The resolution of acute inflammation induced by cyclic AMP is dependent on annexin A1

Annexin A1 (AnxA1) is a glucocorticoid-regulated protein known for its anti-inflammatory and pro-resolving effects. We have shown previously that the cAMP-enhancing compounds rolipram (ROL; a PDE4 inhibitor) and Bt2cAMP (a cAMP mimetic) drive caspase-dependent resolution of neutrophilic inflammation. In this follow-up study, we investigated whether AnxA1 could be involved in the pro-resolving properties of these compounds using a model of LPS-induced inflammation in BALB/c mice. The treatment with ROL or Bt2cAMP at the peak of inflammation shortened resolution intervals, improved resolution indices, and increased AnxA1 expression. In vitro studies showed that ROL and Bt2cAMP induced AnxA1 expression and phosphorylation, and this effect was prevented by PKA inhibitors, suggesting the involvement of PKA in ROL-induced AnxA1 expression. Akin to these in vitro findings, H89 prevented ROL- and Bt2cAMP-induced resolution of inflammation, and it was associated with decreased levels of intact AnxA1. Moreover, two different strategies to block the AnxA1 pathway (by using N-t-Boc-Met-Leu-Phe, a nonselective AnxA1 receptor antagonist, or by using an anti-AnxA1 neutralizing antiserum) prevented ROL- and Bt2cAMP-induced resolution and neutrophil apoptosis. Likewise, the ability of ROL or Bt2cAMP to induce neutrophil apoptosis was impaired in AnxA-knock-out mice. Finally, in in vitro settings, ROL and Bt2cAMP overrode the survival-inducing effect of LPS in human neutrophils in an AnxA1-dependent manner. Our results show that AnxA1 is at least one of the endogenous determinants mediating the pro-resolving properties of cAMP-elevating agents and cAMP-mimetic drug

Estado nutricional e anemia ferropriva em gestantes: relação com o peso da criança ao nascer Nutritional status and iron-deficiency anemia in pregnant women: relationship with the weight of the child at birth

OBJETIVO: Avaliar o estado nutricional e a prevalência de anemia durante a gestação e correlacioná-los com o peso do recém-nascido. MÉTODOS: Foi realizado estudo transversal com gestantes que realizaram o pré-natal no único serviço público de saúde do município de Viçosa, MG, no período de dezembro de 2002 a maio de 2003. Foi aplicado questionário com informações maternas e realizada dosagem de hemoglobina através do Hemocue, além da obtenção de dados de peso e estatura da gestante. As informações referentes aos recém-nascidos foram obtidas no programa Sistema de Informação de Nascidos Vivos/MS. RESULTADOS: Foram avaliadas 168 gestantes de baixo nível socioeconômico e baixa escolaridade. Encontraram-se 41,3% de gestantes com estado nutricional pré-gestacional inadequado, sendo 25,7% com baixo peso e 17,4% com sobrepeso ou obesidade. A maioria das gestantes apresentou ganho de peso inadequado durante a gestação. A prevalência total de anemia ferropriva foi de 21,4%, sendo que essa aumentou com a idade gestacional. A freqüência de baixo peso e peso insuficiente ao nascer foi de 8,9% e 28,6%, respectivamente. As variáveis antropométricas (peso pré-gestacional, estatura, índice de massa corporal pré-gestacional e ganho de peso total) apresentaram associação estatisticamente significante com o peso ao nascer. CONCLUSÃO: As variáveis antropométricas maternas apresentaram correlação com o peso ao nascer. Neste estudo não houve relação entre o estado nutricional de ferro das gestantes e o peso de nascimento.<br>OBJECTIVE: The purpose of the study was to evaluate the nutritional status and prevalence to anemia during pregnancy, and to correlate these factors with the weight at birth. METHODS: A transversal study was carried out with pregnant women who underwent prenatal care at the only public health service in the municipality of Viçosa, MG, Brazil, from December 2002 to May 2003. A questionnaire was applied to obtain information on the mothers, and their hemoglobin levels were dosed using Hemocue, also registering the mothers' height and weight. Information on the newborns was obtained from the Birth Registries Information System. RESULTS: A total of 168 low-income, low-schooling level pregnant women were evaluated, 41.3% showing inadequate pre-gestational nutritional status, 25.7% being underweight and 17.4% overweight or obese. The majority of the pregnant women presented inadequate weight gain during pregnancy. The prevalence of total iron deficiency anemia was 21.4%, increasing with gestational age. The frequencies of low birth weight and insufficient birth weight were 8.9% and 28.6%, respectively. The anthropometrical variables (pre-gestational weight, height, pre-gestational Body Mass Index and total weight gain) presented a statistically significant association with weight at birth. CONCLUSION: The mother's anthropometrical variables correlated with the weight at birth. No correlation was found between the nutritional iron status of the pregnant women and weight at birth

Avaliação nutricional antropométrica de gestantes brasileiras: uma revisão sistemática Anthropometric nutritional evaluation in pregnant Brazilian women: a systematic review

Trata-se de uma revisão sistemática objetivando a identificação de métodos de avaliação nutricional de gestantes adotados no Brasil e sua associação com desfechos obstétricos. A busca bibliográfica foi feita nas bases Medline, Lilacs e Scielo, no período de 1980 a 2006. Os descritores utilizados em combinação foram pregnant, pregnancy nutritional assessment, anthropometric state, weight gain. Foram identificados 26 estudos, sendo o método proposto por Rosso (1985) o mais adotado. Alguns autores usaram apenas a avaliação do estado nutricional pré-gestacional com base no método proposto pelo Institute of Medicine (1990) ou a avaliação do ganho de peso gestacional segundo a Organização Mundial da Saúde (1995). Os resultados indicam a inexistência de metodologia apropriada para avaliação nutricional de gestantes brasileiras, o que pode estar contribuindo para a desvalorização desse procedimento nos serviços de assistência pré-natal. A maior parte dos estudos considerou o peso ao nascer como o principal desfecho do peso gestacional na validação dos métodos de classificação antropométrica. Os resultados encontrados no estudo demonstram a escassez de informações, em quantidade e qualidade, que possam contribuir para analisar a efetividade dos métodos de avaliação nutricional antropométrica para as gestantes brasileiras. O desenvolvimento de estudos com rigor metodológico neste campo é premente, e deverá contemplar as diferenças etárias e os fatores biológicos, socioeconômicos e ambientais das gestantes.<br>A systematic review was carried out of national and international literature on the available knowledge regarding nutritional assessment methods for anthropometric evaluation during pregnancy and its association with obstetric outcomes among Brazilian women was confirmed. Tracking resulted in 26 studies, where the most commonly used weight-gain assessment method was that proposed by Rosso (1985). Some of these used only pregestational nutritional status Institute of Medicine (1990) or weight gain during pregnancy assessments of World Health Organization (1995). The results indicate the lack of appropriate methods for assessing nutrition during pregnancy, which reflects the low importance prenatal services give to the standardization of anthropomorphic evaluation during pregnancy. There is an urgent need for well-defined methodological studies involving pregnant women that address age differences and intervening factors. Most researchers consider birth weight to be the main outcome of nutritional assessment during gestation to validate anthropometric methods. Outcomes encountered in this study demonstrate a lack of information, both quantitative and qualitative, to evaluate the effectiveness of nutritional assessment methods among pregnant Brazilian women. The development of studies using a rigorous methodology in this field is essential and these should address differences in terms of age and biological, socioeconomic and environmental factors