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1
Boulton-Jones, John Robert. "Oral tolerance to soluble protein antigens in humans". Thesis, University of Edinburgh, 2001. http://hdl.handle.net/1842/22766.
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In this thesis, a protocol to demonstrate oral tolerance is described. Keyhole limpet haemocyanin (KLH), a neo-antigen, was used to demonstrate low dose tolerance. A control group was immunised with KLH and the subsequent immune response was assessed by delayed type hypersensitivity responses, in vitro lymphocyte proliferation to KLH and anti-KLH IgG and IgA production. Another group of volunteers was pre-fed a course of KLH prior to receiving the same immunisation schedule. The same measures of the immune response used in the control group were assessed and any differences were attributed to oral tolerance. A third group of volunteers was immunised with ovalbumin (OVA) and the immune response was measured. OVA is a common dietary protein and therefore was used to assess oral tolerance to extended courses of feeding. The group fed 50mg of KLH for 10 days demonstrated reduced DTH responses but without significant differences in in vitro lymphocyte proliferation and priming of anti-KLH IgG production. These changes demonstrated that oral tolerance can occur in the T cell compartment in humans after a short course of antigen feeding. In contrast, those volunteers immunised with OVA showed no in vitro lymphocyte proliferation or DTH responses. Anti-OVA IgA and IgA were detectable in low levels prior to immunisation but there was no increase in humoral response after immunisation. These results suggest that oral tolerance is more pronounced to an antigen that has been encountered over prolonged periods. The nature of the tolerance to KLH is not known. It may be the result of the induction of immunoregulatory cells or the induction of clonal anergy. Experiments were designed to test for the presence of immunoregulatory cells induced by feeding KLH, but no positive results were obtained. The mechanisms maintaining tolerance to OVA are likewise unknown. Attempts to demonstrate clonal anergy by reserving tolerance with IL-2 failed.
2
Rowsell, Paul. "Oral tolerance and immune mechanisms in food-induced diabetes". Thesis, University of Ottawa (Canada), 1996. http://hdl.handle.net/10393/9599.
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Diet controls $\sim$80% of type-I (insulin-dependent) diabetes in the diabetes-prone BioBreeding (BBdp) rat. This study was designed to define the relationship among diet, the gut immune system and the pancreas. BB rats were fed either a diabetogenic NIH-07 (NIH) diet or the diabetes protective, hydrolysed casein (HC) diet. Bovine serum albumin (BSA), ovalbumin (OVA), sheep red blood cells (SRBC) and NIH were given by gavage daily for 5 days. Both BBdp and the diabetes resistant BBc rat when fed NIH became unresponsive in antibody production to NIH antigens. None of the other oral antigen treatments induced tolerance. In delayed-type hypersensitivity (DTH) reactions, footpad injection of NIH resulted in lower DTH reactions and less increase in popliteal lymph node weight when animals were fed NIH than HC. We conclude that oral tolerance, both cell-mediated and humoral, to diabetogenic antigens is inducible in both strains of BB rats. This required daily feeding unlike in other rat strains. The depressed DTH reaction in the animals fed NIH indicates no link between the systemic Th1 DTH reaction to NIH and the Th1 food-induced diabetogenesis. Neonatal intrathymic injection of autoclaved NIH did not affect diabetes incidence, suggesting systemic exposure to these food antigens was not protective. Feeding neonatal BBdp rats a diabetogenic diet between 4 and 7d of age significantly delayed diabetes and reduced incidence. This effect was seen with the NIH diet and its diabetogenic component, wheat gluten. We conclude that early exposure to food diabetogens is protective against food-induced diabetes, indicating a crucial link between the local gut immune system and autoimmunity against pancreatic $\beta$ cells.
3
Smith, Karen Margaret. "An investigation of oral tolerance and priming in vivo". Thesis, University of Glasgow, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.269497.
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Fuller, Kathleen Ann. "Oral tolerance in experimental autoimmune encephalomyelitis : the humoral arm /". The Ohio State University, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=osu148767684711592.
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Afuwape, Adeyemi Olutosin. "Oral tolerance and sensitisation : immunoregulation after feeding of ovalbumin and cow's milk". Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312961.
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Harper, Helen Margaret. "The induction of immune responses in the murine small intestine". Thesis, University of Bristol, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.389589.
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Dieti, Anastasia. "Influence of guar galactomannan on antigen absorption and induction of immunological oral tolerance". Thesis, King's College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433117.
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Meyer, Abbie L. "Oral tolerance to myelin basic protein in mice : suppression of experimental autoimmune encephalomyelitis /". The Ohio State University, 1996. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487934589975749.
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Rider, Kelly N. "Examination of the effect of reduction of probiotic species Lactobacillus due to broad spectrum antibiotic treatment on oral tolerance". Muncie, Ind. : Ball State University, 2009. http://cardinalscholar.bsu.edu/442.
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McGarry, Robert Gerard. "Modelling insulin/glucose dynamics and application to the analysis of oral glucose tolerance tests". Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335562.
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Porter, David A. "The effect of oral coenzyme Q10 on the exercise tolerance of middle-aged, untrained men". Virtual Press, 1991. http://liblink.bsu.edu/uhtbin/catkey/776715.
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Benson, Jacqueline M. "Efficacy and mechanisms of oral tolerance to myelin basic protein in relapsing experimental autoimmune encephalomyelitis /". The Ohio State University, 1998. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487952208108922.
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Morettini, Micaela. "Mathematical model of standard oral glucose tolerance test for characterization of insulin potentiation in health". Doctoral thesis, Università Politecnica delle Marche, 2012. http://hdl.handle.net/11566/241987.
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In questo lavoro di tesi vengono proposte due diverse formulazioni (INT_M1 e INT_M2) di un nuovo modello integrato per la descrizione delle risposte del sistema di regolazione glucosio-insulina alla somministrazione orale di glucosio (oral glucose tolerance test, OGTT).
INT_M1 e INT_M2 si differenziano per la descrizione dell’assorbimento gastrointestinale adottata: un modello ad un compartimento ed una funzione empirica per il primo ed un modello a tre compartimenti non lineare per il secondo.
L’implementazione del modello in ambiente Matlab, all’interno di una nuova procedura di stima parametrica a due passi, ha permesso l’ottimizzazione di parametri caratteristici dell’assorbimento gastro-intestinale e della cinetica del glucosio, dell’insulina e dell’incretina. Il comportamento del modello è stato testato mediante best-fit di dati medi, presi dalla letteratura, delle concentrazioni plasmatiche di glucosio, insulina, di GIP (glucose-dependent insulinotropic polipeptide) e GLP-1 (glucagon-like peptide 1) misurati in due gruppi di soggetti sani (HC-1 e HC-2) sottoposti ad un protocollo OGTT standard e, successivamente, ad un protocollo endovenoso caratterizzato dalla somministrazione di un eguale andamento temporale del glucosio (isoglycemic intravenous glucose, I-IVG, infusion). I due modelli sono stati confrontati per quanto riguarda la capacità di riprodurre il potenziamento dell’insulina indotto dall’incretina ovvero l’aumentata risposta insulinica che si osserva a seguito di un OGTT paragonata a quella dell’I-IVG.
Nell’ipotesi di un’azione additiva del GIP e del GLP-1 sul potenziamento dell’insulina, i risultati hanno mostrato una sostanziale equivalenza dei due modelli nel riprodurre i dati. Inoltre, i parametri stimati sembrano essere buoni indicatori delle differenze osservate nei due gruppi di soggetti sani. Infine la procedura di stima messa a punto apre la strada a future applicazioni mirate all’individualizzazione dell’effetto incretina.Two new formulations, respectively denominated INT_M1 and INT_M2, of an integrated mathematical model to describe the glycemic and insulinemic responses to a 75 g oral glucose tolerance test (OGTT) are proposed and compared. The INT_M1 assumes a single compartment for the intestine and the derivative of a power exponential function for monophasic representation of gastric emptying rate profile. In the INT_M2, a nonlinear three-compartment system model is adopted to produce a more realistic, multiphase gastric emptying rate. Both models were implemented in a Matlab-based, two-step procedure for estimation of seven adjustable coefficients characterizing the gastric emptying rate and the incretin, insulin and glucose kinetics. Model behaviour was tested vs. data of mean plasma glucagon-like peptide 1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP), glucose and insulin concentrations provided by two different laboratories, where glycemic profiles observed during a 75 g OGTT were matched in healthy subjects (HC1- and HC2-group, respectively) by means of an isoglycemic intravenous glucose (I-IVG) infusion. Under the hypothesis of an additive effect of GLP-1 and GIP on insulin potentiation, our results demonstrated a substantial equivalence of the two models in matching the data. Model parameter estimates showed to be suitable markers of differences observed in the OGTT and matched I-IVG responses from the HC1-group compared to the HC2-group. Model implementation in our two-step parameter estimation procedure enhances the possibility of a prospective application for individualization of the incretin effect in a single subject, when his/her data are plugged in.
