RESUMO
Acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD) and COVID-19 have as a common characteristic the inflammatory lesion of the lung epithelium. The therapeutic options are associated with opportunistic infections, a hyperglycemic state, and adrenal involvement. Therefore, the search for new treatment strategies that reduce inflammation, and promote re-epithelialization of damaged tissue is very important. This work describes the relevant pathophysiological characteristics of these diseases and evaluates recent findings on the immunomodulatory, anti-inflammatory and regenerative effect of mesenchymal stem cells (MSC) and their therapeutic use. In Pubmed we selected the most relevant studies on the subject, published between 2003 and 2022 following the PRISMA guide. We conclude that MSCs are an important therapeutic option for regenerative treatment in COPD, ARDS, and COVID-19, because of their ability to differentiate into type II pneumocytes and maintain the size and function of lung tissue by replacing dead or damaged cells.
El síndrome de dificultad respiratoria aguda (SDRA), la enfermedad pulmonar obstructiva crónica (EPOC) y la COVID-19 tienen tienen en común provocar lesión inflamatoria del epitelio pulmonar. El tratamiento actual suele asociarse con infecciones oportunistas, hiperglicemia y afectación suprarrenal, por lo que es importante proponer opciones relacionadas con la disminución de la inflamación y estimulación de la reepitelización del tejido dañado. En esta revisión se detallan las características fisiopatológicas relevantes de dichas enferme-dades y se evalúan los hallazgos recientes del efecto inmunomodulador, antiinflamatorio y regenerativo de las células troncales mesenquimales (MSC) y sus aplicaciones terapéuticas. Se seleccionaron los estudios sobresalientes del tema, publicados entre 2003 y 2022 en PubMed, siguiendo los criterios de la guía PRISMA. Las células troncales mesenquimales representan una opción importante de tratamiento regenerativo en pacientes con EPOC, SDRA y COVID-19, pues se diferencian a neumocitos tipo II, y mantienen el tamaño y la función del tejido pulmonar, supliendo a las células muertas o dañadas.
Assuntos
COVID-19 , Células-Tronco Mesenquimais , Doença Pulmonar Obstrutiva Crônica , Síndrome do Desconforto Respiratório , Humanos , Síndrome do Desconforto Respiratório/terapia , Pulmão , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/patologia , Células-Tronco Mesenquimais/patologia , Células-Tronco Mesenquimais/fisiologiaRESUMO
Whipple's disease is an infrequent multisystemic infection caused by a gram-positive bacterium: Tropheryma whippelii, which after several studies has been characterized as an actinomiceto por 16Sr RNA. It occurs with multiple symptoms, the principal of which are diarrhea, weight loss, stomach pain and arthralgias. Arthritis or artralgia may appear as an isolated symptom and eventually through the years additional digestive, cardiovascular and/or neurological symptoms arise. Diverse immunological abnormalities usually present before or after clinical symptoms are first discovered. Currently there are cabinet, endoscopic, radiological, tomographic and laboratory studies which can help to make a definitive diagnosis, such as the duodenal biopsy submitted to the Schiff test, to the polimerasa chain or an electronic microscopy in order to see the intracellular bacteria in the macrophage and for immunohistochemistry to see specific antibodies to Whipple's disease. Treatment is trimetoprim/sulfametoxazol, it is suggested transfer factor too.
Assuntos
Doença de Whipple , Antibacterianos/uso terapêutico , Anticorpos Antibacterianos/sangue , Artralgia/etiologia , Diarreia/etiologia , Duodeno/imunologia , Duodeno/microbiologia , Humanos , Macrófagos/microbiologia , Fator de Transferência/uso terapêutico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Tropheryma/genética , Tropheryma/imunologia , Tropheryma/isolamento & purificação , Redução de Peso , Doença de Whipple/diagnóstico , Doença de Whipple/tratamento farmacológico , Doença de Whipple/imunologia , Doença de Whipple/microbiologia , Doença de Whipple/patologiaRESUMO
The purpose of this study was to determine the effect of the implantation of Taenia solium metacestodes and the treatment with suppressive metacestode factor (F1) on the ability of spleen cells from Balb/c mice to produce cytokines. Cytokine production was estimated 12 days following the implantation or 4 days after the last dose of F1 (five doses) by RT-PCR and flow cytometry analyses. Spleen cells were obtained from metacestode-implanted, F1-treated and control mice. They were stimulated with concanavalin A (ConA) ex vivo and used for RT-PCR studies and for CD25 expression and intracellular cytokine production estimations using specific monoclonal antibodies labeled with phycoerithrin or fluorescein. Results of the RT-PCR showed that all cells expressed IFN-gamma, IL-2 and IL-4 mRNAs. IL-10 mRNA was not expressed in any case. Flow cytometry analyses showed that both spleen CD4+ and CD8+ cells from metacestode-implanted or treated-F1 mice expressed significantly diminished percentages of CD25 when compared with control cells (P<0.05). The estimation of intracellular cytokines showed that the production of IL-2 and IL-4 in CD8+ cells, and of IFN-gamma in CD4+ cells from mice implanted with metacestodes was significantly impaired when compared with the values from control cells (P<0.05).
Assuntos
Cisticercose/imunologia , Citocinas/análise , Linfócitos T/imunologia , Taenia solium/imunologia , Animais , Proliferação de Células , Células Cultivadas , Cysticercus/imunologia , Citocinas/genética , Modelos Animais de Doenças , Feminino , Perfilação da Expressão Gênica , Ativação Linfocitária , Camundongos , Camundongos Endogâmicos BALB C , RNA Mensageiro/análise , Receptores de Interleucina-2/análise , Baço/citologiaRESUMO
The purpose of this study was to determine the Th1 and Th2 cytokine responses induced by Taenia solium metacestode antigens in mice and correlate them with the immune responses elicited in vivo. To assess this aim, mice were inoculated with metacestode antigens. RNA was obtained from spleen cells of immunized or control mice incubated with metacestode antigens and used to determine the cytokine profile. Peripheral blood eosinophilia was measured daily in each mouse and specific serum antibody levels were determined. Results showed that metacestode antigens induce the synthesis of IL-4, IL-5 and IFN-gamma mRNAs in spleen cells. They also induced peripheral blood eosinophilia and elicited specific IgE and IgG antibodies, especially IgG1. Three antigens were recognized by all IgG subclasses and by IgE (104, 88 and 7 kDa), and a 57-kDa protein was recognized by IgG1, IgG2a, IgG2b, and IgE. IgG1 and IgG2b recognized 52, 30 and 20 kDa antigens. Immune responses elicited in vivo and the cytokine profile showed good correlation.