Navegando por Assunto "PET/MAH"
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Item Acesso aberto (Open Access) Correlação entre a avaliação clínica e o padrão de resposta imunológica periférica de pacientes acometidos por Paraparesia espástica tropical/mielopatia associada ao Vírus linfotrópico de celulas T humanas do tipo 1 (HTLV-1)(Universidade Federal do Pará, 2012) DIAS, George Alberto da Silva; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973Human T lymphotropic virus type 1 (HTLV-1) is an exogenous retrovirus that persistently infects 20–30 million people worldwide. This virus is etiologically related to the development of adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) a chronic disease of the central nervous system. The majority of HTLV-1-infected individuals remain lifelong asymptomatic carriers (ACs) of the virus. However, about 3-5% can develop ATL or HAM/TSP. The virus preferentially infects CD4+ T cells – main host cell of HTLV-1 – and rapidly induces cell activation and proliferation and expression of many host genes, including IFN-γ. The exact mechanism underlying these immunological and clinical events still remains unknown. In the current study, we evaluated the peripheral immune response and correlated with clinical symptoms like spasticity and weakness of the lower extremities, and gait abnormalities. 28 HTLV-1 infected patients were studied. Eight of them developed HAM/TSP and 20 were ACs. Total RNA was extracted from peripheric limphomononuclear cells using the TrizolR reagent (Invitrogen, Carlsbad, CA, USA). The quantitative real-time PCR was performed to quantify IFN-γ, IL-4, IL-5 and IL-10. Total RNA (1μg) of each sample was subjected to reverse transcription with Superscript III (Invitrogen). Real-time PCR was performed in StepOne Plus (Applied Biosystems, Foster City, CA) and signal detection was obtained with the Sybr Green reagent (Applied Biosystems). The amount of mRNA in the sample was expressed as the relative amount to the GAPDH and β-actin genes, according to the formula 2-ΔCT, where ΔCT is CTgene – CThousekeeping. The clinical symptoms of each patient were examined. Spasticity was assessed on the Modified Ashworth Scale, the weakness of the lower limb was measured using a manual scale, and the gait was given scores to the devices that assist in gait. The HAM/TSP patients showed higher expression of IFN-γ (Median: 2,9 x 10-3) than Acs (Median: 1,1 x 10-3), with p = 0,0710. The IFN-γ expression was positively correlated to spasticity (r = 0,2795), weakness (r = 0,6580) and gait (r = 0,7216). Interestingly, patients who need wheelchairs had a higher IFN-γ expression than those who don’t need wheelchair (p = 0,0371). The HAM/TSP patients showed higher Th1 response than ACs. The higher IFN-γ expression is correlated with the development and progression of the HAM/TSP.Item Acesso aberto (Open Access) Estudo da função tímica em portadores de HTLV-1 com PET/MAH(Universidade Federal do Pará, 2017) GOMES, Jéssica Antonia Nunes; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973In HTLV-1 infeccions 90% of carriers remain asymptomatic, 2-3% develop Adult T-cell leukemia/lymphoma (ATL) and 0.25-4% develop HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In HAM/TSP, specific CD8 + T cell infiltrates are found in the marrow that destroy infected CD4 + T cells, leading to a chronic activated immune response. Recently emigrated T cells (or naïve T cells) have excised circles by the rearrangement of T cell receptor (TREC) genes that do not double in cell proliferation, being a good indicator to quantify the number of naïve T cells and thus evaluate the thymic function. This study aimed to verify the thymic function of patients with HTLV-1 infection by quantifying the number of TREC in peripheral blood mononuclear cells. This is a cross-sectional, analytical study of 39 patients over 18 years of age, divided into two groups: HAM/TSP (PET) and without HAM/TSP (NPET). We performed a clinical and physiotherapeutic evaluation, blood collection, lymphomononuclear cell separation, DNA and RNA extraction, absolute TREC curve, DNA and RNA quantification, TREC particle detection and quantification, cDNA synthesis, cytokine IL-7 and statistical analysis