RESUMO
Clostridium difficile causes intestinal inflammation, which increases adenosine. We compared the expression of adenosine receptors (AR) subtypes A1, A2A, A2B, and A3 in HCT-8, IEC-6 cells, and isolated intestinal epithelial cells, challenged or not with Clostridium difficile toxin A and B (TcdA and TcdB) or infection (CDI). In HCT-8, TcdB induced an early A2BR expression at 6 h and a late A2AR expression at 6 and 24 h. In addition, both TcdA and TcdB increased IL-6 expression at all time-points (peak at 6 h) and PSB603, an A2BR antagonist, decreased IL-6 expression and production. In isolated cecum epithelial cells, TcdA induced an early expression of A2BR at 2s and 6 h, followed by a late expression of A2AR at 6 and 24 h and of A1R at 24 h. In CDI, A2AR and A2BR expressions were increased at day 3, but not at day 7. ARs play a role in regulating inflammation during CDI by inducing an early pro-inflammatory and a late anti-inflammatory response. The timing of interventions with AR antagonist or agonists may be of relevance in treatment of CDI.
Assuntos
Toxinas Bacterianas , Clostridioides difficile , Infecções por Clostridium , Receptores Purinérgicos P1/metabolismo , Animais , Anti-Inflamatórios , Proteínas de Bactérias , Modelos Animais de Doenças , Enterotoxinas , Infecções , Interleucina-6 , Regulação para CimaRESUMO
OBJECTIVE: This study evaluated oral mucosal lesions in liver-transplanted children. METHODS: A retrospective study was performed on pediatric patients who underwent liver transplantation between 2002 and 2009, at A.C. Camargo Hospital, Sao Paulo-SP. Alterations, such as polypoid lesions over the dorsum of the tongue, lip swelling, angular cheilitis, fissures of the lips, mucosal tags, cobblestone appearance, and fissures of the tongue, were considered as orofacial granulomatosis (OFG)-like lesions. All clinical data were collected from medical records. Descriptive analyses and logistic regression were used to characterize and identify OFG-like lesion predictors. RESULTS: Of the 265 transplanted children, 56.6% were female, and 64.1% had biliary atresia. Fourteen patients died as a consequence of the transplantation surgery and were therefore excluded from the analysis related to oral lesions. Hence, among 251 patients, 64 showed OFG-like lesions. The lesions occurred around 26 months after transplantation, and the only therapy that all the patients were receiving in common was tacrolimus. Furthermore, patients aged 12 months old or less at transplantation presented higher risk to present oral lesions. CONCLUSIONS: This study described specific oral mucosal lesions in liver-transplanted children. Such lesions have recently been described as a novel entity. Although young age at transplantation has been associated to its development, the etiology of this condition is uncertain.