Dopamine up-regulates Th17 phenotype from individuals with generalized anxiety disorder

AbstractOur objective was to evaluate the effect of stress-related dose of dopamine (DA) on the in vitro proliferation and cytokine production in polyclonally-activated T cells from healthy individuals or individuals with generalized anxiety disorder (GAD). Our results demonstrated that cell cultures from GAD group proliferated less following T cell activation, as compared with control group. The addition of DA reduced the proliferative response in cell cultures from healthy but not from GAD individuals. The cytokine profile in GAD individuals revealed Th1 and Th2 deficiencies associated with a dominant Th17 phenotype, which was enhanced by DA. A similar DA-induced immunomodulation was also observed in PPD-activated cell cultures from GAD individuals. Unlike the control, DA-enhanced Th17 cytokine production in GAD individuals was not affected by glucocorticoid. In conclusion, our results show that the T cell functional dysregulation in GAD individuals is significantly amplified by DA. These immune abnormalities can have impact in increasing the susceptibility of individuals with anxiety disorders to infectious diseases and inflammatory/autoimmune disorders

As diversas faces do acompanhamento de crianças hospitalizadas

This article approaches the technical implications and follow-up policies for hospitalized children in a large-size hospital of Rio de Janeiro in the past two decades. For this purpose, it resumes previous studies considering the following aspects: the hospitalization conditions for children and their accompanying persons at the public service; the analysis of the functions performed by the accompanying persons; the working conditions, which health professionals are subject to and the general conditions of the public service operations. It concludes that the follow-up implications are not restricted to the guarantee of child’s protection and care, but that they interfere strongly in the institutional dynamics. Participation of third parties in (the) medical assistance (conduction of) to hospitalized children in public and private health units generates direct consequences on the service quality, and also on structures of established power.Este artigo aborda as implicações técnicas e políticas do acompanhamento de crianças hospitalizadas em um hospital de grande porte do município de Rio de Janeiro nas últimas duas décadas. Para isso, retoma estudos prévios, considerando os seguintes aspectos: as condições de hospitalização de crianças e seus acompanhantes na rede pública; o exame das funções exercidaspelos acompanhantes; as condições de trabalho a que estão submetidos os profissionais de saúde e as condições gerais de funcionamento de um serviço público. Conclui que as implicações do acompanhamento não se restringem ao cuidado e à garantia de proteção da criança, mas interferem na dinâmica institucional de maneira intensa. A participação de terceiros na conduçãomédico-assistencial das crianças hospitalizadas em unidades públicas e privadas de saúde tem conseqüências diretas sobre a qualidade do serviço, mas também sobre as estruturas de poder instituído. Informações sobre o artigoRecebido em: 14/04/2011         Aceito em: 21/03/201

The many faces of the hospitalized monitored children

Made available in DSpace on 2017-01-27T17:41:26Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 4.pdf: 285304 bytes, checksum: f34c58905038484a23cfdc115fc26407 (MD5) Previous issue date: 2012Universidade Federal do Rio de Janeiro. Centro de Filosofia e Ciências Humanas. Escola de Serviço Social. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Centro de Filosofia e Ciências Humanas. Escola de Serviço Social. Rio de Janeiro, RJ, Brasil.Este artigo aborda as implicações técnicas e políticas do acompanhamento de crianças hospitalizadas em um hospital de grande porte do município de Rio de Janeiro nas últimas duas décadas. Para isso, retoma estudos prévios, considerando os seguintes aspectos: as condições de hospitalização de crianças e seus acompanhantes na rede pública; o exame das funções exercidas pelos acompanhantes; as condições de trabalho a que estão submetidos os profissionais de saúde e as condições gerais de funcionamento de um serviço público. Conclui que as implicações do acompanhamento não se restringem ao cuidado e à garantia de proteção da criança, mas interferem na dinâmica institucional de maneira intensa. A participação de terceiros na condução médico-assistencial das crianças hospitalizadas em unidades públicas e privadas de saúde tem conseqüências diretas sobre a qualidade do serviço, mas também sobre as estruturas de poder instituído.This article approaches the technical implications and follow-up policies for hospitalized children in a large-size hospital of Rio de Janeiro in the past two decades. For this purpose, it resumes previous studies considering the following aspects: the hospitalization conditions for children and their accompanying persons at the public service; the analysis of the functions performed by the accompanying persons; the working conditions, which health professionals are subject to and the general conditions of the public service operations. It concludes that the follow-up implications are not restricted to the guarantee of child’s protection and care, but that they interfere strongly in the institutional dynamics. Participation of third parties in (the) medical assistance (conduction of) to hospitalized children in public and private health units generates direct consequences on the service quality, and also on structures of established power

Evaluation of immune response in HIV-1-exposed uninfected neonates born from seropositive pregnant women

Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorA síndrome da imunodeficiência adquirida (AIDS), causada pelo vírus da imunodeficiência humana (HIV), é uma das mais destrutivas epidemias do mundo, e a infecção pelo HIV em mulheres jovens vem aumentando rapidamente nos dias atuais. Esse fato tem um impacto importante na transmissão vertical do vírus. Apesar da grande maioria dos casos de aids pediátrica em todo mundo resultar da transmissão vertical, aproximadamente dois terços das crianças expostas ao HIV durante a vida fetal não são infectadas pelo vírus. Muitos trabalhos sugerem que durante a gestação doenças infecciosas maternas podem ter consequências complexas para o desenvolvimento do feto, e poucos trabalhos têm explorado o impacto da exposição ao HIV sobre a responsividade imunológica de crianças não infectadas a diferentes estímulos, particularmente na era das drogas antirretrovirais. Portanto, esse trabalho teve como objetivo avaliar eventos imunes em neonatos não-infectados expostos ao HIV-1 nascidos de gestantes que controlam (G1) ou não (G2) a carga viral plasmática, usando neonatos não expostos como controle. Para tanto, sangue do cordão umbilical de cada neonato foi coletado, plasma e células mononucleares foram separados e a linfoproliferação e o perfil de citocinas foram avaliados. Os resultados demonstraram que a linfoproliferação in vitro induzido por ativadores policlonais foi maior nos neonatos do G2. Entretanto, nenhuma cultura de célula respondeu a um conjunto de peptídeos sintéticos do envelope do HIV-1. A dosagem de citocinas no plasma e nos sobrenadantes das culturas ativadas policlonalmente demonstrou que, enquanto a IL-4 e IL-10 foram as citocinas dominantes produzidas nos grupos G1 e controle, a secreção de IFN-γ, IL-1, Il-6, IL-17 e TNF-α foi significativamente superior nos neonatos G2. Níveis sistêmicos de IL-10 observados dentre os neonatos G1 foram maiores naqueles nascidos de mães tratadas com drogas inibidoras da transcriptase reversa do vírus. Por outro lado, níveis superiores de citocinas inflamatórias foram observados dentre estes nascidos de gestantes tratadas com terapia antirretroviral de alta eficácia. Em resumo, nossos resultados indicam uma responsividade imune alterada em neonatos expostos in utero ao HIV-1 e reforça o papel do tratamento materno anti-viral com drogas menos potentes em atenuar tais distúrbios.The acquired immunodeficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV), is one the most destructive epidemic in the world, and the HIV-infection in young women has been increasing fast in the recent times. This fact has an important impact on vertical virus transmission. Although the great majority of the pediatric AIDS cases all over the world results from vertical transmission, approximately two thirds of the children exposed to the HIV during the fetal life are not infected by the virus. Many works suggest that during pregnancy, maternal infectious diseases could have complex consequences to the fetus development, and few works have explored the impact of HIV exposition on immunological responsiveness of uninfected children to different stimuli, particularly in the era of the anti-retroviral drugs. Therefore, this work aimed to evaluate immune events in HIV-1-exposed uninfected neonates born from pregnant women who controlled (G1) or not (G2) the plasma viral load, using unexposed neonates as control. Cord blood from each neonate was collected, plasma and mononuclear cells were separated and the lymphoproliferation and cytokine pattern were evaluated. The results demonstrated that the in vitro lymphoproliferation induced by polyclonal activators was higher in the G2 neonates. Nevertheless, no cell culture responded to poll synthetic HIV-1 envelope peptides. The cytokine dosage in the plasma and supernatants of polyclonally-activated cultures demonstrated that, while IL-4 and IL-10 were the dominant cytokines produced in G1 and control groups, the secretion of IFN-γ, IL-1, Il-6, IL-17 and TNF-α was significantly higher in G2 neonates. Systemic levels of IL-10 observed among the G1 neonates were higher in those born from mothers treated with viral transcriptase reverse inhibitors drugs. On the other hand, higher levels of inflammatory cytokines were observed among them born from pregnant women treated with highly active anti-retroviral therapy. In summary, our results indicate an altered immune responsiveness in neonates exposed in utero to HIV and support the role of maternal anti-viral treatment with less potent drugs to attenuate it

B- and T-cell subpopulations in patients with severe idiopathic membranous nephropathy may predict an early response to rituximab