14
Gregg, Amy B. "The immunological effects of antibiotic treatment and probiotic populations on oral tolerance in ova fed mice". Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1371839.
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Probiotics are a live microbial supplement that reside within the intestinal tract and are considered normal flora. The Balb/c mouse model was used to determine if the elimination of probiotics, general LAB species, by antibiotics plays a role in the breakdown of oral tolerance leading to the generation of an immune response to oral antigens. A mouse model was developed for in vivo research regarding probiotic populations and the effect on the induction of oral tolerance. The Balb/c mouse was used to determine if the mouse model had a colonized intestinal tract with probiotics followed by a reduction of probiotics that was done with orally administered antibiotics. After the reduction of probiotics, mice were fed oral antigen, ovalbumin, to determine that an immune response was not shown with oral antigen alone. After the mouse model was set up, mice were then fed oral antigen and then stimulated with immunizations to study the induction of oral tolerance and the possible effect of the absence of probiotics. The results indicated that mice with reduced probiotics and fed with oral antigen alone do not show an immune response. In contrast, mice fed with oral antigen followed by immunization indicate a higher OVA-specific serum IgG. This is evidence that correlates with clinical findings in disease states such as Crohn's Disease and Irritable Bowel Syndrome (IBD).Department of Biology
15
Jewell, Scott Douglas. "The distribution of MBP-specific T cell populations in experimental autoimmune encephalomyelitis : mechanisms of oral tolerance /". The Ohio State University, 1993. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487848078449496.
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Matsunaga, Yoichi. "Oral immunization with size-purified microsphere beads as a vehicle selectivery induces systemic tolerance and sensitization". Kyoto University, 2000. http://hdl.handle.net/2433/151402.
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Klinke, Thomas, Susanne Kneist, Soet Johannes J. de, Eberhard Kuhlisch, Stephan Mauersberger, André Förster i Wolfgang Klimm. "Acid Production by Oral Strains of Candida albicans and Lactobacilli". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-133219.
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Both Candida albicans and lactobacilli are common colonizers of carious lesions in children and adolescents. The purpose of this study is to compare the velocity of acid production between C. albicans and several Lactobacillus species at different pH levels and concentrations of glucose. Washed, pure resting-cell suspensions were obtained by culturing a total of 28 oral isolates comprising the species C. albicans, Lactobacillus rhamnosus, Lactobacillus paracasei paracasei, Lactobacillus paracasei tolerans and Lactobacillus delbrueckii lactis. Acid production from glucose was determined at a constant pH of 7.0, 5.5, 5.0 and 4.0 by repeated titrations with NaOH in an automated pH-stat system. Acid formation rates of yeast and lactobacilli proved to be similar at both neutral and low pH, while in a moderately acidic environment C. albicans produced less acid than the lactobacilli. Ion chromatographic analysis of the cell-free medium after titration revealed pyruvate to be the predominant organic acid anion secreted by C. albicans. The proportion of organic acids to overall acid production by the yeast was below 10% at neutral conditions, in contrast to 42–66% at pH 4.0. Compared to lactobacilli, yeast required a concentration of glucose that was about 50 times higher to allow acid production at half the maximum speed. Considering the clinical data in the literature about the frequency and proportions of microorganisms present in early childhood caries lesions, the contribution of oral lactobacilli as well as C. albicans to overall microbial acid formation appears to be importantDieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
18
Peron, Jean Pierre Schatzmann. "O fenômeno da tolerância oral e a regulação de células patogênicas Th17 no modelo de encefalomielite experimental auto-imune". Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/42/42133/tde-17092008-113606/.
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Recentemente demonstrou-se o papel de células T produtoras de IL-17 na patogênese da esclerosa múltipla e de seu modelo, a EAE. Através da produção desta e de outras citocinas, a população chamada Th17 promove o rompimento da barreira hematoencefálica e a conseqüente infiltração de células patogênicas para dentro do SNC. Nesse contexto, em nosso trabalho utilizamos o fenômeno da tolerância oral para avaliar a capacidade deste em suprimir a resposta imune durante o modelo de EAE, mais especificamente as células Th17. Nossos dados demonstram uma diminuição de IL-17 tanto na periferia como no SNC dos animais tolerados. Além disso, detectamos menos CCL2 e IL-6 em células extraídas do CNS dia 10 pós-imunização. Não observarmos diferença na produção de IL-4,5,10, 13, IL-12p70, TNF-a, e IFN-g entre os grupos. Em suma, nossos resultados mostram que o fenômeno da tolerância oral é capaz de suprimir parâmetros de EAE devido a uma menor capacidade linfoproliferativa associada a uma supressão de células patogênicas Th17 tanto na periferia como no SNC.It has recently been shown the role of IL-17 secreting cells on the pathogenesis of multiple sclerosis and also in its model, EAE. Due to the secretion of this and other cytokines, the population so called Th17, promotes the disruption of the blood-brain barrier and the following infiltration of pathogenic cells into the CNS. In this context, in our work we used the oral tolerance phenomenon to evaluate its supressive capacity, more specifically over the Th17 cells. We showed that oral tolerated mice has a diminished production of IL-17 both in the periphery and in the CNS. Futhermore, we detected lower levels of CCL2 and IL-6 also from brain and spinal cord extracted mononucear cells at day 10th post-immunization. We were not able to detect differences on IL-4,5,10, 13, IL-12p70, TNF-a, e IFN-g between the groups. Thus, our results show that the oral tolerance phenomenon suppresses EAE findings, mainly due to a lower lymphoprolipherative response associated to a supression over the expansion of Th17 pathogenic T cells both in the periphery and inside the CNS.
19
Ljunggren, Stefan, i Robert G. Hahn. "Oral nutrition or water loading before hip replacement surgery; a randomized clinical trial". Linköpings universitet, Anestesiologi med intensivvård, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-84540.
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Background Surgery induces insulin resistance that might be alleviated by a nutritional drink given preoperatively. The authors hypothesized that some of the beneficial effects of the drink could be attributed to the volume component (approximately 1 L) rather than to the nutrients. Methods Sixty patients scheduled for elective total hip replacement under spinal anesthesia were recruited to a clinical trial, and randomly allocated to preoperative fasting, to oral ingestion of tap water, or to oral ingestion of a carbohydrate drink. An intravenous glucose tolerance test calculated glucose clearance and insulin sensitivity on the day before surgery, in the postoperative ward, and on the day after surgery. Other parameters were stress (cortisol in plasma and urine), muscle catabolism (urinary 3-methylhistidine), and wellbeing. Results Fifty-seven patients completed the study. In the postoperative ward, the glucose clearance and the insulin response had decreased from the previous day by 23% and 36%, respectively. Insulin sensitivity did not decrease until the next morning (−48%) and was due to an increased insulin response (+51%). Cortisol excretion was highest on the day of surgery, while 3-methylhistidine increased 1 day later. Follow-up on the third postoperative day showed an average of 1.5 complications per patient. Wellbeing was better 2 weeks after than before the surgery. None of the measured parameters differed significantly between the study groups. Conclusions Preoperative ingestion of tap water or a nutritional drink had no statistically significant effect on glucose clearance, insulin sensitivity, postoperative complications, or wellbeing in patients undergoing elective hip surgery.Funding Agencies|Olle Engkvist Byggmastare Foundation||Stockholm County Council|2009-0433|
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Xavier, Aurelizia Maria Lemos. "Estudo imunológico e histopatológico da infecção experimental por Schistosoma mansoni em camundongos geneticamente selecionados para tolerância oral". Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=8174.
