Resumo: A hanseníase é doença crônica infecciosa que se caracteriza por apresentar formas clínicas contrastantes, que são dependentes da interação do bacilo com a resposta imune do hospedeiro. O estudo dos processos imunológicos torna-se fundamental para o entendimento dos mecanismos envolvidos na apresentação e no desenvolvimento da doença. Neste artigo, é revisada a imunopatogê-nese da hanseníase. INTRODUÇÃOA hanseníase é uma infecção granulomatosa crônica, que afeta principalmente a pele e os nervos periféricos, sendo transmitida pelas vias aéreas superiores de pessoa a pessoa através do convívio de susceptíveis com doentes bacilíferos sem tratamento. 1 A afecção pode ser mais bem entendida se for considerada associação de duas doenças. A primeira é uma infecção crônica causada pelo Mycobacterium leprae, organismo intracelular obrigatório que induz extraordinária resposta imune nos indivíduos acometidos. A segunda é neuropatia periférica iniciada pela infecção e acompanhada por eventos imunológicos, cujas evolução e seqüelas freqüentemente se estendem por muitos anos após a cura da infecção, podendo levar a grave debilidade física, social e conseqüências psicoló-gicas. 2 A hanseníase é influenciada por fatores genéti-cos do hospedeiro, fatores ambientais, como o estado nutricional, vacinação com BCG e taxa de exposição ao M. leprae ou outras micobactérias. 3 A resposta imune é de fundamental importância para a defesa do organismo frente à exposição ao bacilo. A hanseníase caracteriza-se por apresentar alta infectividade e baixa patogenicidade, sendo a maioria da população, mais de 95% dos indivíduos, é naturalmente imune. 4,5 Na hanseníase, a alteração da resposta imune está asso-

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Regardless the level of proteinuria, INS patients had increased expression of TNF-α in CD4-lymphocytes and reduced expression of IFN-γ in CD8-lymphocytes. Persistence of proteinuria was associated with higher levels of inflammatory markers.

BackgroundStem bark of Luehea ochrophylla (L. ochrophylla) is used by the traditional Brazilian medicine for treatment of rheumatic diseases and tumors. This study aimed to investigate inhibition of acute and chronic inflammations and cytotoxic activity of extracts, fractions, and isolated compounds from L. ochrophylla.MethodsHexane (HE) and ethanol (EE) extracts obtained from stem bark of L. ochrophylla were submitted to chromatographic fractionation. In order to test acute inflammation, experimental model of impact injury was used, followed by transdermal application of gels using phonophoresis. Histological analysis was based on scores assigned by the capacity of decreasing the lesion. To evaluate the effect EE and fractions on cell proliferation, human lymphocytes were stimulated with phytohemagglutinin and analyzed using flow cytometry. Proliferation was measured using VPD 450 staining and the calculated proliferative index (PI). The cytotoxic activity was evaluated using MTT colorimetric method against MDA-MB-231, MCF-7, HCT-116, and Vero cells. GraphPad Prism Version 5 was used for statistical analysis.ResultsHE and EE provided friedelin, β-friedelinol, lupeol, mixture of lupeol and pseudotaraxasterol, β-sitosterol, betulinic acid, mixture of lupeol and taraxasterol, (−)-epicatechin, β-sitosterol-3-O-β-D-glucopyranoside, and (+)-epicatechin-(4β-8)-epicatechin. HE, ethyl acetate fraction (AF), betulinic acid, and β-sitosterol promoted regeneration of muscle fibers caused by muscle injury. AF significantly (p < 0.05) reduced the lymphocyte proliferation index (1.36 for cultures stimulated with PHA, 0.7 for untreated cultures and 0.12 for cultures stimulated with PHA and treated with AF 25 μg/mL and AF 50 μg/mL, respectively). β-Sitosterol-3-O-β-D-glucopyranoside exhibited high cytotoxic activity (IC50 = 1.279 μg/mL) against HCT-116 cell line.ConclusionThese results suggest that extracts, fractions, and chemical constituents from L. ochrophylla decreases inflammatory processes generated by muscle injury. The anti-inflammatory activity may be justified by high inhibition of T cell proliferation. These extracts, fractions, and chemical constituents from L. ochrophylla may be useful as a therapeutic agent against rheumatic diseases. Moreover, chemical constituents from L. ochrophylla show potent cytotoxic activity against colon and rectal carcinomas.

The formation of thrombi in medical devices that come into contact with blood is a common cause of increased morbidity and mortality. Prolonged use of central venous catheters (CVCs) may cause high infection rates or compromise CVC patency due to thrombus development. In this study, we sought insights into possible changes in the hemostatic system during prolonged use of inserted CVCs for hemodialysis by assessing platelets by CD62P and CD41a expression and the potential for thrombin generation (TG). This study included patients with chronic renal failure who were undergoing hemodialysis three times a week using a CVC, and healthy subjects as controls. The participants were distributed into three groups: Group 1: clinically and laboratorially healthy individuals matched by sex and age to the patients (controls); Group II: patients who had completed 1 month of CVC insertion; and Group III: the same patients after they had completed 4 months of CVC insertion. Platelet activation analysis and TG evaluation were performed using blood samples obtained through two different accesses, that is, through a peripheral vein and directly from the CVC lumen. The data showed platelet activation and an increase in the generation of thrombin, particularly after 4 months of CVC use. The results also indicated that insertion of the catheter into the blood stream stimulated the intrinsic rather than the extrinsic pathway. Taken together, the data showed a direct relationship between the use of CVCs in hemodialysis patients and a state of hypercoagulability, most likely associated with endothelial damage and the contact of the medical device with blood components such as platelets and coagulation factors.

Inflammatory bowel diseases (IBD) affect the gastrointestinal tract, and the imbalance of intestinal immune homeostasis can trigger them. Pequi oil (PO), a monounsaturated (MUFA) and carotenoid-rich food with nutraceutical potential, could help reshape the intestinal immune response, ameliorating IBD outcomes. This study investigates the effects of a 28 days intake of PO on elements of the intestinal immune response of mice with DSS-induced ulcerative colitis (disease activity index, colonic damage, inflammatory cells and markers). PO reduces body weight, colonic crypt and goblet cell losses and ameliorates diarrhea. In the colon, it increases T cells and secretory-IgA and decreases CD8+T cells. In lymphoid organs, it reduces CD8+T cells. Moreover, it also reduces the IL-17 and CRP in plasma. PO oil promotes a less cytotoxic response that may protect mice from immunological injuries caused by an IBD in the intestinal mucosa, improving the disease prognosis. Practical applications: This study demonstrates that the intake of pequi oil contributes to the regulation of immune response and improves clinical and histological signs of DSS-induced ulcerative colitis in mice. Its effects in cytotoxic cell reduction and other inflammatory markers and stimulation of regulatory cells, and preservation of mucus-producing cells, provide news insights about the importance of the regular intake of this food to better prognosis of ulcerative colitis acute episodes. In addition, these findings encourage further studies with foods with a protective potential for the intestinal mucosa.

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