International audiencePrimary membranous nephropathy (PMN) is characterized by antibodies to the podocyte, but little is known about B- and T-cell populations and their response to rituximab is controversial. To help resolve this we compared 33 lymphocyte subpopulations and 27 cytokines/chemokines in 25 patients with severe PMN and 27 age-matched healthy individuals. At baseline, patients had a significantly increased percentage of naive B-cells with significantly decreased switched and non-switched memory B-cells. There was a significantly decreased percentage of natural killer (NK) cells with an increase in the CD56brightCD16-/lo NK subset. There were a significantly decreased percentage of regulatory T cells, together with an increased plasma concentration of TNF-alpha, IL-5 and IL-2RA. We then investigated 16 patients at eight days and three and six months after treatment with rituximab added to supportive therapy compared to nine patients with supportive therapy alone. After rituximab, B-cell recovery was still incomplete at six months, with persistent alterations of B-cell subsets, a significant increase of both T-regulatory (Treg) cells and NK cells, and a significant decrease of both the CD56brightCD16-/lo NK subset and TNF-alpha levels. The patients who clinically responded to rituximab had a significantly lower percentage of Tregs at baseline compared to non-responders and a significantly increased percentage at day eight. Tregs remained unchanged in non-responders and in patients treated with supportive therapy alone. Thus, evaluation of Tregs might be useful for predicting early response to rituximab

Different interleukin-17-secreting Toll-like receptor+ T-cell subsets are associated with disease activity in multiple sclerosis.

Signalling through Toll-like receptors (TLRs) may play a role in the pathogenesis of autoimmune diseases, such as multiple sclerosis (MS). In the present study, the expression of TLR-2, -4 and -9 was significantly higher on CD4+ and CD8+ T-cells from MS patients compared to healthy individuals. Following in-vitro activation, the proportion of interleukin (IL)-17+ and IL-6+ CD4+ and CD8+ T-cells was higher in the patients. In addition, the proportion of IFN-γ-secreting TLR+ CD8+ T-cells was increased in MS patients. Among different IL-17+ T-cell phenotypes, the proportion of IL-17+ TLR+ CD4+ and CD8+ T-cells producing IFN-γ or IL-6 were positively associated with the number of active brain lesions and neurological disabilities. Interestingly, activation of purified CD4+ and CD8+ T-cells with ligands for TLR-2 (Pam3Csk4), TLR-4 [lipopolysaccharide (LPS)] and TLR-9 [oligodeoxynucleotide (ODN)] directly induced cytokine production in MS patients. Among the pathogen-associated molecular patterns (PAMPs), Pam3Csk4 was more potent than other TLR ligands in inducing the production of all proinflammatory cytokines. Furthermore, IL-6, IFN-γ, IL-17 and granulocyte-macrophage colony-stimulating factor (GM-CSF) levels produced by Pam3Csk4-activated CD4+ cells were directly associated with disease activity. A similar correlation was observed with regard to IL-17 levels released by Pam3Csk4-stimulated CD8+ T-cells and clinical parameters. In conclusion, our data suggest that the expansion of different T helper type 17 (Th17) phenotypes expressing TLR-2, -4 and -9 is associated with MS disease activity, and reveals a preferential ability of TLR-2 ligand in directly inducing the production of cytokines related to brains lesions and neurological disabilities

E.L., a modern-day Phineas Gage: Revisiting frontal lobe injury

BackgroundHow the prefrontal cortex (PFC) recovers its functionality following lesions remains a conundrum. Recent work has uncovered the importance of transient low-frequency oscillatory activity (LFO; < 4 Hz) for the recovery of an injured brain. We aimed to determine whether persistent cortical oscillatory dynamics contribute to brain capability to support 'normal life' following injury.MethodsIn this 9-year prospective longitudinal study (08/2012-2021), we collected data from the patient E.L., a modern-day Phineas Gage, who suffered from lesions, impacting 11% of his total brain mass, to his right PFC and supplementary motor area after his skull was transfixed by an iron rod. A systematic evaluation of clinical, electrophysiologic, brain imaging, neuropsychological and behavioural testing were used to clarify the clinical significance of relationship between LFO discharge and executive dysfunctions and compare E.L.´s disorders to that attributed to Gage (1848), a landmark in the history of neurology and neuroscience.FindingsSelective recruitment of the non-injured left hemisphere during execution of unimanual right-hand movements resulted in the emergence of robust LFO, an EEG-detected marker for disconnection of brain areas, in the damaged right hemisphere. In contrast, recruitment of the damaged right hemisphere during contralateral hand movement, resulted in the co-activation of the left hemisphere and decreased right hemisphere LFO to levels of controls enabling performance, suggesting a target for neuromodulation. Similarly, transcranial magnetic stimulation (TMS), used to create a temporary virtual-lesion over E.L.'s healthy hemisphere, disrupted the modulation of contralateral LFO, disturbing behaviour and impairing executive function tasks. In contrast to Gage, reasoning, planning, working memory, social, sexual and family behaviours eluded clinical inspection by decreasing LFO in the delta frequency range during motor and executive functioning.InterpretationOur study suggests that modulation of LFO dynamics is an important mechanism by which PFC accommodates neurological injuries, supporting the reports of Gage´s recovery, and represents an attractive target for therapeutic interventions.FundingFundação de Amparo Pesquisa Rio de Janeiro (FAPERJ), Universidade Federal do Rio de Janeiro (intramural), and Fiocruz/Ministery of Health (INOVA Fiocruz)