of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) has been related to various physiological and pathological processes, including salivary gland morphogenesis and tumor invasion and metastasis processes. Pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) respectively represent benign and malignant neoplasias of salivary glands. Although they share the same cell origin, they present distinct biological behavior. The aim of this study was to compare the immunohistochemical expression of MMPs -2, -7, -9 and -26, and of TIMPs -1 and -2, in cases of PA and ACC of minor salivary glands. Twenty cases of PA and twenty cases of ACC were assessed according to the presence, intensity and location of MMPs and TIMPs in the tumor parenchyma. Most of the PAs and ACCs presented a high expression of MMP -2, -7, -9 and -26 and of TIMP -1 and -2, predominantly located in tumor cells. There was no significant difference in the expression of MMPs -2 (p=0.359), -7 (p=0.081) and -26 (p=0.553), as well as of TIMPs -1 (p=0.657) and -2 (p=0.248), between the parenchyma of PAs and ACCs. However, MMP-9 showed a significant difference of expression between the two tumors, with the ACC showing more intense marking for this gelatinase (p=0.041). The strong expression of MMP-9 observed in the parenchyma suggests that this gelatinase may play an important role in the biological behavior of these tumors. On the other hand, although there was no significant difference between the marking of MMP -2, 7 and 26 in the studied tumors, the data, when analyzed as a whole, suggest that these proteases may take part in the process of tissue remodeling in both tumors, but do not present a direct relation with the pattern of aggressiveness of ACC. Nonetheless, matrilisins may indirectly influence the behavior of this tumor due to their capacity of activating MMP-9, strongly expressed in the parenchyma of ACC / O balan?o entre a express?o das metaloproteinases da matriz (MMPs) e seus inibidores teciduais (TIMPs) tem sido relacionado a v?rios processos fisiol?gicos e patol?gicos, incluindo a morfog?nese de gl?ndulas salivares e os processos de invas?o e met?stase tumoral. O adenoma pleom?rfico (AP) e o carcinoma aden?ide c?stico (CAC) representam, respectivamente, neoplasias benignas e malignas de gl?ndulas salivares que, embora compartilhem a mesma origem celular, apresentam comportamentos biol?gicos distintos. O prop?sito deste estudo foi comparar a express?o imuno-histoqu?mica das MMPs -2, -7, -9 e - 26 e dos TIMPs -1 e -2 em casos de AP e CAC de gl?ndulas salivares menores. Vinte casos de AP e vinte casos de CAC foram avaliados quanto ? presen?a, intensidade e localiza??o das MMPs e TIMPs no par?nquima tumoral. A maioria dos APs e CACs apresentaram alta express?o das MMPs e dos TIMPs, predominantemente localizada nas c?lulas tumorais. N?o houve diferen?a estatisticamente significativa na express?o das MMPs -2 (p=0,359), -7 (p=0,081) e -26 (p=0,553), bem como dos TIMPs -1 (p=0,657) e -2 (p=0,248), entre o par?nquima dos APs e CACs. A MMP-9 demonstrou uma diferen?a significativa de express?o entre os dois tumores, apresentando o CAC uma marca??o mais intensa para esta gelatinase (p=0,041). A forte express?o da MMP-9 observada no par?nquima dos CACs sugere que esta gelatinase possa desempenhar um papel importante no comportamento biol?gico destes tumores. Por outro lado, apesar de n?o ocorrer uma diferen?a significativa entre as m?dias das MMPs -2, 7 e 26 nos tumores estudados, os dados quando analisados em conjunto sugerem que estas proteases podem estar participando de processos de remodela??o tecidual em ambos os tumores, mas n?o apresentam uma rela??o direta com o padr?o de agressividade do CAC. Entretanto, as matrilisinas poderiam influenciar indiretamente o comportamento deste tumor devido a sua capacidade de ativar a MMP-9, fortemente expressa no par?nquima destes tumores

