SUMMARYDuring the course of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), several immune and neuroendocrine changes associated with pregnancy may exert positive (amelioration) or negative (exacerbation) effects on the clinical outcome. In order to shed light on the mechanisms underlying these responses, we performed a prospective longitudinal study in RA and SLE pregnant women, including healthy pregnant women as a control group. Cytokine messenger RNA (mRNA) expression assessed by quantitative competitive polymerase chain reaction (PCR) in peripheral blood mononuclear cells (PBMC), cytokine levels and lymphocyte proliferation responses (LPR) following phytohaemagglutinin (PHA) stimulation of PBMC, plasma metalloprotease-9 activity (MMP-9) and hormonal status during pregnancy were determined. TNFa was the most abundant cytokine mRNA expressed in PBMC in all groups studied (healthy pregnant women, RA and SLE pregnant patients). However, a general T H 2 response reflected by high IL-10 levels was found in RA, as well as SLE, patients. A significant change in IFN-g was observed in RA patients but only during the first trimester of pregnancy. This compared with a major T H 1 response in healthy pregnant women. Interestingly, our study showed a homogeneous hormonal pattern in RA and SLE patients. Although decreased cortisol levels were observed in all patients studied, this is possibly related to the remission of disease activity status brought about by steroid treatment before and during pregnancy. In summary, we suggest that complex immune and hormonal networks are involved in pregnancy and that rheumatic diseases are very dynamic immune processes that cannot be described with a clear-cut cytokine profile. Furthermore, the observations in this study may reflect treatment-related immune effects more than those associated with disease.
Objective: Rheumatoid Arthritis (RA) is an autoimmune and chronic inflammatory disease of unknown etiology. Killer cell immunoglobulin-like receptors are expressed on the surface of natural killer cells and CD28nullT-cells, both present in synovial membrane of RA. Therefore we evaluated the associations ofKIRgenes with RA.Methods: 16KIRgenes were genotyped in 100 healthy subjects (HS) and 100 RA patients from Western Mexico using PCR-SSP. Differences inKIRgenotypes and gene frequencies were assessed using theX2test.Results: Gene frequency ofKIR2DL3was lower in RA than in HS (p= 0.0019), whereasKIR2DL2andKIR2DS2were higher in RA than HS (p= 0.0004 andp= 0.0487, respectively). In addition were identified 38 genotypes (from G1-G38) in both studied groups, and the genotype frequencies of G1, G6 and G14 showed significant differences (p= 0.0001,p= 0.0208 andp= 0.0300, respectively).Conclusions: The presence ofKIR2DL2,KIR2DS2and absence ofKIR2DL3are associated with RA. Moreover, two genotypes BX are associated with RA. These results suggest thatKIRscan be involved in RA susceptibility.
The study demonstrated that a 4-week nutritional recovery period with a starting infant formula and 0.8 kcal/mL energy density favorably affected the natural and cell-mediated immune response in infants with severe protein-energy malnutrition.
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