Proinflammatory profile of in vitro monocytes in the ageing is affected by lymphocytes presence

Background: Aging is associated with complex and constant remodeling of the immune function, resulting in an increasing susceptibility to infection and others diseases. The infections caused by Gram-negative microorganisms, present in nursing homes and hospitals, constitute one of the most common infections in the elderly, and are mainly combated by innate immune cells. Although the functions of innate immunity seem more preserved during aging than of adaptive immune mechanisms, two systems operate in an integrated way in the body, so that injury in one part of the immune system inevitably affects the other as they are part of a defensive network. The aim of this study was to investigate the in vitro production of proinflammatory (TNF-α, IL-6, IL-1α, CXCL-8 and MCP-1) and antiinflammatory (TGF-α and IL-10) cytokines by monocytes, stimulated or not (basal) with lipopolysaccharide, from healthy young and elderly subjects. By means of PBMCs, we also studied if cytokine profile is altered in these different patient groups, in the presence of lymphocytes, under the same experimental conditions. Results: The monocytes from elderly presented higher basal production of TNF-α, MCP-1 and lower of TGF-α than young monocytes. PBMC showed similar cytokines production, irrespective age or stimulation presence. In the presence of lymphocytes, the spontaneous production of IL-10 was higher and of TGF-α was lower than monocytes, regardless of age. After LPS-stimulation, the presence of lymphocytes resulted in increased IL-6, IL-1α, MCP-1 and IL-10 and decreased CXCL-8 and TGF-α in comparison to pure culture of monocytes from young patients. With age, the same differences were observed, except for CXCL-8 and TGF-α which production was the same between monocytes and PBMC stimulated with LPS.Conclusion: These findings reinforce the systemic state of inflamm-aging frequently reported in elderly and considered a factor of susceptibility to numerous diseases. Still, the cytokine production from just monocytes of the elderly showed alterations, while in the lymphocyte presence not, suggesting an immunomodulator role of lymphocytes on monocytes. In addition, the differences between the production patterns by LPS-stimulated PBMC between young and elderly volunteers can be related with an imbalance in response against Gram-negative bacteria in throughout life

Efeito modulador de citocinas sobre a formação e atividade fungicida de células gigantes multinucleadas obtidas de mnóctos humanos estimulados com antígeno de Paracoccidioides brasiliensis

Células gigantes multinucleadas (CGM) são células características, presentes em lesões granulomatosas, induzidas por agentes infecciosos e, sua formação pode ser modulada por citocinas produzidas por células da resposta imune. No presente trabalho avaliou-se o efeito modulador de citocinas pró-inflamatórias (IFN-γ e TNF-α) e anti-inflamatórias (IL-10 e TGF-β1) na formação de CGM in vitro, a partir de monócitos humanos, estimulados com antígenos de Paracoccidioides brasiliensis (AgPb) e sobre a atividade fungicida dessas células desafiadas com a cepa Pb18 de P.brasiliensis. Monócitos do sangue periférico de indivíduos saudáveis foram cultivados na ausência de estímulo (controle), com AgPb (100ug/mL) ou com associações de AgPb e GM-CSF (100 U/ml) com as citocinas: IFN-γ (300UI/mL), IL-10 (50U/mL), TGF- β1 (250pg/mL) ou TNF-α (50U/mL). A formação de CGM foi avaliada após três dias de cultivo, estabelecendo-se o índice de fusão (IF) e a percentagem de CGM após fixação e coloração das células com May-Grunwald-Giemsa. Além disso, a atividade fungicida dessas células foi avaliada após 4 h de co-cultivo das CGM com 4 x 104 células leveduriformes viáveis da cepa Pb18 de P. brasiliensis, por plaqueamento das co-culturas em meio BHI-ágar e determinação da recuperação de fungos viáveis. O método estatístico empregado para comparação dos resultados foi análise de variância, com nível de significância de 5%. Os resultados mostraram que a incubação de monócitos com AgPb+GM-CSF+IFN-γ induziu IF significativamente mais elevados em relação a todas as demais culturas: controle, apenas estimulados com AgPb ou AgPb adicionado das demais citocinas. A adição de TNF- α+AgPb+GM-CSF não resultou em IF maiores do que os obtidos na cultura estimulada apenas com o AgPb, enquanto as citocinas IL-10 e TGF-β1 apresentaram efeito supressor...Multinucleated giant cells (MGC) are characteristics cells present in granulomatous lesions induced by infectious agents and also may be modulated by cytokines produced by cells of the immune response. The present study evaluated the modulatory effect of interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) pro-inflammatory cytokines, and interleukin-10 (IL-10) and transforming growth factor beta (TGF-β1) anti-inflammatory cytokines on in vitro formation of MGC derived from human monocytes, stimulated with Paracoccidioides brasiliensis antigen (PbAg) and on fungicidal activity of these cells challenged with the Pb18 strain of P.brasiliensis. Peripheral blood monocytes obtained from healthy individuals were cultured for three days without stimulus (control) or with PbAg (100 ug/mL) or with association of PbAg and granulocyte macrophage colony stimulator factor (GMCSF (100 U/mL) with the following cytokines: IFN-γ (300 UI/mL), IL-10 (50 UI/mL), TGF-β1 (250 pg/mL) or TNF-α (50 UI/mL). The generation of MGC was evaluated by fusion index (FI) and the percentage of MGC formation after cell fixing and May-Grumwald-Giensa staining. Fungicidal activity of monocytederived MGC was evaluated 4h after co-culture of MGC with 4 x 104 viable yeast cells of Pb18 strain, by plating the cultures in BHI-agar and determination of viable fungi recovery. The statistical method employed for the comparison of the results was analysis of variance with the significance set at p< 0.05. The results showed that the incubation of monocytes with PbAg+GM-CSF+IFN-γ induced FI significantly higher than those observed in all the other cultures, such as control cultures, cultures stimulated with PbAg only or cultures stimulated with PbAg associated with the other cytokines. Stimulation with PbAg+TNF+GM-CSF did not result in FI higher than those obtained in the culture stimulated with PbAg only... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Fungicidal activity of human monocyte-derived multinucleated giant cells induced in vitro by Paracoccidioides brasiliensis antigen