Introdução: A obstrução infravesical (OIV) de longo prazo secundária a hiperplasia prostática benigna (HPB) pode causar alterações funcionais e morfológicas na bexiga. Um dos principais eventos consiste no aumento da deposição de colágeno e perda de complacência vesical, levando a alteração de armazenamento e esvaziamento urinário. O aumento da deposição de colágeno na matriz extracelular (MEC) da musculatura detrusora é a principal razão para a diminuição da complacência vesical. Na bexiga, assim como em outros órgãos, este fenômeno depende da atividade equilibrada de enzimas proteolíticas, incluindo as metaloproteinases (MMP) e os seus inibidores endógenos (inibidores teciduais de metaloproteinases-TIMPs). Como estes fenômenos são desconhecidos na bexiga obstruída, o objetivo deste estudo foi avaliar a expressão gênica de colágeno, MMPs e seus inibidores na bexiga de pacientes com obstrução infravesical. Material e Métodos: Foi realizada uma análise prospectiva e controlada de 43 pacientes com OIV devido a HPB, que foram submetidos à ressecção transuretral da próstata (RTUP) entre 2011 e 2012. Como grupo controle foram selecionados espécimes de músculo detrusor de 10 pacientes que foram submetidos a prostatectomia radical retropúbica devido adenocarcinoma de próstata. Todos estes pacientes tinham idade menor que 60 anos, tamanho de próstata menor que 30 gramas ao ultra-som e escore internacional de sintomas prostáticos (IPSS) menor que 7. Todos os pacientes foram submetidos a estudo urodinâmico pré e pós operatório (após 6 meses). A biópsia de fragmento de músculo da bexiga foi realizada ao final da RTUP e colocada em solução estabilizadora de RNA para quantificação da expressão de colágenos I e III, metaloproteinases de matriz 1, 2 e 9, e inibidores de MMPs (TIMP1, TIMP2 e RECK) na bexiga de pacientes com HPB. Os genes descritos foram avaliados através da técnica de reação em cadeia da polimerase quantitativa em tempo real (qRT-PCR). Resultados: Todos os pacientes com HPB tinham confirmado OIV, através da análise do estudo urodinâmico (média de pressão detrusora no fluxo máximo de 78,5 cmH2O e fluxo urinário máximo de 7,7 ml / s). O gene MMP1 mostrou-se superexpresso em pacientes com HPB (mediana = 1,87). MMP9, TIMP1 e RECK estavam subexpressos na maioria dos casos, enquanto TIMP2, colágeno I e III foram superexpressos (1,5, 4,4 e 1,9 vezes, respectivamente). No que diz respeito às características clínicas e urodinâmicas encontramos que MMP2 foi mais expresso entre pacientes com um baixo IPSS global (0,005) e sem urgência (p=0,035). Colágeno III foi mais expresso em pacientes com contrações vesicais não inibidas (p = 0,049). Os outros genes não mostraram nenhuma correlação estatística com quaisquer características clínicas ou urodinâmicas. Após 6 meses de RTU, pacientes que possuíam expressão aumentada de duas ou mais MMPs, apresentaram resolução da CNI em 66,6% dos casos, contra 14,0% quando apenas uma ou nenhuma MMP estava aumentada (p=0,038) Conclusões: Encontramos um perfil de superexpressão de MMP1, TIMP2, colágenos I e III, e expressão baixa de MMP9, TIMP1 e RECK nos pacientes com OIV. Considerando o escore de sintomas prostáticos e a urgência miccional, encontramos curiosamente uma maior expressão de MMP2 em pacientes menos sintomáticos e sem urgência miccional. Encontramos uma associação entre a maior expressão de colágeno III com HD. A expressão aumentada de duas ou mais MMPs está relacionada à maiores taxas de resolução das CNIs. / Introduction: Long-term Bladder outlet obstruction (BOO) secondary to Benign prostatic Hyperplasia (BPH) can cause functional and morphological abnormalities in the bladder, such as increased collagen deposition and loss of compliance, leading to urinary storage and voiding symptoms. A decrease in bladder compliance is known to be correlated with deterioration of renal function. Increased deposition of collagen in the extracellular matrix (ECM) is the primary reason for a decreased compliance. In the bladder, as in other organs, this phenomenon is dependent on the balanced activity of proteolytic enzymes, including matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs). The imbalance between MMPs and TIMPs is a key regulator in ECM turnover. Since these mechanisms are unknown in the obstructed bladder, the objective of this study was to evaluate gene expression of collagen, MMPs and their inhibitors in patients with bladder outlet obstruction due to BPH. Material and Methods: We performed a prospective and controlled analysis of 43 patients with BOO due to BPH who underwent transurethral resection of the prostate (TURP) from 2011 to 2012. The control group was comprised of 10 bladder specimens from patients with < 60 years who underwent radical prostatectomy with an International Prostatic Symptom Score (IPSS) < 8 and prostate volume < 30 grams. All patients underwent urodynamic analysis pre and post operatively after 6 months. A biopsy of the bladder muscle was performed at the