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A esquistossomose acomete 207 milhões de pessoas, com mais de 200 mil mortes anuais. Seu principal agente etiológico é o helminto Schistosoma e o principal modelo experimental, o camundongo. Linhagens de camundongos selecionadas geneticamente para susceptibilidade (TS) e resistência (TR) a tolerância imunológica constituem bons modelos para o estudo da resposta imunológica específica e inespecífica nas infecções. O objetivo deste trabalho foi caracterizar a infecção experimental por S. mansoni nestes camundongos, evidenciando a imunopatologia por diversos parâmetros na fase aguda da infecção. TR e TS não diferiram quanto a penetração de cercárias, recuperação de vermes adultos, fecundidade/produtividade de ovos das fêmeas de S. mansoni, mas predominaram ovos mortos em TS. Quanto maior o número de casais, maior a probabilidade de troca de casais e regressão sexual da fêmea, além de pequena redução da produtividade de ovos. Análise ultraestrutural dos parasitos machos recuperados de TS apresentaram tubérculos edemaciados, espinhos encurtados e em menor densidade que os parasitos dos TR. O tegumento dos parasitos recuperados de TS apresentou-se desorganizado, intensamente vacuolizado e com tendência a se desprender da superfície e espinhos internalizados e células vitelínicas desorganizadas. TS desenvolveram granulomas hepáticos grandes, com fibras radiais e predomínio do estágio exsudativo-produtivo com características de fase produtiva (EP/P), enquanto camundongos TR desenvolveram granulomas menores, com fibras concêntricas e predomínio de granulomas exsudativo-produtivos. TS desenvolveu hepatomegalia mais acentuada na fase aguda da infecção e exacerbada esplenomegalia na fase crônica. A aspartato aminotransferase mais elevada nos TR foi coerente com a acentuada histólise nos granulomas iniciais dos TR. É possível que a histólise menor em TS tenha contribuído para sua intensa hepatomegalia na fase aguda. Leucócitos totais séricos aumentaram em TS, nas fases aguda e crônica, mas não em TR. TS apresentaram anemia durante a fase crônica da infecção, possivelmente devido ao desvio na hematopoiese medular para a produção de leucócitos ou apoptose das hemácias. A mieloperoxidase neutrofílica hepática e no íleo foi maior em TS e a peroxidase de eosinófilos foi mais elevada no íleo do TS. Ambas as linhagens produziram IFN-γ, mas os níveis funcionais de IFN-γ foram diferentes nas duas linhagens em cultura de células. É possível que a imunopatologia hepática grave na linhagem TS possa estar relacionada aos altos títulos IFN-γ. TS produziu IL-10 em maior quantidade, entretanto esta citocina não foi capaz de regular o crescimento exacerbado dos granulomas hepáticos. Altos títulos de IL-4 na linhagem TS também são coerentes com a exacerbação dos granulomas, pois, como a IL-13, a IL-4 induz síntese de colágeno e está relacionada ao desenvolvimento da fibrose no granuloma esquistossomótico. Observamos redução do percentual relativo de células T CD4+ hepáticas de animais infectados em ambas as linhagens e redução percentual nas subpopulações de linfócitos B na medula óssea (precursores, linfócitos B imaturos, maduros e plasmócitos) mais acentuada em TS que em TR, possivelmente devido a extensa mobilização de B imaturos induzida pela inflamação ou desvio da hematopoiese para síntese de granulócitos em TS. Quantitativamente, TR não alterou suas subpopulações de linfócitos B. TS e TR são bons modelos para estudo da resposta imunológica na infecção esquistossomótica experimental. Novos estudos são necessários para confirmar nossas propostas e compreender os mecanismos envolvidos na diferença da resposta imunológica dessas linhagens na relação schistosoma-hospedeiro.Schistosomiasis affects 207 million people, with more than 200 000 deaths annually. Its main etiological agent is the helminth Schistosoma and the main experimental model, the mouse. Strains of mice genetically selected for susceptibility (TS) and resistance (TR) immunological tolerance are good models for the study of specific and nonspecific immune response in infections. The objective of this study was to characterize the experimental infection with S. mansoni in these mice, demonstrating the immunopathology of several parameters in the acute phase of infection. TR and TS did not differ in the penetration of cercariae, adult worms recovery, fecundity/ productivity of eggs from females of S. mansoni, but dead eggs prevailed in TS. The greater the number of couples, the more probability of changing couples and female sexual regression, and slight reduction of the eggs productivity. Ultrastructural analysis of parasites recovered from TS males had swollen tubercles, shortened spines and lower density of them than the parasites of TR. The tegument of the parasites recovered from TS appeared disorganized, intensely vacuolated and with a tendency to detach from the surface and internalized spines and disorganized vitelline cells. TS developed large hepatic granulomas with radial fibers and predominance of exudative-productive stage with characteristics of productive stage (EP/P), while TR mice developed smaller granulomas, with concentric fibers and predominance of exudative-productive granulomas. TS developed hepatomegaly more pronounced in the acute phase of infection and exacerbated splenomegaly in chronic phase. The aspartate aminotransferase was higher in TR mice consistent with the marked histolysis in initials TR granulomas. It is possible that the lower histolysis in TS mice has contributed to its severe hepatomegaly in acute phase. Serum total leukocytes increased in TS acute and chronic phases, but not in TR. TS had anemia during the chronic phase of infection, possibly due to deviation in bone marrow hematopoiesis for the production of leukocytes or apoptosis of red blood cells. The neutrophil myeloperoxidase from liver and ileum were higher in TS and the eosinophil peroxidase was higher in the TS ileum. Both strains produced IFN-γ, but functional levels of IFN-γ were different in the two strains in cell culture. It is possible that severe liver immunopathology in TS strain may to be related to high IFN-γ titers. TS produced IL-10 in larger quantities, however this cytokine was not able to regulate the overgrowth of hepatic granulomas. High levels of IL-4 in TS strain are also consistent with the exacerbation of granulomas, because as IL-13, IL-4 induces collagen synthesis and is related to the development of fibrosis in schistosomal granuloma. We observed reduction in the relative percentage of TCD4 + liver cells of infected animals in both strains and percentage reduction in subpopulations of B lymphocytes in bone marrow (precursors, immature and mature B lymphocytes, plasma cells) stronger in TS than TR, possibly due to extensive mobilization of immature B cells induced by inflammation or hematopoiesis deviation for synthesis of granulocytes in TS. Quantitatively, TR did not change their subpopulations of B lymphocytes. TS and TR are good models for studying the immune response in experimental schistosome infection. Further studies are needed to confirm our proposals and to understand the mechanisms underlying the difference in immune response of these strains in the relationship schistosoma-host.
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Klinke, Thomas, Susanne Kneist, Soet Johannes J. de, Eberhard Kuhlisch, Stephan Mauersberger, André Förster i Wolfgang Klimm. "Acid Production by Oral Strains of Candida albicans and Lactobacilli". Karger, 2009. https://tud.qucosa.de/id/qucosa%3A27496.
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Both Candida albicans and lactobacilli are common colonizers of carious lesions in children and adolescents. The purpose of this study is to compare the velocity of acid production between C. albicans and several Lactobacillus species at different pH levels and concentrations of glucose. Washed, pure resting-cell suspensions were obtained by culturing a total of 28 oral isolates comprising the species C. albicans, Lactobacillus rhamnosus, Lactobacillus paracasei paracasei, Lactobacillus paracasei tolerans and Lactobacillus delbrueckii lactis. Acid production from glucose was determined at a constant pH of 7.0, 5.5, 5.0 and 4.0 by repeated titrations with NaOH in an automated pH-stat system. Acid formation rates of yeast and lactobacilli proved to be similar at both neutral and low pH, while in a moderately acidic environment C. albicans produced less acid than the lactobacilli. Ion chromatographic analysis of the cell-free medium after titration revealed pyruvate to be the predominant organic acid anion secreted by C. albicans. The proportion of organic acids to overall acid production by the yeast was below 10% at neutral conditions, in contrast to 42–66% at pH 4.0. Compared to lactobacilli, yeast required a concentration of glucose that was about 50 times higher to allow acid production at half the maximum speed. Considering the clinical data in the literature about the frequency and proportions of microorganisms present in early childhood caries lesions, the contribution of oral lactobacilli as well as C. albicans to overall microbial acid formation appears to be important.Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
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Crimmins, Nancy. "Prevalence and Predictors of Abnormalities in Carbohydrate Metabolism in a Cohort of Obese Youth". University of Cincinnati / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1258490989.
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Legere, Susan Elena. "Narratives of Injustice: Measuring the Impact of Witness Testimony in the Classroom". Thesis, Boston College, 2012. http://hdl.handle.net/2345/2599.
