RESUMO
STUDY DESIGN: This was an animal study. OBJECTIVES: Local inflammation is attenuated below high thoracic SCI, where innervation of major lymphoid organs is involved. However, whether inflammatory responses are affected after low thoracic SCI, remains undetermined. The aim of this study was to characterize the influence of low thoracic SCI on carrageenan-induced paw swelling in intact and paralyzed limbs, at acute and subacute stages. SETTING: University and hospital-based research center, Mexico City, Mexico. METHODS: Rats received a severe contusive SCI at T9 spinal level or sham injury. Then, 1 and 15 days after lesion, carrageenan or vehicle was subcutaneously injected in forelimb and hindlimb paws. Paw swelling was measured over a 6-h period using a plethysmometer. RESULTS: Swelling increased progressively reaching the maximum 6 h post-carrageenan injection. Swelling increase in sham-injured rats was approximately 130% and 70% compared with baseline values of forelimbs and hindlimbs, respectively. Paws injected with saline exhibited no measurable swelling. Carrageenan-induced paw swelling 1-day post-SCI was suppressed in both intact and paralyzed limbs. Fifteen days post-injury, the swelling response to carrageenan was completely reestablished in forelimbs, whereas in hindlimbs it remained significantly attenuated compared with sham-injured rats. CONCLUSIONS: SCI at low spinal level affects the induced swelling response in a different way depending on both, the neurological status of challenged regions and the stage of injury. These findings suggest that neurological compromise of the main immunological organs is not a prerequisite for the local swelling response to be affected after injury.
Assuntos
Inflamação/fisiopatologia , Traumatismos da Medula Espinal/imunologia , Doença Aguda , Animais , Carragenina , Modelos Animais de Doenças , Progressão da Doença , Feminino , Membro Anterior , Membro Posterior , Inflamação/patologia , Paralisia/imunologia , Paralisia/patologia , Distribuição Aleatória , Ratos Sprague-Dawley , Traumatismos da Medula Espinal/patologia , Vértebras Torácicas , Fatores de TempoRESUMO
BACKGROUND: Thyrotoxic periodic paralysis (TPP) is characterized by episodes of neuromuscular weakness occurring in the context of hypokalemia and hyperthyroidism and has been predominantly described in Oriental populations. Whereas it is uncommon in Caucasians and Blacks, TPP does occur in individuals of Native American descent. The objective was to analyze the clinical, biochemical, and HLA characteristics of a group of Mexican mestizo patients with TPP. METHODS: The sample was comprised of 14 men with TPP diagnosed since January 1990, based on one or more episodes of flaccid paralysis, accompanied by hypokalemia and occurring in the context of clinical and biochemical hyperthyroidism. Eight were available for HLA testing. RESULTS: Hyperthyroidism was diagnosed before the development of periodic paralysis in five of the patients, whereas in six it occurred afterward. The severity of paralysis did not correlate with the degree of either hypokalemia or hyperthyroidism. An increased frequency of HLA-DR3 was found in Graves' patients without paralysis but not in those with paralysis, as compared to the general population. CONCLUSIONS: TPP is more common than previously thought in Mexicans, in whom it behaves as in other Native American groups. The lack of HLA-DR3 association in Graves' patients with TPP is interesting, but at the moment has no pathophysiological implications.
Assuntos
Etnicidade , Doença de Graves/complicações , Antígenos HLA/análise , Hipopotassemia/etnologia , Paralisia/etnologia , Tireotoxicose/etnologia , Adulto , Povo Asiático/genética , Etnicidade/genética , Frequência do Gene , Predisposição Genética para Doença , Doença de Graves/sangue , Doença de Graves/imunologia , Antígenos HLA/genética , Antígeno HLA-DR3/análise , Antígeno HLA-DR3/genética , Humanos , Hipopotassemia/sangue , Hipopotassemia/etiologia , Hipopotassemia/imunologia , Indígenas Norte-Americanos/genética , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Paralisia/sangue , Paralisia/etiologia , Paralisia/imunologia , Periodicidade , Potássio/sangue , Fatores Sexuais , Espanha/etnologia , Hormônios Tireóideos/sangue , Tireotoxicose/sangue , Tireotoxicose/etiologia , Tireotoxicose/imunologia , População Branca/genéticaRESUMO
Tropical spastic paraparesis (TSP), a neuromyelopathy predominantly involving the pyramidal tract and commonly observed in tropical and equatorial areas, was recently found to be associated with human T lymphotropic virus type I (HTLV-I). We investigated sera and cerebrospinal fluid (CSF) from 19 patients with TSP who were from the Caribbean area, French Guiana, and Africa. Our results showed an elevated intra-blood-brain barrier IgG synthesis rate and an elevated IgG index, with an increased HTLV-I antibody-to-albumin ratio and the presence of CSF oligoclonal bands in the majority of the patients. These data, in association with similar HTLV-I antibody patterns between patients with TSP who were from these three regions, strengthen the probable etiologic role of HTLV-I in the pathogenesis of such chronic neuromyelopathies.
