The imbalance between Treg and Th17 cells caused by FTY720 treatment in skin allograft rejection

OBJECTIVES: FTY720 modulates CD4+T cells by the augmentation of regulatory T cell activity, secretion of suppressive cytokines and suppression of IL-17 secretion by Th17 cells. To further understand the process of graft rejection/acceptance, we evaluated skin allograft survival and associated events after FTY720 treatment. METHODS: F1 mice (C57BL/6xBALB/c) and C57BL/6 mice were used as donors for and recipients of skin transplantation, respectively. The recipients were transplanted and either not treated or treated with FTY720 by gavage for 21 days to evaluate the allograft survival. In another set of experiments, the immunological evaluation was performed five days post-transplantation. The spleens, axillary lymph nodes and skin allografts of the recipient mice were harvested for phenotyping (flow cytometry), gene expression (real-time PCR) and cytokine (Bio-Plex) analysis. RESULTS: The FTY720 treatment significantly increased skin allograft survival, reduced the number of cells in the lymph nodes and decreased the percentage of Tregs at this site in the C57BL/6 recipients. Moreover, the treatment reduced the number of graft-infiltrating cells and the percentage of CD4+ graft-infiltrating cells. The cytokine analysis (splenocytes) showed decreased levels of IL-10, IL-6 and IL-17 in the FTY720-treated mice. We also observed a decrease in the IL-10, IL-6 and IL-23 mRNA levels, as well as an increase in the IL-27 mRNA levels, in the splenocytes of the treated group. The FTY720-treated mice exhibited increased mRNA levels of IL-10, IL-27 and IL-23 in the skin graft. CONCLUSIONS: Our results demonstrated prolonged but not indefinite skin allograft survival by FTY720 treatment. This finding indicates that the drug did not prevent the imbalance between Tr1 and Th17 cells in the graft that led to rejection

High dose of dexamethasone protects against EAE-induced motor deficits but impairs learning/memory in C57BL/6 mice

Multiple sclerosis (MS) is an autoimmune and neuroinflammatory disease characterized by demyelination of the Central Nervous System. Immune cells activation and release of pro-inflammatory cytokines play a crucial role in the disease modulation, decisively contributing to the neurodegeneration observed in MS and the experimental autoimmune encephalomyelitis (EAE), the widely used MS animal model. Synthetic glucocorticoids, commonly used to treat the MS attacks, have controversial effects on neuroinflammation and cognition. We sought to verify the influence of dexamethasone (DEX) on the EAE progression and on EAE-induced cognitive deficits. In myelin oligodendrocyte glycoprotein peptide (MOG35-55)-induced EAE female mice, treated once with DEX (50 mg/kg) or not, on the day of immunization, DEX decreased EAE-induced motor clinical scores, infiltrating cells in the spinal cord and delayed serum corticosterone peak. At the asymptomatic phase (8-day post-immunization), DEX did not protected from the EAE-induced memory consolidation deficits, which were accompanied by increased glucocorticoid receptor (GR) activity and decreased EGR-1 expression in the hippocampus. Blunting hippocampal GR genomic activation with DnGR vectors prevented DEX effects on EAE-induced memory impairment. These data suggest that, although DEX improves clinical signs, it decreases cognitive and memory capacity by diminishing neuronal activity and potentiating some aspects of neuroinflammation in EAE