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Thesis advisor: Paul S. GrayCan a vivid presentation about a tragic chapter of history elicit in viewers an empathetic reaction, as well as evidence of the telescopic perspective Mills[1] ([1959] 2000) described as the "sociological imagination"? Does the addition of victims' voices make a noticeable difference in their response to the historical event, as well contemporary controversies? Some scholars propose that oral histories, especially witness testimonies, have the potential to reach audiences more deeply than facts alone. "Narratives," as K. Slobin observed, "unfold with flesh and blood...encouraging empathy, identification and a humanization of content" (in Bochner and Ellis, 1992:171).[2] But, little systematic research has examined how or to what extent personal testimony may encourage empathetic understanding and a broader, more nuanced understanding of social problems. In an era where entertainment content skews toward "reality" programming and technology supersedes face-to-face interactions, the challenge to pierce cultural white noise is great. Educators, then, must figure out ways to counteract the desensitization, apathy and cynicism that follow these trends--but in ways that are proven, effective and lasting. My research sought to discover if victim narratives help students connect intellectually and emotionally with lessons about social justice. Thirteen undergraduate classes were exposed to three variations of a fact-based, multimedia presentation about Japanese internment in America during WWII. Each presentation included the same photographs, newsreel, and factual information. Presentations varied, however, in their use of survivor testimony and in the manner of its incorporation (video versus written accounts). Two groups of the sample were exposed to survivors describing their experiences in the internment camps. All groups completed surveys, and 21 participants gave extensive interviews. Data analysis examined information recall, sociological perspective, emotional response, empathetic identification and predictions of future behavior. The experiment generated much-needed empirical data on the efficacy of testimony and its ability to shape attitudes, broaden world view, and possibly influence behavior. These findings will assist educators in anticipating outcomes associated with various heuristic strategies, especially those including witness testimonies. [1] Mills, C. Wright. 1959. The Sociological Imagination. New York: Oxford, 2000. [2] Bochner, Arthur P. and Caroyln Ellis. 1992. "Personal Narrative as a Social Approach to Interpersonal Communication." Communication Theory 2(2)165-172. Comment from K. Slobin is listed as a personal communication with the authors in February 1991
Thesis (PhD) — Boston College, 2012
Submitted to: Boston College. Graduate School of Arts and Sciences
Discipline: Sociology
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Helm, Jennifer. "Assessing glycaemic control in cystic fibrosis". Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/assessing-glycaemic-control-in-cystic-fibrosis(44f8e211-ef09-468d-ad22-f393457eb51b).html.
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Four studies investigating the assessment of glycaemic control in cystic fibrosis are presented within this thesis. The first was a validation study of continual glucose monitoring (CGM) in cystic fibrosis (CF). 50 stable adults with CF underwent home CGM for 3 days, during which time they attended the CF centre for OGTT. Gold standard fasting (0 hour) plasma glucose and 2 hour plasma glucose values during OGTT were compared with concurrent CGM sensor glucose values using a 'limits of agreement' analysis. CGM was found to be valid in adults with CF, with its accuracy being consistent with that published in non-CF populations. The next investigation compared OGTT with CGM with several objectives: to determine whether OGTT is a relevant and adequate measure of glycaemia in CF, find out whether CGM could offer a superior alternative to OGTT and explore whether OGTT and CGM results are associated with prior change in lung function and weight in adults with CF. Data from the first study was used to show that the OGTT can only identify abnormal glycaemic control in CF at a late stage, and that CGM is a more relevant reflection of everyday glycaemia in CF. No correlation was found between prior change in lung function and nutritional status in CF and glycaemia measured by OGTT or CGM. The subsequent study investigated whether CGM could identify early abnormal glycaemic control in CF. This involved ten non-CF healthy controls undergoing the same study protocol as the 50 stable adults with CF, to determine 'normal' glycaemic control parameters. Of 25 CF patients with normal glucose tolerance by OGTT, 19 (76%) had significantly higher mean and/or variability of CGM levels than healthy controls. This lead to changes in their management, including 2 subjects being commenced on insulin therapy. The final investigation was a questionnaire study, asking the 50 CF patients to provide information on their experience of undergoing CGM. 58% of patients responded, with replies indicating that they found CGM broadly acceptable, interfering little in their lives and that their experiences were generally positive. This insight into patients' experiences of CGM can be used to guide future clinical and research roles for this tool. These studies have provided novel data regarding the assessment of glycaemic in CF. Information captured by CGM has greater relevance to CF patients' daily lives than OGTT. CGM can identify early problems with glycaemic control leading to changes in management that may not be detected by conventional measures. CGM offers potential in further clinical application and research to improve the lives and outcomes for adults with CF.
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Delgobo, Murilo. "MODULAÇÃO DA RESPOSTA IMUNE FRENTE À INDUÇÃO DE TOLERÂNCIA ORAL A TOXINA DERMONECRÓTICA PRESENTE NO VENENO DE Loxosceles intermedia e TOLERÂNCIA ORAL SOB A PERSPECTIVA DE SISTEMAS COMPLEXOS". UNIVERSIDADE ESTADUAL DE PONTA GROSSA, 2014. http://tede2.uepg.br/jspui/handle/prefix/984.
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Previous issue date: 2014-02-21Brown-Spider’s venom (Loxosceles sp.) is presented as a complex mixture of toxins, able to induce skin necrosis with gravitational spreading, intense inflammatory response, edema induction and increase in vascular permeability in vivo. Recently, the biotechnological potential of the toxins was explored by its use in clinical test, in the study of inflammatory response, as a research tool in cell biology, as a biopesticide and in immunotherapy, through the production of antiserum. In this context, immunotherapy is broadly spread through the production of vaccines, available for the treatment of deleterious reactions developed in accidents. In the present work, we investigated if immunological tolerance induction to dermonecrotic recombinant toxin (LiRecDT1) and its mutated form (LiRecDT1 H12A), through its oral administration, could modulate inflammatory and deleterious responses triggered by dermonecrotic toxin. For this purpose, an oral tolerance protocol was designed, consisting in the administration of 10 μg of LiRecDT1 and LiRecDT1 H12A three times in a week, for three weeks. Adult Swiss mice were further immunized, and oral tolerance induction was observed by reduction in serum levels of IgG antibody anti-toxin when compared with control group. It was observed that mice tolerant to LiRecDT1 H12A present a reduction in paw edema, caused by the injection of 6 μg of dermonecrotic toxin in plantar surface hind paw. Mice tolerized with LiRecDT1 and challenged with 50 μg of dermonecrotic toxin, exhibited higher survival, when compared to control group. This effect was not observed in mice tolerized to LiRecDT1 H12A. The present findings suggested that oral tolerance induction to LiRecDT1 H12A was able to alleviate inflammatory responses triggered by dermonecrotic toxin in paw edema and oral tolerance to LiRecDT1 increase survivability in challenge. The results shown that LiRecDT1 and LiRecDT1 H12A can be explored as a tool in the induction and study of oral tolerance phenomena. The generation of T regulatory cells (Tregs) and following involvement of immunosuppressive cytokines might take part in the modulation of immune response.
O veneno de aranha-marrom (Loxosceles sp.) apresenta-se como uma mistura complexa de toxina, capazes de causar necrose com espalhamento local, intensa resposta inflamatória, indução de edema e aumento da permeabilidade vascular in vivo. Recentemente, o potencial biotecnológico das toxinas foi explorado através de seu uso em análises clínicas, no estudo da resposta inflamatória, como ferramenta de pesquisa na biologia celular, como biopesticidas e na imunoterapia, através da produção de anti-soro. No presente trabalho, foi investigado se a indução de tolerância imunológica à toxina dermonecrótica recombinante (LiRecDT1) e sua forma mutada (LiRecDT1 H12A), através de sua administração oral, poderia modular as respostas inflamatórias e deletérias causadas pela toxina dermonecrótica. Para tal, foi desenvolvido um protocolo para indução de tolerância oral, consistindo na administração de 10 μg de LiRecDT1 e LiRecDT1 H12A três vezes por semana, durante três semanas. Camundongos Swiss fêmeas adultas foram posteriormente imunizadas, e a indução de tolerância foi confirmada pela diminuição nos níveis de anticorpos IgG anti-toxina em relação ao grupo controle, resultado que aponta a obtenção de sucesso na indução de tolerância imunológica. Observou-se que animais tolerantes a LiRecDT1 H12A apresentaram uma diminuição no edema desenvolvida na pata, causado pela aplicação de 6 μg de LiRecDT1 na superfície plantar traseira. Animais tolerizados com LiRecDT1 e desafiados com 50 μg intraperitoneal de toxina dermonecrótica apresentaram maior índice de sobrevivência, quando comparados ao grupo controle. Esse efeito não foi observado em animais tolerizados com LiRecDT1 H12A. Os dados obtidos no presente trabalho sugerem que a indução de tolerância oral à LiRecDT1 H12A é capaz de atenuar o desenvolvimento da resposta inflamatória no edema de pata, enquanto a tolerância oral a LiRecDT1 foi capaz de aumentar a sobrevivência em animais desafiados com LiRecDT1. Os resultados demonstram que as toxinas LiRecDT1 e LiRecDT1 H12A podem ser exploradas como ferramenta na indução e estudo da tolerância oral. A geração de células T regulatórias (Tregs) e subsequente participação de citocinas imunossupressoras devem estar envolvidas na modulação da resposta imune.
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Ruberti, Maristela 1975. "Caracterização fenotípica e funcional das células imunocompetentes da mucosa intestinal envolvidas na tolerância oral a ovalbumina". [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/317404.