Assuntos
Anticorpos Antivirais/biossíntese , Infecções por Deltaretrovirus/imunologia , Deltaretrovirus/imunologia , Imunoglobulina G/biossíntese , Paralisia/imunologia , Doenças da Medula Espinal/imunologia , Adulto , Idoso , Anticorpos Antivirais/líquido cefalorraquidiano , Barreira Hematoencefálica , Côte d'Ivoire , Infecções por Deltaretrovirus/líquido cefalorraquidiano , Feminino , Guiana Francesa , Humanos , Imunoensaio , Imunoglobulina G/líquido cefalorraquidiano , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular , Paralisia/líquido cefalorraquidiano , Senegal , Doenças da Medula Espinal/líquido cefalorraquidiano , Clima Tropical , Índias OcidentaisRESUMO
Tropical spastic paraparesis (TSP), a neuromyelopathy predominantly involving the pyramidal tract and commonly observed in tropical and equatorial areas, was recently found to be associated with human T lymphotropic virus type I (HTLV-I). We investigated sera and cerebrospinal fluid (CSF) from 19 patients with TSP who were from the Caribbean area, French Guiana, and Africa. Our results showed an elevated intra-blood-brain barrier IgG synthesis rate and an elevated IgG index, with an increased HTLV-I antibody-to-albumin ratio and the presence of CSF oligoclonal bands in the majority of the patients. These data, in association with similar HTLV-I antibody patterns between patients with TSP who were from these three regions, strenghten the probable etiologic role of HTLV-I in the pathogenesis of such chronic neuromyelopathies. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Anticorpos Antivirais/biossíntese , Infecções por Deltaretrovirus/imunologia , Deltaretrovirus/imunologia , Imunoglobulina G/biossíntese , Paralisia/imunologia , Doenças da Medula Espinal/imunologia , Estudo Comparativo , Anticorpos Antivirais , Barreira Hematoencefálica , Guiana Francesa , Infecções por Deltaretrovirus , Imunoglobulina G , Imunoensaio , Côte d'Ivoire , Espasticidade Muscular , Paralisia , Senegal , Doenças da Medula Espinal , Clima Tropical , Índias OcidentaisRESUMO
Of 13 West-Indian-born UK residents with spastic paraparesis of unknown cause, 11 were tested for serum antibody to human T-cell lymphotropic virus type 1 and all were positive. Their magnetic resonance imaging scans were normal or showed only minor abnormalities in the brain, and the spinal cord was normal in the 5 investigated. Of 48 patients with multiple sclerosis, mainly caucasian, none had antibody to HTLV-1 in the blood.
Assuntos
Anticorpos Antivirais/análise , Deltaretrovirus/imunologia , Paralisia/imunologia , Adulto , Idoso , Anticorpos Antideltaretrovirus , Feminino , Humanos , Espectroscopia de Ressonância Magnética , Pessoa de Meia-Idade , Esclerose Múltipla/imunologia , Espasticidade Muscular/etiologia , Espasticidade Muscular/imunologia , Paralisia/etiologia , Clima Tropical , Reino Unido , Índias Ocidentais/etnologiaRESUMO
Tropical spastic paraparesis (TSP) is a common myeloneuropathy with primary and predominant involvement of the pyramidal tract and minimal sensory loss. The epidemic form of TSP is related to toxic nutritional factors, but the endemic form occurs in clusters in tropical areas, especially in India, Africa, the Seychelles, Colombia, and areas of the Caribbean. We describe the clinical and epidemiological features of 25 TSP patients from Martinique (French West Indies) with serum antibodies to human T-lymphotropic virus type I (HTLV-I). Furthermore, all 11 patients who were seropositive for HTLV-I had specific HTLV-I antibodies in their CSF. All were women. The age of onset varied from 25 to 60 years (mean, 45 years). The main clinical features are spastic paraparesis or paraplegia with spasticity of the upper limbs, minimal sensory loss, and bladder dysfunction. Minimal estimated incidence and prevalence are 1 per 100,000 inhabitants per year and 8 per 100,000, respectively. Seventeen percent of the relatives of patients with HTLV-I-associated TSP have HTLV-I antibodies (1 husband and 7 children). In Martinique, the prevalence of HTLV-I antibodies in the general population is about 2% and reaches 10% for neurological disorders other than TSP. Since our initial report, the association between spastic paraparesis and HTLV-I has been confirmed in Jamaica, Colombia, and Japan, suggesting the neurotropism of this lymphotropic human retrovirus.
Assuntos
Anticorpos Antivirais/análise , Deltaretrovirus/imunologia , Paralisia/imunologia , Adulto , Feminino , HIV/imunologia , Humanos , Masculino , Martinica , Pessoa de Meia-Idade , Espasticidade Muscular/epidemiologia , Espasticidade Muscular/imunologia , Paralisia/epidemiologia , SorologiaRESUMO
Of 13 West-Indian-born UK residents with spastic paraparesis of unknown cause, 11 were tested for serum antibody to human T-cell lymphotropic virus type 1 and all were positive. Their magnetic resonance imaging scans were normal or showed only minor abnormalities in the brain, and the spinal cord was normal in the 5 investigated. Of 48 patients with multiple sclerosis, mainly caucasian, none had antibody to HTLV-1 in the blood.(AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Feminino , Anticorpos Antivirais/análise , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Paralisia/imunologia , Reino Unido , Esclerose Múltipla/imunologia , Espasticidade Muscular/etiologia , Espasticidade Muscular/imunologia , Espectroscopia de Ressonância Magnética , Paralisia/etiologia , Clima Tropical , Índias Ocidentais/etnologiaRESUMO
Owing to the frequent occurrence in tropical countries of subacute spinal cord diseases of unknown origin, a nosological entity called tropical spastic paraparesis has been individualized. Twenty-two cases have been observed in Martinique. The presence in the serum of antibodies directed against human T-cell leukaemia/lymphoma virus (HTLV-I) in 15 of these 22 patients suggests that this lymphotropic virus or a related one might also be neurovirulent.