end of TURP for analysis of collagen, metalloproteinases and TIMPs gene expressions. For this purpose we used the quantitative real time polymerase chain reaction method (qRT-PCR). Results: All patients with BPH had confirmed BOO confirmed through urodynamic analysis (mean detrusor pressure at maximun flow 78.5 cmH2O and mean maximun flow 7.7 ml/s). MMP1 gene showed an important an overexpression in patients with BPH (median = 1.87). A similar phenomenon occurred in a lesser extent to MMP2, to which 13 of 23 subjects had under-expression (mean = 1.2). MMP9, TIMP1 and RECK were under-expressed in the majority of cases, while TIMP2, colagen I and III were over-expressed (1.5, 4.4 and 1.9x respectively) (figure). With regard to clinical and urodynamic characteristics we found that MMP2 was more over-expressed among patients with a low global IPSS (0.005) and without urgency (p=0.035). Colagen III was more over-expressed in patients with non-inhibited bladder contractions (p=0.049), RECK was more over-expressed in patients with a decreased complacence (p=0.049). The other genes showed no statistical correlation with any clinical or urodynamic characteristics. After 6 months of TURP, patients with non-inhibited bladder contractions showed resolution in 66.6% of cases, when had increased expression of two or more (> 02) MMPs in patients compared with 14.0% when only 01 MMP was increased (p = 0.038) Conclusions: BOO is related with an over-expression of MMP1, TIMP2, colagens I and III, and with an under-expression of MMP9, TIMP1 and RECK. Detrusor overactivity is related with higher collagen III expression, this fact may be due to a lower MMP1 expression. A lower global IPSS and no urgency were related to a higher expression of MMP2, sugesting that this gene may be inhibiting collagen deposition in the bladder. The increased expression of two or more MMPs isrelated to greater rates of resolution of non-inhibited bladder contractions

Introdução: A obstrução infravesical (OIV) de longo prazo secundária a hiperplasia prostática benigna (HPB) pode causar alterações funcionais e morfológicas na bexiga. Um dos principais eventos consiste no aumento da deposição de colágeno e perda de complacência vesical, levando a alteração de armazenamento e esvaziamento urinário. O aumento da deposição de colágeno na matriz extracelular (MEC) da musculatura detrusora é a principal razão para a diminuição da complacência vesical. Na bexiga, assim como em outros órgãos, este fenômeno depende da atividade equilibrada de enzimas proteolíticas, incluindo as metaloproteinases (MMP) e os seus inibidores endógenos (inibidores teciduais de metaloproteinases-TIMPs). Como estes fenômenos são desconhecidos na bexiga obstruída, o objetivo deste estudo foi avaliar a expressão gênica de colágeno, MMPs e seus inibidores na bexiga de pacientes com obstrução infravesical. Material e Métodos: Foi realizada uma análise prospectiva e controlada de 43 pacientes com OIV devido a HPB, que foram submetidos à ressecção transuretral da próstata (RTUP) entre 2011 e 2012. Como grupo controle foram selecionados espécimes de músculo detrusor de 10 pacientes que foram submetidos a prostatectomia radical retropúbica devido adenocarcinoma de próstata. Todos estes pacientes tinham idade menor que 60 anos, tamanho de próstata menor que 30 gramas ao ultra-som e escore internacional de sintomas prostáticos (IPSS) menor que 7. Todos os pacientes foram submetidos a estudo urodinâmico pré e pós operatório (após 6 meses). A biópsia de fragmento de músculo da bexiga foi realizada ao final da RTUP e colocada em solução estabilizadora de RNA para quantificação da expressão de colágenos I e III, metaloproteinases de matriz 1, 2 e 9, e inibidores de MMPs (TIMP1, TIMP2 e RECK) na bexiga de pacientes com HPB. Os genes descritos foram avaliados através da técnica de reação em cadeia da polimerase quantitativa em tempo real (qRT-PCR). Resultados: Todos os pacientes com HPB tinham confirmado OIV, através da análise do estudo urodinâmico (média de pressão detrusora no fluxo máximo de 78,5 cmH2O e fluxo urinário máximo de 7,7 ml / s). O gene MMP1 mostrou-se superexpresso em pacientes com HPB (mediana = 1,87). MMP9, TIMP1 e RECK estavam subexpressos na maioria dos casos, enquanto TIMP2, colágeno I e III foram superexpressos (1,5, 4,4 e 1,9 vezes, respectivamente). No que diz respeito às características clínicas e urodinâmicas encontramos que MMP2 foi mais expresso