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Orientador: Wirla Maria da Silva Cunha TamashiroTese (doutorado) - Universidade Estadual de Campinas, Instituto de Biologia
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Resumo: Trabalhos anteriores de nosso laboratório mostraram que camundongos transgênicos DO11.10, cuja maioria dos linfócitos T expressam TCR específico para ovalbumina (OVA) no contexto de...Observação: O resumo, na íntegra, poderá ser visualizado no texto completo da tese digital
Abstract: Previous work from our laboratory showed that DO11.10 transgenic mice, in which the most of T lymphocytes express TCR specific for ovalbumin (OVA) in the context of...Note: The complete abstract is available with the full electronic document
Doutorado
Imunologia
Doutor em Genetica e Biologia Molecular
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Santos, Patricia Barros dos. "Efeito imunomodulatório do resveratrol em células do sistema imune in vitro e na administração via oral de ovalbumina em camundongos". Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/9/9134/tde-06082010-142006/.
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O resveratrol, um polifenol de origem natural, é descrito como uma substância antiinflamatória, antioxidante, cardioprotetora e anticancerígena. Diversos estudos comprovam a atividade imunomodulatória do resveratrol in vitro e in vivo, estimulando ou diminuindo a secreção de citocinas envolvidas na resposta Th1/Th2. Além do uso em vacinas como adjuvantes, a descoberta de novas substâncias imunomodulatórias pode ser aplicada na profilaxia e tratamento de doenças imunodegenerativas com perda da tolerância sistêmica ou periférica. O objetivo desse estudo é relacionar o efeito modulador do resveratrol em ensaios de endocitose em macrófagos e de secreção de citocinas IL-6(produção de IgA) e IL-10(resposta Th2 e tolerância em mucosas) com a produção de anticorpos anti-ova IgG e IgA após imunização via-oral. Os resultados obtidos demonstraram que in vitro, houve aumento da endocitose em macrófagos e diminuição na secreção de IL-6 pelas células isoladas de placas de peyer em concentrações abaixo de 50 µM de resveratrol. Após a administração oral de resveratrol de 5 mg e 10 mg/kg observou-se o aumento significativo da secreção de IL-10 em esplenócitos isolados de camundongos Balb/C. Nos grupos imunizados com 1 mg de ovalbumina/animal e resveratrol (5 mg e 10 mg/kg) via oral 2 vezes, com 14 dias de intervalos, houve aumento significativo da produção de IgG sérico em relação ao grupo imunizado somente com ovalbumina. Porém a produção de IgA sérico e em lavado intestinal diminuiu, indicando um possível aumento da tolerância oral. Esses resultados demonstram o efeito imunomodulador do resveratrol in vitro/in vivo e a necessidade de maiores estudos sobre o uso desta substãncia como adjuvante de vacinas ou uma droga imunossupressora de mucosa.Resveratrol, a polyphenol of natural origin, is described as a substance-inflammatory, antioxidant, cardioprotective and anticancer. Several studies have demonstrated the immunomodulatory activity of resveratrol in vitro and in vivo, stimulating or decreasing the secretion of cytokines involved in Th1/Th2 response. Besides the use as adjuvants in vaccines, the discovery of new immunomodulatory substances can be applied for prophylaxis and treatment of diseases imunodegenerativas with loss of peripheral tolerance or systemic. The aim of this study is to relate the modulating effect of resveratrol on tests of endocytosis in macrophages and secretion of IL-6 (IgA production) and IL-10 (Th2 response and mucosal tolerance) with the production of anti-ova IgG and IgA after oral immunization route. The results of in vitro tests showed an increase of endocytosis in macrophages and decrease in IL-6 secretion by cells isolated from Peyer\'s patches at concentrations below 50 mM of resveratrol. After oral administration of resveratrol 10 mg / kg was observed to significantly increase the secretion of IL-10 in splenocytes isolated from Balb / C. In groups immunized with 1 mg ovalbumin / animal and resveratrol (5 mg and 10 mg / kg) orally two times with 14 days intervals, significant increase of IgG level in relation to the group immunized with ovalbumin only. But the production of IgA in serum and intestinal lavage decreased, indicating a possible increase in oral tolerance. These results demonstrate the immunomodulatory effect of resveratrol in vitro / in vivo and the need for more studies on substance use as a vaccine adjuvant or immunosuppressive drugs mucosa.
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Ferreira, Tamara Nascimento. "Potencial das toxinas recombinantes Potencial das toxinas recombinantes do veneno de aranha marrom como ferramentas na indução de tolerância oral e imunomodulaçãodo veneno de aranha marrom como ferramentas na indução de tolerância oral e imunomodulação". Universidade Estadual de Ponta Grossa, 2015. http://tede2.uepg.br/jspui/handle/prefix/2432.
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A tolerância oral é definida como uma supressão a respostas imunológicas específicas após imunização com um antígeno que foi previamente administrado por via oral. Esse método tem sido estudado, nas últimas décadas, como uma ferramenta na redução de respostas imunes humorais e celulares envolvidas em doenças autoimunes e alergias e parece ser uma alternativa para reduzir ou retardar a rejeição de transplantes. Neste estudo investigamos o potencial das toxinas dermonecróticas recombinantes do veneno da aranha marrom Loxosceles intermedia em induzir estado de tolerância de mucosas em modelo animal, avaliando os mecanismos celulares envolvidos e a resposta imune do animal tolerante frente a estímulos imunológicos específicos e inespecíficos. As toxinas recombinantes utilizadas para indução da tolerância oral foram a LiRecDT1 (com atividade dermonecrótica) e sua forma mutada, LiRecDT1H12A, (com atividade dermonecrótica residual). Para indução de tolerância oral foi utilizado protocolo com baixas doses de antígeno, onde foram tolerizados camundongos adultos Swiss, tratados oralmente com as toxinas recombinantes durante 21 dias, num total de 90g por animal. Para investigar possíveis mecanismos envolvidos na tolerância oral, foi avaliada a expressão fator de transcrição Foxp3 e da citocina TGF-β. Após o protocolo de tolerização os linfonodos mesentéricos foram processados para ensaio de western blotting e a expressão do fator de transcrição Foxp3 e da citocina TGF-β foram avaliados. Os grupos tolerizados com ambas as toxinas mostraram um aumento na expressão dos dois componentes, demonstrando que um dos mecanismos de tolerância oral no nosso modelo pode envolver aumento na população de linfócitos T regulatórios. Esse resultado pode ser reforçado pela dimimuição de edema de pata em camundongos naive que receberam, via intravenosa, esplenócitos de animais tolerizados com a toxina LiRecDT1 H12A (transferência adotiva). Além disso, pudemos observar que a tolerância induzida pela toxina LiRecDT1 H12A se estendeu a antígenos não relacionados (tolerância cruzada) com diminuição na produção de anticorpos IgG específicos e edema de pata em animais desafiados com veneno da vespa Polybia paulista. A tolerância oral induzida pela toxina LiRecDT1 H12A também permitiu aparente redução da resposta imunológica do animal tolerante frente ao enxerto alogênico de camundongos C57BL/6. Considerando os resultados obtidos é possível concluir que a tolerância oral induzida pelas toxinas LiRecDT1 e LiRecDT1 H12A pode envolver aumento na população de linfóticos T regulatórios cuja produção de citocinas anti-inflamatórias, pelo menos na tolerância induzida pela toxina LiRecDT1 H12A, pode reduzir a resposta imune a antígenos específicos e inespecíficos na tolerância cruzada e na redução de rejeição a transplantes.
Oral tolerance refers to physiologic induction of immunosuppression that occurs in mucosal induced by oral administration of an antigen. This method has been used to induce reduction of humoral and cellular responses involved in autoimmune diseases, allergies and may be an alternative to reduce transplant rejection. We investigated potential of dermonecrotic recombinant toxins of brown spider Loxosceles intermedia specie to induce a state of mucosal tolerance in a animal model. We did this by assessing the cellular mechanisms involved and the immune response of tolerant animals against specific and nonspecific immune stimulation. Dermonecrotic toxin LiRecDT1 and its mutated form, LiRecDT1 H12A (with residual dermonecrotic activity), has been used. Mice were treated with recombinant toxins, orally, for 21 days, with a total of 90g per animal. After oral tolerance protocol, mesenteric lymph nodes were processed for western blotting and the expression of nuclear transcription factor Foxp3 and cytokine Tgf-β were analyzed. LiRecDT1 and LiRecDT1 H12A tolerant groups showed an increase in expression of both proteins, which could be related to a increase in regulatory T-cells population. Adoptive transfer of splenocytes to naive mice from LiRecDT1 H12A tolerated group induced paw edema reduction, with supports this theory (adoptive transfer). Our results also demonstrated a bystander tolerance when LiRecDT1 H12A tolerated mice showed a decrease in IgG production and paw edema induction by Polybia paulista wasp venom. LiRecDT1 H12A tolerance also showed an apparent reduction in skin allograft rejection using C57BL/6 mice as donor and tolerated Swiss mice as receptor. Considering the results we concluded that oral tolerance induced by LiRecDT1 and LiRecDT1 H12A toxins could be involve increase in Tregs and non-inflammatory cytokines, and LiRecDT1 H12A tolerance can reduce specific and non specific immunology responses and allografts transplants rejection.