an international survey before and during the COVID-19 pandemic

Funding Information: The Société Française d’Anesthésie et de Réanimation (SFAR), Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC), Sociedad Argentina de Terapia Intensiva (SATI), Sociedad Chilena de Medicina Intensiva (SOCHIMI), Associação de Medicina Intensiva Brasileira (AMIB-Net) and the Brazilian Research in Intensive Care Network (BricNet) supported this survey. We would also like to thank our friend Tiago Rocha for making the amazing logo for this study. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001. Publisher Copyright: © 2022, The Author(s).Background: Since the publication of the 2018 Clinical Guidelines about sedation, analgesia, delirium, mobilization, and sleep deprivation in critically ill patients, no evaluation and adequacy assessment of these recommendations were studied in an international context. This survey aimed to investigate these current practices and if the COVID-19 pandemic has changed them. Methods: This study was an open multinational electronic survey directed to physicians working in adult intensive care units (ICUs), which was performed in two steps: before and during the COVID-19 pandemic. Results: We analyzed 1768 questionnaires and 1539 (87%) were complete. Before the COVID-19 pandemic, we received 1476 questionnaires and 292 were submitted later. The following practices were observed before the pandemic: the Visual Analog Scale (VAS) (61.5%), the Behavioral Pain Scale (BPS) (48.2%), the Richmond Agitation Sedation Scale (RASS) (76.6%), and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) (66.6%) were the most frequently tools used to assess pain, sedation level, and delirium, respectively; midazolam and fentanyl were the most frequently used drugs for inducing sedation and analgesia (84.8% and 78.3%, respectively), whereas haloperidol (68.8%) and atypical antipsychotics (69.4%) were the most prescribed drugs for delirium treatment; some physicians regularly prescribed drugs to induce sleep (19.1%) or ordered mechanical restraints as part of their routine (6.2%) for patients on mechanical ventilation; non-pharmacological strategies were frequently applied for pain, delirium, and sleep deprivation management. During the COVID-19 pandemic, the intensive care specialty was independently associated with best practices. Moreover, the mechanical ventilation rate was higher, patients received sedation more often (94% versus 86.1%, p < 0.001) and sedation goals were discussed more frequently in daily rounds. Morphine was the main drug used for analgesia (77.2%), and some sedative drugs, such as midazolam, propofol, ketamine and quetiapine, were used more frequently. Conclusions: Most sedation, analgesia and delirium practices were comparable before and during the COVID-19 pandemic. During the pandemic, the intensive care specialty was a variable that was independently associated with the best practices. Although many findings are in accordance with evidence-based recommendations, some practices still need improvement.publishersversionpublishe

Modernist Toilette: Degas, Woolf, Lawrence

<p>COPD animals were submitted to therapeutic protocols as described in materials and methods. Further, all animals were euthanized, lungs were obtained and sections were stained by PAS (Periodic Acid Schiff) as described in methods. In A) representative graphs and B) photomicrographs of PAS stained sections. Data representative of two experiments. n = 5–8 animals per group. One-way ANOVA.</p

Doença de chagas: tendência epidemiológica por regiões do Brasil / Chagas disease: epidemiological trend by regions of Brazil

A doença de Chagas é uma condição crônica negligenciada com elevada carga de morbimortalidade, no período de 2000 a 2013 foram notificados 1.570 casos de doença de Chagas aguda . Trata-se de um estudo transversal de caráter descritivo, teve como população os casos de notificados doença de chagas aguda dos últimos anos disponíveis do DATASUS,foram dos anos 2013 a 2014 no Brasil. Os dados obtidos foram coletados do DATASUS nas informações de saúde (TABNET). O total de 191 de notificações de doença de chagas aguda no anos de 2014 no Brasil. Os dados epidemiológicos demonstram a necessidade de se aumentar à vigilância na região Norte e incorporar indicadores ambientais para a detecção precoce e prevenção de agravos à saúde da população em relação a doença de chagas

Relationship between the pattern of cytokines secreted by microglia cells activated in vitro and T cell generation