entre pacientes com um baixo IPSS global (0,005) e sem urgência (p=0,035). Colágeno III foi mais expresso em pacientes com contrações vesicais não inibidas (p = 0,049). Os outros genes não mostraram nenhuma correlação estatística com quaisquer características clínicas ou urodinâmicas. Após 6 meses de RTU, pacientes que possuíam expressão aumentada de duas ou mais MMPs, apresentaram resolução da CNI em 66,6% dos casos, contra 14,0% quando apenas uma ou nenhuma MMP estava aumentada (p=0,038) Conclusões: Encontramos um perfil de superexpressão de MMP1, TIMP2, colágenos I e III, e expressão baixa de MMP9, TIMP1 e RECK nos pacientes com OIV. Considerando o escore de sintomas prostáticos e a urgência miccional, encontramos curiosamente uma maior expressão de MMP2 em pacientes menos sintomáticos e sem urgência miccional. Encontramos uma associação entre a maior expressão de colágeno III com HD. A expressão aumentada de duas ou mais MMPs está relacionada à maiores taxas de resolução das CNIs. / Introduction: Long-term Bladder outlet obstruction (BOO) secondary to Benign prostatic Hyperplasia (BPH) can cause functional and morphological abnormalities in the bladder, such as increased collagen deposition and loss of compliance, leading to urinary storage and voiding symptoms. A decrease in bladder compliance is known to be correlated with deterioration of renal function. Increased deposition of collagen in the extracellular matrix (ECM) is the primary reason for a decreased compliance. In the bladder, as in other organs, this phenomenon is dependent on the balanced activity of proteolytic enzymes, including matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs). The imbalance between MMPs and TIMPs is a key regulator in ECM turnover. Since these mechanisms are unknown in the obstructed bladder, the objective of this study was to evaluate gene expression of collagen, MMPs and their inhibitors in patients with bladder outlet obstruction due to BPH. Material and Methods: We performed a prospective and controlled analysis of 43 patients with BOO due to BPH who underwent transurethral resection of the prostate (TURP) from 2011 to 2012. The control group was comprised of 10 bladder specimens from patients with < 60 years who underwent radical prostatectomy with an International Prostatic Symptom Score (IPSS) < 8 and prostate volume < 30 grams. All patients underwent urodynamic analysis pre and post operatively after 6 months. A biopsy of the bladder muscle was performed at the end of TURP for analysis of collagen, metalloproteinases and TIMPs gene expressions. For this purpose we used the quantitative real time polymerase chain reaction method (qRT-PCR). Results: All patients with BPH had confirmed BOO confirmed through urodynamic analysis (mean detrusor pressure at maximun flow 78.5 cmH2O and mean maximun flow 7.7 ml/s). MMP1 gene showed an important an overexpression in patients with BPH (median = 1.87). A similar phenomenon occurred in a lesser extent to MMP2, to which 13 of 23 subjects had under-expression (mean = 1.2). MMP9, TIMP1 and RECK were under-expressed in the majority of cases, while TIMP2, colagen I and III were over-expressed (1.5, 4.4 and 1.9x respectively) (figure). With regard to clinical and urodynamic characteristics we found that MMP2 was more over-expressed among patients with a low global IPSS (0.005) and without urgency (p=0.035). Colagen III was more over-expressed in patients with non-inhibited bladder contractions (p=0.049), RECK was more over-expressed in patients with a decreased complacence (p=0.049). The other genes showed no statistical correlation with any clinical or urodynamic characteristics. After 6 months of TURP, patients with non-inhibited bladder contractions showed resolution in 66.6% of cases, when had increased expression of two or more (> 02) MMPs in patients compared with 14.0% when only 01 MMP was increased (p = 0.038) Conclusions: BOO is related with an over-expression of MMP1, TIMP2, colagens I and III, and with an under-expression of MMP9, TIMP1 and RECK. Detrusor overactivity is related with higher collagen III expression, this fact may be due to a lower MMP1 expression. A lower global IPSS and no urgency were related to a higher expression of MMP2, sugesting that this gene may be inhibiting collagen deposition in the bladder. The increased expression of two or more MMPs isrelated to greater rates of resolution of non-inhibited bladder contractions