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Thomé, Rodolfo 1987. "Modulação da artrite experimental induzida pela associação de colágeno tipo II e ovalbumina". [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/317410.
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Orientadores: Wirla Maria da Silva Cunha Tamashiro. Patrícia Ucelli SimioniDissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia
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Resumo: O camundongo BALB/c, linhagem geneticamente resistente à artrite induzida por colágeno (CIA), pode desenvolver um quadro similar ao de camundongos susceptíveis quando uma proteína não relacionada ao próprio, como a ovalbumina (OVA), é associada a colágeno tipo II (CII). Utilizando esse modelo, avaliamos se a tolerância oral a OVA poderia interferir nas respostas imunes contra CII, bem como o efeito da transferência adotiva de células dendríticas (DCs) tolerogênicas para camundongos artríticos. Para avaliação dos efeitos da tolerância oral sobre o desenvolvimento de artrite em BALB/c, os camundongos foram alimentados com OVA misturada à água de beber na concentração de 4mg/mL, por sete dias consecutivos, antes ou depois do desafio com CII+OVA (100?g/mL de cada antígeno). Para avaliar a participação de células dendríticas (DCs) tolerogênicas na modulação da artrite em BALB/c, células CD11c+ foram isoladas de baços de animais tolerantes à OVA e transferidas adotivamente para camundongos naïve, que foram subsequentemente imunizados com CII+OVA (100?g de cada antígeno). Para acompanhamento da evolução dos quadros de artrite, foram avaliados: o edema de patas, tomando-se regularmente as medidas de espessura de patas; realizadas análises histológicas dos tecidos articulares de joelhos e; conduzidas avaliações ex-vivo dos níveis séricos de anticorpos anti-CII e de respostas proliferativas e produção de citocinas de linfócitos T esplênicos. O tratamento com OVA antes da indução de CIA preveniu o desenvolvimento da artrite em todos os parâmetros analisados, enquanto que o tratamento com OVA após o estabelecimento da doença reduziu significativamente a inflamação e a produção de anticorpos anti-CII. Observamos ainda que a transferência de DCs tolerogênicas preveniu o aparecimento dos sinais clínicos da doença e o aumento dos níveis de anticorpos específicos no soro e reduziu significativamente a proliferação de linfócitos T CII-específicos. Enquanto a frequência de células CD4+CD25+Foxp3+ foi maior nas culturas de células de animais recipientes de DCs tolerogênicas, houve redução significativa na frequência de células produtoras de IFN? e IL-17. Os níveis de TGF-?, IL-4 e IL-10 foram significativamente mais elevados nas culturas de células esplênicas de animais recipientes de DCs tolerogênicas, enquanto que os de IFN-?, IL-6 e TNF-? foram mais reduzidos. Tomados em conjunto, nossos resultados indicam que a tolerância oral a um antígeno não relacionado ao próprio modifica o curso da artrite experimental em resposta ao colágeno, e que células dendríticas com perfil tolerogênico estão envolvidas nos fenômenos observados
Abstract: BALB/c mice, genetically resistant to collagen-induced arthritis (CIA), can develop a inflammatory condition resembling what is observed in susceptible strains when a non-related protein, such as ovalbumin (OVA), is associated with type II collagen (CII). Using this model, we evaluated whether oral tolerance to OVA could interfere in the immune response against CII, as well as the effect of adoptive transfer of tolerogenic dendritic cells (DCs) to arthritic mice. In order to evaluate the effect of oral tolerance over arthritis development in BALB/c mice, animals were fed with OVA in the drinking water at a 4mg/mL concentration, for seven consecutive days, before or after challenge with CII+OVA (100?g of each antigen). In order to evaluate the participation of tolerogenic DCs in the modulation of arthritis, splenic CD11c+ cells were isolated from OVA tolerant mice and adoptively transferred to naïve mice, which were subsequently immunized with CII+OVA. In order to monitor the evolution of the severity of arthritis, we evaluated paw edema, taking paw thickness regularly measured; performed histological analyses of articular knee tissues and, conducted ex-vivo evaluation of serum specific antibody levels and proliferation and cytokine secretion of splenic T lymphocytes. The treatment with OVA before CIA induction prevented the development of arthritis in all analyzed parameters, while the treatment after disease onset significantly reduced inflammation and CII-specific antibody production. We also observed that tolerogenic DC transfer prevented the appearance of clinical signs of arthritis, the increase of serum specific antibody levels and significantly reduced CII-specific T lymphocytes proliferation. While the frequency of CD4+CD25+Foxp3+ cells were higher in cell culture from tolerogenic DC recipient mice, frequency of IFN?- and IL-17- producing cells were significantly reduced. We observed that levels of TGF-?, IL-4 and IL-10 were significantly higher in cultures of splenic cells from mice recipient of tolerogenic DC, while levels of IFN-?, IL-6 and TNF-? were reduced. Taken together, our results indicate that oral tolerance to a non-related antigen modifies the course of experimental arthritis in response to collagen, and that dendritic cells with a tolerogenic profile are involved in the observed phenomena
Mestrado
Mestre em Genética e Biologia Molecular
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Ruiz, Viviane Christina. "Papel da indução de tolerância oral no remodelamento de vias aéreas e na expressão da óxido nítrico sintase neuronal". Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-17102014-102736/.
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INTRODUÇÃO: A indução de tolerância oral atenua a resposta inflamatória e a produção de anticorpos anafiláticos secundários presentes em quadros alérgicos pulmonares tanto em humanos quanto em modelos experimentais. Nestas situações, a modulação do remodelamento brônquico e o papel do óxido nítrico não foram previamente estudados. OBJETIVOS: 1. Desenvolver dois modelos de tolerância oral em cobaias com inflamação crônica pulmonar caracterizando: mecânica pulmonar, hiper-responsividade a metacolina, óxido nítrico exalado (NOex), anticorpos IgG1, inflamação brônquica e eosinofilopoiese. 2. Avaliar o remodelamento brônquico e a expressão da enzima óxido nítrico sintase neuronal (nNOS) no epitélio brônquico nestes animais. MÉTODOS: As cobaias receberam inalações de ovoalbumina ou soro fisiológico durante 15 minutos ou até que apresentassem desconforto respiratório (este tempo foi denominado tempo de inalação). O protocolo foi repetido duas vezes por semana durante quatro semanas. Para a indução da tolerância foi administrada ovoalbumina a 2% por via oral e oferecida ad libitum, sendo formados os grupos: 1. TO1 (recebeu ovoalbumina oral a 2% a partir da primeira inalação com ovoalbumina); 2. TO2 (recebeu ovoalbumina oral a 2% a partir da quarta inalação com ovoalbumina); 3. SAL (recebeu água ad libitum e inalações com soro fisiológico); 4. OVA (recebeu água ad libitum e inalações com solução de ovoalbumina). Após os animais serem anestesiados e ventilados, foram avaliados: 1. mecânica pulmonar basal e após inalação com ovoalbumina (30mg/ml) ou soro fisiológico, 2. hiper-responsividade brônquica à metacolina, 3. coletado o NOex. Ao final do experimento, os fragmentos pulmonares foram retirados e corados com hematoxilina e eosina, com a técnica histoquímica cianeto resistente para peroxidase eosinofílica (células EPO+), com a técnica imunoistoquímica para a detecção da óxido nítrico sintase neuronal (nNOS) e com resorcina-fucsina, resorcina-fucsina oxidada e picro-sírius. A medula óssea foi retirada e corada com hematoxilina e eosina. O índice de edema peribrônquico, as células EPO+, os mononucleares e os polimorfonucleares brônquicos e os eosinófilos da medula óssea foram avaliados por morfometria. As células epiteliais brônquicas nNOS+ e as fibras elásticas e colágenas foram avaliadas por densitometria óptica. Os anticorpos IgG1 foram detectados por anafilaxia cutânea passiva. A análise estatística foi feita com o programa SigmaStat