INTRODUÇÃO: Atualmente as células da microglia têm recebido grande atenção dentro da resposta imune, isto devido ao fato de que sua ativação por citocinas inflamatórias é capaz de promover a infiltração e destruição do sistema nervoso central (SNC) durante algumas doenças, principalmente no caso da esclerose múltipla (EM). Além de seu papel pró-inflamatório, já demonstrou-se que estas também são capazes de expressar moléculas supressoras como a indoleamina-2,3-dioxigenase (IDO), capaz de suprimir a proliferação de células T. Contudo, ainda pouco se sabe sobre seu verdadeiro papel na patogenia da EM. Recentemente tem sido descrita uma população de células T chamadas Th17, capaz de secretar grandes quantidades de IL-17, IL-21 e GM-CSF possuindo uma importância fundamental na patogenia da EM e de seu modelo murino, a EAE. Nesse contexto, a relação entre as Th17 e as células da microglia pode nos fornecer dados importantes acerca dos mecanismos envolvidos nas lesões observadas no SNC. OBJETIVO: Este trabalho teve como objetivo melhor elucidar a relação existente entre a expressão das moléculas imunes por células da microglia e a ação que estas promovem sobre as células T. MÉTODOS: Utilizamos culturas de células da microglia de linhagem, chamadas C8-B4, assim como cultura primária de células da microglia obtidas a partir sistema nervoso de camundongos C57BL/6 adultos. Caracterizamos o perfil imune da microglia, avaliando a transcrição de genes para citocinas através de PCR em tempo real assim como a expressão de suas moléculas ativadoras por citometria de fluxo. A avaliação da IDO se deu através da expressão da mesma por células da microglia ativadas ou não por LPS ou IFN-?. Ja sua capacidade funcional foi medida através da atividade proliferativa de linfócitos T CD4 específicos para MOG 35-55. RESULTADOS: Nossos resultados demonstraram que as células de ambas as culturas possuem a capacidade de expressar diversas moléculas imunes, tanto pró quanto anti-inflamatórios. Dentre estas observamos TLR-4, TLR-2, IL-6, IL-10 e TGF-?. Além disso, confirmamos a expressão da enzima IDO por estas células. O bloqueio de tal enzima impede o controle que a microglia tem sobre a proliferação dos linfócitos T CD4, tanto in vitro quanto in vivo. No modelo in vivo tal efeito repercute em uma encefalomilite mais severa, onde o quadro clínico do animal não regride. CONCLUSÃO: Os resultados aqui obtidos nos dão a certeza da influência das microglias dentro do contexto inflamatório, afirmando sua capacidade de modular a resposta imune. Além disto, fica clara a importância da enzima IDO, cuja ação dentro do controle de uma autoimunidade demonstra ser altamente necessáriaINTRODUCTION: Microglia cells has gained great attention recently because its activation by inflammatory cytokines can promote infiltration and destruction of Central Nervous System (CNS) during some disease, mainly in the case of Multiple Sclerosis (MS). On the other hand, these cells may also express suppressor molecules such as the indoleamine-2,3-dioxygenase (IDO), able to suppress T cell proliferation. However, still little is known about its role in MS pathogenesis. Recently it has been described a new population of T cells called Th17, able to secrete high amounts of IL-17, IL-21 and GM-CSF, with a fundamental importance on MS and its murine model, EAE. In this context, the relationship between Th17 and microglia cells can provide us important data about the mechanisms involved in the establishment of CNS lesions. OBJECTIVES: This work had the objective to better elucidate the relationship between the expression of some molecules by microglia and its role T cell activation. METHODS: Through a cellular lineage knowing as C8-B4 and primary cultures of microglia obtained from CNS of adult mice C57BL6 we investigated the transcription of several genes for cytokines and membrane expression of several pattern recognition receptors. The IDO evaluation was performed after activation with LPS or rIFN-?. Its functional capacity was measured trough its action over T cell proliferation. RESULTS: Our results demonstrated that both cells have the capacity of express several immune molecules, both pro and anti-inflammatory. Among this, we observed TLR-4, TLR-2, IL-6, IL-10 and TGF-?. We also confirmed IDO expression by these cells. The blockade of such enzyme prevents the control of microglia above T CD4 lymphocytes proliferation, both in vitro and in vivo. Using the in vivo model, IDO blocker rendered a encephalomyelitis more severe. Conclusion: The results here obtained give us the certainty of microglia influence in inflammatory context, stating its capacity of modulating the immune respons

Glutamate through NMDAr signaling modulates the immune cell response in vitro during hypoxia.

O Acidente vascular cerebral é uma doença aguda neuroinflamatória cuja prevalência aumentou nos últimos anos. Seus sintomas são decorrente da morte neuronal provocada pela privação de glicose e oxigênio. Após a morte neuronal, há liberação de citocinas, radicais livres e neurotransmissores, dentre eles o glutamato. Nosso objetivo é averiguar como o glutamato através do seu receptor NMDA modula a resposta inflamatória tanto de células residentes do SNC, quanto de células imunes infiltrantes. Para a realização desse estudos, realizamos experimentos in vitro e in vivo com o bloqueador do NMDAr, sob o processo de hipóxia. Nossos resultados demonstraram que a sinalização por NMDAr modula a expressão de moléculas envolvidas na apresentação de antígeno em células da microglia e macrófagos, bem como na produção de óxido nítrico por neutrófilos. O seu bloqueio diminui morte celular e lesão cerebral. Por fim, nossa pesquisa mostra que a sinalização NMDAr está envolvido não só com excitotoxicidade, mas também com a modulação da resposta da células inata.Stroke is an acute neuroinflammatory disease whose prevalence has increased in recent years. Its symptoms are due to the neuronal death caused by the deprivation of glucose and oxygen. After neuronal death, there is release of cytokines, free radicals and neurotransmitters, among them glutamate. Our goal is to investigate how glutamate through its NMDA receptor modulates the inflammatory response of both resident CNS cells and infiltrating immune cells. For the accomplishment of these studies, we performed experiments in vitro and in vivo with the NMDAr blocker under the hypoxia process. Our results demonstrated that NMDAr signaling modulates the expression of molecules involved in the presentation of antigen in microglia and macrophages cells, as well as in the production of nitric oxide by neutrophils. Its blockage decreases cell death and brain damage. Finally, our research shows that NMDAr signaling is involved not only with excitotoxicity, but also with the modulation of the innate cell response