Multinucleated giant cells (MGC) are characteristic cells in granulomatous disorders such as paracoccidioidomycosis (PCM) and also are formed in vitro from peripheral blood mononuclear cells by several stimuli. In this study, the authors investigated in vitro formation of MGC derived from monocytes of healthy individuals, stimulated with Paracoccidioides brasiliensis antigen (PbAg), compared with other stimuli such as IFN-gamma and supernatant of Con-A-stimulated peripheral blood mononuclear cells (CM-ConA). Besides, the fungicidal activity of monocytes and monocyte-derived MGC challenged with P. brasiliensis were compared, at a ratio of one fungus per 50 monocytes. Results demonstrated that PbAg, IFN-gamma, and CM-ConA stimuli were able to induce MGC generation, with fusion indices significantly higher than control cultures. Striking results were observed when MGC induced by PbAg and IFN-gamma presented higher fungicidal activity than monocytes, submitted to the same stimuli, showing a better capacity of these cells to kill P. brasiliensis. In summary, the results suggest that PbAg is able to induce MGC generation, and these cells presented higher fungicidal activity against P. brasiliensis than monocytes

Evaluation of Alpha-1 Antitrypsin Levels and SERPINA1 Gene Polymorphisms in Sickle Cell Disease

Alpha-1 antitrypsin (AAT) is an inhibitor of neutrophil elastase and a member of the serine proteinase inhibitor (serpin) superfamily, and little is known about its activity in sickle cell disease (SCD). We hypothesize that AAT may undergo changes in SCD because of the high oxidative stress and inflammation associated with the disease. We have found high AAT levels in SCD patients compared to controls, while mutant genotypes of SERPINA1 gene had decreased AAT levels, in both groups. AAT showed negative correlation with red blood cells, hemoglobin (Hb), hematocrit, high-density lipoprotein cholesterol, urea, creatinine, and albumin and was positively correlated with mean corpuscular Hb concentration, white blood cells, neutrophils, Hb S, bilirubin, lactate dehydrogenase, ferritin, and C-reactive protein. Patients with higher levels of AAT had more infection episodes (OR = 1.71, CI: 1.05–2.65, p = 0.02), gallstones (OR = 1.75, CI: 1.03–2.97, p = 0.02), and had more blood transfusions (OR = 2.35, CI: 1.51–3.65, p = 0.0001). Our data on AAT association with laboratory indices of hemolysis and inflammation suggest that it may be positively associated with SCD severity; the negative correlations with renal parameters suggest a cytoprotective mechanism in SCD patients. In summary, AAT may need to be included in studies related to SCD and in the discussion of further therapeutic strategies

Evaluation of Alpha-1 Antitrypsin Levels and SERPINA1 Gene Polymorphisms in Sickle Cell Disease