e considerado significante um P<0,05. RESULTADOS: Nos grupos TO1 e TO2 houve aumento no tempo de inalação, diminuição na resposta máxima de elastância do sistema respiratório após desafio antigênico e com metacolina, diminuição do edema peribrônquico, dos eosinófilos, dos polimorfonucleares, das fibras elásticas e colágenas, da eosinofilopoiese e dos títulos de IgG1 (P < 0,05). Os mononucleares, a resposta máxima de resistência do sistema respiratório depois do desafio antigênico, e a metacolina diminuíram em TO2 (P < 0,05). O NOex e a percentagem de células epiteliais nNOS+ não foram alterados nos grupos tolerizados. CONCLUSÕES: A indução de tolerância oral concomitante ao início da sensibilização ou depois de estabelecida a resposta alérgica foi capaz de atenuar a inflamação eosinofílica, os títulos de IgG1 e o remodelamento brônquico presentes neste modelo de inflamação crônica pulmonar. A redução dos linfomononucleares e da hiper-responsividade brônquica foi mais efetiva quando a indução de tolerância foi feita em animais previamente sensibilizados. A dissociação entre o controle da inflamação eosinofílica e a avaliação do NOex e da expressão da nNOS no epitélio brônquico sugere um mecanismo novo ativado pela indução de tolerância oralINTRODUCTION: The oral tolerance induction attenuates the inflammatory response and the production of secondary anaphylactic antibodies present in pulmonary allergy pictures in humans as well as in experimental models. In these situations, the bronchial remodeling modulation and the role of nitric oxide have not been previously studied. OBJECTIVES: 1. To develop two models of oral tolerance in guinea pigs with chronic pulmonary inflammation, characterizing: pulmonary mechanics, hyperreponsiveness to methacholine, exhaled nitric oxide (NOex), IgG1 antibodies, bronchial inflammation and eosinophylopoiesis. 2. To evaluate the bronchial remodeling and the expression of the neuronal nitric oxide synthase enzyme (nNOS) in bronchial epithelium of these animals. METHODS: The guinea pigs were submitted to ovalbumin or saline solution inhalation for 15 minutes or until they presented respiratory stress (this time period was called inhalation time). The protocol was repeated twice a week for 4 weeks. Oral tolerance induction was carried out by the administration of 2% oral ovalbumin, offered ad libitum, and the following groups were formed: 1. OT1 (received 2% oral ovalbumin from the first ovalbumin inhalation; 2. OT2 (received 2% oral ovalbumin from the fourth ovalbumin inhalation; 3. SAL (received water ad libitum and saline solution inhalations; and 4. OVA (received water ad libitum and ovalbumin solution inhalations). After being anesthetized, the animals were ventilated and evaluated regarding: 1. basal pulmonary mechanics and after ovalbumin (30mg/ml) or saline solution inhalation; 2. bronchial hyperresponsiveness to methacholine; and 3. NOex was collected. At the end of the experiment, the pulmonary fragments were removed and stained with hematoxylin-eosin, with the cyanide-resistant eosinophilic peroxidase histochemical technique (EPO+ cells), with the immunohistochemical technique for the detection of neuronal nitric oxide synthase (nNOS) and with Resorcin-fuchsin, Resorcin-fuchsin with oxidation and Picrosirius. The bone marrow was removed and stained with hematoxylin-eosin. The index of peribronchial edema, the EPO+ cells, the bronchial mononuclear and polymorphonuclear cells and the eosinophils from the bone marrow were evaluated by morphometry. The epithelial bronchial nNOS+ cells and the elastic and collagen fibers were evaluated by optical densitometry. IgG1 antibodies were detected by Passive Skin Anaphylaxis. Statistical analysis was performed with the SigmaStat software program and a P value < 0.05 was considered significant. RESULTS: The OT1 and OT2 groups showed increased inhalation time, decrease in the maximum elastance response of the respiratory system after the antigenic challenge and with methacholine, decrease of peribronchial edema, eosinophils, polymorphonuclear, elastic and collagen fibers, eosinophylopoiesis, and IgG1 titers (P < 0.05). The mononuclear cells, the maximum resistance response of the respiratory system after the antigenic challenge and methacholine decreased in OT2 (P < 0.05). NOex and the percentage of nNOS+ epithelial cells were not altered in the tolerized groups. CONCLUSIONS: The oral tolerance induction concomitant to the start of sensitization or after the allergic response has been established, was capable of attenuating the eosinophilic inflammation, IgG1 titers and the bronchial remodeling present in this model of chronic pulmonary inflammation. The decrease in lymphomononuclear cells and bronchial hyperresponsiveness was more effective when the tolerance induction was carried out in animals that had been previously sensitized. The dissociation between the eosinophilic inflammation and NOex evaluation and the expression of nNOS in the bronchial epithelium suggests a new mechanism activated by the oral tolerance induction
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Kondo, Yaeko. "The study of plasma glucose level and insulin secretion capacity after glucose load in Japanese". Kyoto University, 2016. http://hdl.handle.net/2433/215958.
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Shao, Jing. "Glycated haemoglobin A1c compared to fasting plasma glucose and oral glucose tolerance testing for diagnosing type 2 diabetes and pre-diabetes : a meta-analysis". Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/43240.
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BACKGROUND
In 2010, glycated haemoglobin A1c (HbA1c) was officially recommended as a screening tool to diagnose type 2 diabetes mellitus (T2DM) and pre-diabetes, with cut-off points 6.5% and 5.7% to 6.4% respectively. The implications of using the HbA1c criterion, compared to the general diagnostic criteria: fasting glucose test (FPG) and oral glucose tolerance test (OGTT), is however still being debated.
OBJECTIVES
The objectives of this study were to evaluate and compare the pooled prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes, as measured by the Haemoglobin A1c (HbA1c) test, or the fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT). Secondly, to determine and compare the diagnostic test characteristics (sensitivity, specificity) of these tests.
METHODS
Published papers, with a cross sectional study design, were selected for a systematic review and meta-analysis. The search strategy was an electronic review of journal articles listed on MEDLINE, PubMed and Google scholar between 1996 and 2012. Reference lists were checked, journals were hand searched and experts were contacted when necessary. Initially all studies related to the validation of HbA1c as a tool to detect pre-diabetes or T2DM in humans, published in English, were examined.
Studies were excluded if they did not meet the above mentioned criteria, and/or were conducted with pregnant women. Further analysis was done if FPG or OGTT was compared to HbA1c. The diagnosis of diabetes had to have been based on ADA or WHO criteria. These criteria are: HbA1c 5.7%-6.4% for pre-diabetes and >=6.5% for T2DM; FPG 5.6mmol-7mmol/l for pre-diabetes and >=7mmol/l for T2DM; OGTT 7.8mmol-11.1mmol/l for pre-diabetes and >=11.1mmol/l for T2DM). The OGTT and FPG tests were used as the reference tests and the prevalence reflected as a positive or negative proportion.
The sensitivity and specificity of HbA1c >=6.5% among cases defined by OGTT or FPG should have been reported, or it was possible to calculate these from the data provided. Study results relating to diagnostic accuracy were extracted and synthesized using multivariate random effects meta-analysis methods. This study focused on patients who were suspected of having T2DM, from two sub-groups (a community-based group and a high-risk group) to compare the detection rate of HbA1c with FPG and OGTT.Dissertation (MSc)--University of Pretoria, 2014.
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Silva, Daniele Vieira. "Efeito da terapia oral combinada com probióticos, Hsp65 e aloantígenos do doador no transplante de pele murino". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5146/tde-01032017-133659/.
