Perfil de citocinas em pacientes com polipose nasossinusal associada à fibrose cística analisado por RT-PCR.
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Universidade Federal de Minas Gerais
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Tese de doutorado
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Membros da banca
Evaldo Nascimento
Ivana Duval de Araujo
Rodrigo de Paula Santos
Eulália Sakano
Paulo Fernando Tormim Borges Crosara
Ivana Duval de Araujo
Rodrigo de Paula Santos
Eulália Sakano
Paulo Fernando Tormim Borges Crosara
Resumo
A polipose nasossinusal frequentemente complica a evolucao dos pacientes com Fibrose Cistica. As citocinas nos polipos destes individuos sao pouco estudadas, assim como a importancia destas citocinas no prognostico e na resposta terapeutica. O objetivo deste estudo foi analisar o perfil de citocinas em pacientes com polipose nasossinusal, associada a Fibrose Cistica. Foram analisados osseguintes aspectos: percentagem de eosinofilos e perfil das citocinas. Realizou-se um estudo transversal, selecionando-se 13 pacientes com Fibrose Cistica e polipose nasossinusal (grupo Fibrose Cistica). Seis pacientes (46,15%) eram do sexo masculino, sete (53,85%) do sexo feminino e a media das idades foi de 22,45 anos (6-57). O grupo controle foi constituido de 11 pacientes sem doenca nasossinusal eteste alergico negativo, submetidos a procedimentos cirurgicosotorrinolaringologicos. Cinco pacientes (45,45%) eram do sexo feminino, seis (54,54%) masculinos e a media das idades foi de 17,7 anos (3-43). A percentagem de eosinofilos foi analisada no fragmento do polipo nasal (grupo Fibrose Cistica), atraves de estudo anatomopatologico, e o perfil das citocinas, pesquisado nos fragmentos de mucosa (grupo Controle) ou polipo nasal (grupo Fibrose Cistica), atraves da reacao reversa da cadeia de polimerase (RT-PCR). Foram estudadas astranscricoes para as citocinas IL-4, IL-5, IL-6, IL-8, IFN-Á e GM-CSF, ajustadas pelo valor da À-actina. No grupo Fibrose Cistica, tres (23%) polipos eram eosinofilicos e 10 (77%) nao eosinofilicos. Nao houve diferenca estatisticamente significativa nos dois grupos em relacao a idade (p=0,32). As interleucinas 5, 6, 8 e GM-CSF foram semelhantes nos dois grupos, observando-se menores valores de IFN-Á (p=0,03) eforte tendencia de aumento de IL-4 (p=0,06) no grupo Fibrose Cistica. As celulas inflamatorias e estruturais, incluindo epitelio, fibroblastos e endotelio vascular, teriam a habilidade de produzir RNA mensageiro para IL-4, bloqueando a producao de outras citocinas como o INF-y, o que pode sugerir uma participacao especial deste mecanismo na formacao dos polipos nasais da Fibrose Cistica.
Abstract
Nasal polyposis often complicates the progress of patients with cystic fibrosis. There has been little study into the cytokines in the polyps of such individuals and the importance of these cytokines in the prognosis and response to therapy. The aim of the present study was to analyze the profile of cytokines in patient with nasal polyposis associated to cystic fibrosis. The percentage of eosinophils and cytokine profile were analyzed. A cross-sectional study was carried out on 13 patients withcystic fibrosis and nasal polyposis (Cystic Fibrosis Group); six patients (46.15%) were male and seven (53.85%) were female; average age was 22.45 years (6-57). The control group was made up of 11 patients with no nasal condition and negative allergy test, submitted to ororhinolaryngological surgery procedures; five patients (45.45%) were female and six (54.54%) were male; average age was 17.7 years (3-43). The percentage of enosinophyls was determined in fragments from nasal polyps (Cystic Fibrosis Group) through an anatomopathological analysis and the cytokine profile was researched in mucous fragments (Control Group) or polyps (Cystic Fibrosis Group) through reverse transcription polymerase chain reaction (RT-PCR). Transcriptions were studied for the cytokines IL-4, IL-5, IL-6, IL-8, IFN-ã and GMCSF,adjusted for the â-actin value. In the Cystic Fibrosis Group, three (23%) polyps were eosinophilic and 10 (77%) were non-eosinophilic. There was no statistically significant difference between groups with regard to age (p=0.32). Interleukins 5, 6, 8 and GM-CSF were similar in both groups, whereas there were lower IFN-ã values (p=0.03) and a strong tendency toward an increase in IL-4 (p=0.06) in the Cystic Fibrosis Group. Inflammatory and structural cells, including epithelium, fibroblastsand vascular endothelium, appear to have the ability to produce messenger RNA for IL-4, blocking the production of other cytokines such as INF-y, which may suggest a special participation of this mechanism in the formation of nasal polyps in cystic fibrosis.
Assunto
Citocinas, Pólipos nasais, Fibrose cística, Oftalmologia
Palavras-chave
Citocinas, Fibrose cística, Polipose nasossinusal