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-02-27T17:10:13Z No. of bitstreams: 1 Carvalho MO Evaluation of Alpha-1 Antitrypsin Levels ....pdf: 1761644 bytes, checksum: dc153a1f79523e2c24e83c470f3b6da6 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-02-27T17:22:46Z (GMT) No. of bitstreams: 1 Carvalho MO Evaluation of Alpha-1 Antitrypsin Levels ....pdf: 1761644 bytes, checksum: dc153a1f79523e2c24e83c470f3b6da6 (MD5)Made available in DSpace on 2018-02-27T17:22:46Z (GMT). No. of bitstreams: 1 Carvalho MO Evaluation of Alpha-1 Antitrypsin Levels ....pdf: 1761644 bytes, checksum: dc153a1f79523e2c24e83c470f3b6da6 (MD5) Previous issue date: 2017Brazilian National Council of Research (CNPq) (311888/2013-5) (MG); the Foundation of Research and Extension of Bahia (FAPESB) (3626/2013, 1431040053063, and 9073/2007) (MG); and PPSUS/ FAPESB (020/2013 EFP_00007295) (MG) and MCD/CNPq/MS-SCTIE-DECIT (409800/2006-6) (MG).Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Complexo Hospital Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil.Universidade Federal da Bahia. Salvador, BA, Brasil.Universidade Federal da Bahia. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação de Hematologia e Hemoterapia da Bahia. Salvador, BA, Brasil.Fundação de Hematologia e Hemoterapia da Bahia. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.Kuwait University. Department of Pediatrics. Kuwait City, Kuwait.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.Alpha-1 antitrypsin (AAT) is an inhibitor of neutrophil elastase and a member of the serine proteinase inhibitor (serpin) superfamily, and little is known about its activity in sickle cell disease (SCD). We hypothesize that AAT may undergo changes in SCD because of the high oxidative stress and inflammation associated with the disease. We have found high AAT levels in SCD patients compared to controls, while mutant genotypes ofSERPINA1gene had decreased AAT levels, in both groups. AAT showed negative correlation with red blood cells, hemoglobin (Hb), hematocrit, high-density lipoprotein cholesterol, urea, creatinine, and albumin and was positively correlated with mean corpuscular Hb concentration, white blood cells, neutrophils, Hb S, bilirubin, lactate dehydrogenase, ferritin, and C-reactive protein. Patients with higher levels of AAT had more infection episodes (OR = 1.71, CI: 1.05-2.65,p = 0.02), gallstones (OR = 1.75, CI: 1.03-2.97,p = 0.02), and had more blood transfusions (OR = 2.35, CI: 1.51-3.65,p = 0.0001). Our data on AAT association with laboratory indices of hemolysis and inflammation suggest that it may be positively associated with SCD severity; the negative correlations with renal parameters suggest a cytoprotective mechanism in SCD patients. In summary, AAT may need to be included in studies related to SCD and in the discussion of further therapeutic strategies

Granulocyte macrophage colony-stimulating factor enhances the modulatory effect of cytokines on monocyte-derived multinucleated giant cell formation and fungicidal activity against Paracoccidioides brasiliensis

Multinucleated giant cells (MGC) are cells present in characteristic granulomatous inflammation induced by intracellular infectious agents or foreign materials. The present study evaluated the modulatory effect of granulocyte macrophage colony-stimulating factor (GM-CSF) in association with other cytokines such as interferon-gamma (IFN-γ), tumour necrosis factor-alpha, interleukin (IL)-10 or transforming growth factor beta (TGF-β1) on the formation of MGC from human peripheral blood monocytes stimulated with Paracoccidioides brasiliensis antigen (PbAg). The generation of MGC was determined by fusion index (FI) and the fungicidal activity of these cells was evaluated after 4 h of MGC co-cultured with viable yeast cells of P. brasiliensis strain 18 (Pb18). The results showed that monocytes incubated with PbAg and GM-CSF plus IFN-γ had a significantly higher FI than in all the other cultures, while the addition of IL-10 or TGF-β1 had a suppressive effect on MGC generation. Monocytes incubated with both pro and anti-inflammatory cytokines had a higher induction of foreign body-type MGC rather than Langhans-type MGC. MGC stimulated with PbAg and GM-CSF in association with the other cytokines had increased fungicidal activity and the presence of GM-CSF also partially inhibited the suppressive effects of IL-10 and TGF-β1. Together, these results suggest that GM-CSF is a positive modulator of PbAg-stimulated MGC generation and on the fungicidal activity against Pb18

ABC-SPH risk score for in-hospital mortality in COVID-19 patients : development, external validation and comparison with other available scores

The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO/FiO ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19

ABC₂-SPH risk score for in-hospital mortality in COVID-19 patients

Objectives: The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods: Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results: Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO2/FiO2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.</p