with the Mann-Whitney tests and Spearman's correlation, with p ≤ 0.05 as significance level. Of the 39 patients studied, two were excluded from the study because they presented autoimmune disease. Regarding the comparison between groups of TREC quantification: there was a difference between the PET and NPET groups (p = 0.01), in patients with age ≤59 years between the PET and NPET groups (p = 0.04), in the (p = 0.003) and the group with a wheelchair and without a wheelchair (p = 0.05). As for the comparison of IL-7 gene expression between groups: in the NPET group there was a difference between the group ≤59 years and the ≥60 years (p = 0.02), in the female there was a difference between the PET and NPET groups (p = 0.04). Thymic function was impaired in patients with HTLV-1 with HAM/TSP compared to those without HAM/TSP, as there was a loss in naïve T cell production in this population, shown by the differences between variables in both PET and NPET groups With respect to the quantification of TREC. Although the importance of this compromise in the triggering and / or evolution of HAM/TSP is not yet clear, it is inferred that the reduction of naïve T cell production can alter the immunological response in these patients, directly affecting their clinical picture.Item Acesso aberto (Open Access) Padrão de resposta imunológica periférica em pacientes infectados pelo HTLV-1 e sua correlação com as manifestações neurológicas funcionais nos indivíduos com PET/MAH(Universidade Federal do Pará, 2014) DIAS, George Alberto da Silva; FUZII, Hellen Thais; http://lattes.cnpq.br/0026958665547973Human T-cell lymphotropic virus type 1 (HTLV-1) is associated with adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP is an inflammatory disease of the central nervous system (CNS); however, the mechanism by which HTLV-1 induces HAM/TSP is not yet clear. The virus–host interaction may provoke changes in the immunological response, such as the enhanced production of inflammatory cytokines, which are implicated in the pathogenesis of HAM/TSP. This work aimed to analyze the peripheral immune response of patients infected with HTLV-1 and correlate it with functional neurological manifestations in patients with HAM/TSP. In the current study, 69 HTLV-1 infected patients were studied. 26 of them developed HAM/TSP and 43 didn’t develop HAM/TSP. In patients with HAM/TSP was evaluated the functional neurological manifestations like muscle strength, muscle tone, balance and walking aid. Five mL peripheral blood was collected into a tube with EDTA and lymphomononuclear cells were separated on a Ficoll-PaqueTM Plus density gradient (GE Healthcare). Total RNA was extracted from 106 cells with Trizol reagent. After RNA quantification, 1 μg of total RNA was submitted to reverse transcription for the generation of cDNA using the Superscript III kit (Invitrogen). IFN-, TNF-, IL-4, IL-10 and TGF- gene expression was measured quantitatively with the StepOnePlus Real-Time PCR System (Applied Biosystem) using SYBR Green reagent (Applied Biosystem). The amount of mRNA in the sample was expressed as the relative amount to the GAPDH and β-actin genes, according to the formula 2-Ct, where Ct is Ctgene – Cthousekeeping gene. The gene expression showed higher expression of Th1 cytokine in patients with and without HAM/TSP, principally IFN-. In HAM/TSP patients also showed higher TNF- expression. The gene expression showed lower expression of Th2 cytokine in patients with HAM/TSP. As regards the anti-inflammatory response, gene expression of IL-10 showed impaired in patients with HAM/TSP and expression of TGF- initially showed higher in both groups. After ratio analysis between TGF-andIL it was observed that the expression of TGF-wasequivalent to the expression of IL-10, suggesting its involvement as a non-inflammatory cytokine, but as possible repair action tissue. The inflammatory profile was positively associated with the walking aid and balance, showing significant results only for the expression of IFN-. The patients infected with HTLV-1 who developed HAM/TSP showed increased Th1 response compared to patients who did not develop HAM/TSP, and this increased expression of IFN- is related to the development and progression of the disease.