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Apesar do sucesso do transplante na clínica, os importantes efeitos adversos dos imunossupressores, usados para prevenir e tratar a rejeição, apontam para a necessidade de novas terapias imunorreguladoras. A via oral tem sido efetiva na indução de imunorregulação, em diversos modelos experimentais, principalmente de doenças autoimunes. A Hsp60/65 é uma molécula com grande potencial imunoterapêutico, por sua capacidade de induzir respostas imunes pró-inflamatória e imunorreguladora. Testamos se a terapia oral com o probiótico Lactococcus lactis que expressa a Hsp65, combinada à administração de aloantígenos do doador (AloAg-doador), atua sinergicamente na indução de tolerância ao enxerto de pele semialogeneico murino, ou no aumento de sua sobrevida. Testamos diferentes combinações de terapia oral, assim como a influência da utilização de um anti-inflamatório, inibidor seletivo de COX-2 (celecoxibe). O transplante de pele foi realizado 10 dias após a última administração oral dos probióticos e aloantígenos do doador. Não observamos efeitos benéficos na sobrevida do enxerto no grupo de animais que receberam L.lactis que produz Hsp65, sozinho ou em combinação com AloAg-doador e/ou o anti-inflamatório. Em contraste, a terapia oral combinada com o probiótico L.lactis selvagem e AloAg-doador aumentou significativamente a sobrevida do enxerto (p=0,01), em comparação com o grupo não tratado. Nesse grupo que teve maior sobrevida do aloenxerto (L,lactis selvagem e AloAg-doador), também observamos maior quantidade de epitélio preservado (p=0,02) e maior expressão de TGF-beta (p=0,04), no enxerto, em comparação com o grupo sem tratamento. Não observamos diferenças significativas na expressão, in situ, de FOXP3 e IL-17, que foi baixa em todos os grupos experimentais. Concluímos que a Hsp65 não induziu efeito imunorregulador capaz de prolongar a sobrevida do enxerto. No entanto, a manipulação da microbiota com a terapia combinada com o L.lactis selvagem e a exposição a antígenos do doador, previamente, ao transplante, induz mecanismos imunorreguladores capazes de controlar, mesmo que parcialmente, as respostas inflamatórias dirigidas ao aloenxerto de pele, provavelmente, com a participação de TGF-betaDespite the success of clinical transplantation, the significant side effects induced by immunosupressants used to prevent and treat rejection, indicate the need for novel immunoregulatory therapies. The oral route has been effective in inducing immunoregulation in several experimental models, mostly in pathological autoimmunity. Heat Shock protein 60/65 (Hsp) displays great immunotherapeutic potential due to its capacity to induce both pro-inflammatory and immunregulatory responses. We tested whether oral therapy with the probiotic Lactococcus lactis that expresses Hsp65, in combination with donor alloantigens (Donor-Allo-Ag), acted synergically, inducing immunotolerance or increasing graft survival, in a murine model of semiallogeneic skin transplantation. We tested different oral therapy combinations, as well as the association with a COX-2 selective nonsteroidal anti-inflammatory drug (celecoxib). Skin transplantation was performed 10 days after the last oral administration of probiotics and Donor-Allo-Ag. We observed no beneficial effect on graft survival in the group that received L.lactis that produce Hsp65, alone or in combination with Donor-Allo-Ag/and/or the anti-inflammatory drug. In contrast, combined oral therapy with wild type L.lactis and Donor-Allo-Ag significantly prolonged graft survival (p=0.01), in comparison to non-treated animals. In this prolonged-survival group (L.lactis and Donor-Allo-Ag), we also found higher extension of preserved epithelium (p=0.02) and higher expression of TGF-beta (p=0.04), within the graft, in comparison to non-treated animals. We found no significant differences in the intragraft expression of FOXP3 and IL-17, which was essentially absent or very low. We conclude that Hsp65 did not induce immunoregulatory effects capable of prolonging graft survival. However, the microbiota manipulation with the combined oral therapy with wild type L.lactis and Donor-Allo-Ag, prior to transplantation, induce immunoregulatory mechanisms capable of partially controlling the inflammatory responses to the graft, most likely involving the participation of TGF-beta
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Turfkruyer, Mathilde. "Impact de la vitamine A du lait maternel sur le développement de la tolérance orale chez le nouveau-né et la prévention des maladies allergiques". Thesis, Nice, 2014. http://www.theses.fr/2014NICE4103/document.
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La constante augmentation des allergies en début de vie suggère une déficience de régulation immunitaire au cours de cette période. La tolérance orale est un mécanisme clé de régulation au niveau de l’intestin pour le maintien de l’homéostasie immunitaire. L’objectif de ma thèse a été de déterminer dans un modèle murin les mécanismes à l’origine de la tolérance orale en début de vie afin de mieux prévenir le développement d’allergies. L’induction de tolérance orale en début de vie n’est efficace qu’à partir de la 3ème semaine de vie. Le défaut de tolérance orale observé au cours des 2 premières semaines de vie est la conséquence d’un défaut de capture de l’antigène et d’expression de la RALDH (enzyme de conversion du rétinol en acide rétinoïque) par les cellules dendritiques CD103+ mésentériques, résultant en une ignorance de l’antigène. Les taux de rétinol sanguins en période néonatale sont très bas, et un enrichissement du lait maternel en vitamine A permet de corriger cette déficience néonatale ainsi que le défaut de présentation antigénique des cellules dendritiques CD103+. Cet enrichissement permet également de prévenir l’apparition de l’allergie dès les premiers jours de vie. De manière surprenante, alors que chez la souris adulte, la tolérance orale dépend de la génération de lymphocytes T régulateurs, la tolérance orale observée chez les souriceaux âgés de 3 semaines et chez les nouveau-nés ayant reçu de la vitamine A, dépend de la génération de lymphocytes Th1Increased prevalence of allergies in early life suggests a deficiency of immune regulation during this period. Oral tolerance is a key immuno-regulatory mechanism in the gut for immune homeostasis. The principal objective of my thesis was to determine in a murine model the mechanisms at the origin of oral tolerance in early life to better prevent allergy development. We found that induction of oral tolerance in early life is effective only from the 3rd week of life. The defect of oral tolerance observed during the first 2 weeks of life is the consequence of a defect in antigen capture and RALDH expression (enzyme which converts retinol in retinoic acid) by mesenteric CD103+ dendritic cells. Serum levels of retinol in neonatal period are very low, and an enrichment of the maternal milk with vitamin A allows to correct this neonatal deficiency as well as the defect of antigen presentation by the CD103+ dendritic cells. This enrichment also allows allergy prevention from the first days of life. To our surprise, while in adult mice, oral tolerance depends on the generation of regulatory T lymphocytes, oral tolerance observed in the 3 week-old mice and in the newborn which received vitamin A, depends on the generation of Th1 lymphocytes. These results demonstrate that vitamin A levels in early life are directly correlated with Th1 differentiation induced by oral administration of allergen, necessary for allergy prevention. This knowledge should now be taken into account for the implementation of allergy prevention strategies, more specific and better adapted to the neonatal period, such as a supplementation with vitamin A
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Fors, Ronny. "Nickel allergy in a Swedish adolescent population and its relation to orthodontic treatment and lifestyle factors". Doctoral thesis, Umeå universitet, Odontologi, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1639.
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Nickel stands out as the main cause of contact allergy in both children and adults, which has given rise to concern and the introduction of regulations by official bodies. Today´s youths are frequently exposed to body piercing and orthodontic treatment. Changes in youth lifestyle practices are also likely to influence nickel exposure and thus, the occurrence of nickel allergy. However, against patient and parental concern regarding nickel exposure to orthodontic appliances, often evoked by allergies following piercing, stand results from studies indicating that early orthodontic appliance treatment may reduce, rather than increase, prevalence of nickel allergy; a finding that has been suggested to result from tolerance induction by early exposure to nickel via the oral route. The objective of the present thesis was to investigate the association between nickel allergy and exposure to different orthodontic appliances and lifestyle, in particular piercing, as well as to study nickel release from orthodontic appliances into the oral cavity. Furthermore, one objective was to establish baseline prevalence data of nickel allergy in a Swedish adolescent population. Data was generated from a cross-sectional survey, in which about 6000 youths completed a questionnaire and almost 4500 of these were patch-tested for contact allergy. Information on exposure to orthodontic appliances was verified by dental records, whilst nickel content in saliva and dental biofilm was measured in a clinical study. Questionnaire data demonstrated a reduced risk of nickel allergy when orthodontic treatment preceded piercing (OR 0.5; 95 % CI 0.3-0.8) and similar results were found for data verified from dental records, however statistical significance was lost when adjusting for background factors (OR 0.6, 95 % CI 0.4-1.0). Exposure to full fixed appliances with NiTi-containing alloys, as well as a pooled ‘high nickel-releasing’ appliance group prior to piercing correlated with a significantly reduced risk of nickel allergy and a trend towards a reduced risk with exposure duration. Nickel could also be found in significantly higher concentrations from dental plaque samples, but not saliva samples, in orthodontic patients who were well into treatment compared to patients who had not been exposed to orthodontic appliances. The effect was not found to be due to differences in estimated dietary nickel intake between the two groups. Significantly more girls than boys (13.3 % versus 2.5 %) were found to be patch-test positive to nickel. Positive nickel tests were also most prevalent in occupational programmes and least prevalent in natural science programmes, indicating differences in lifestyle and exposure to nickel. Dropout from testing was handled using a missing-value analysis. This internal validation showed that our results overestimated the occurrence of nickel allergy to a minor degree. More girls than boys reported piercing, vegetarian/vegan diet, and smoking practices, whereas an interesting shift in tattooing prevalence was observed with a larger proportion of girls reporting this practice compared to boys. Sex, number of piercings, smoking and orthodontic appliance treatment prior to piercing were found to influence weighted risk estimates of nickel allergy. To conclude, although orthodontic patients are exposed to nickel intraorally, we found no increased risk of sensitising adolescents to nickel by the use of oral orthodontic appliances. On the contrary, early orthodontic treatment preceding piercing reduced the risk of nickel allergy by a factor of 1.5-2.0. This reduced risk appears to be associated with estimated nickel release of the appliance and duration of treatment, in all supporting a hypothesised induction of immunological tolerance via oral administration of nickel. Our study also showed a strong association between lifestyle and nickel allergy. Although there have been changes in lifestyle over time, as indicated by the strong shift in tattooing practices, no large change in nickel allergy prevalence was found compared with previous Swedish data. Our data will serve as a baseline for future studies of the effect of nickel exposure regulations, such as the Nickel Directive, and for studies of lifestyle changes and their effects on nickel allergy.
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Firouzi, Shelby Anne. "Sagittal Abdominal Diameter, Waist Circumference, and BMI as Predictors of Multiple Measures of Glucose Metabolism: An NHANES Investigation of U.S. Adults". BYU ScholarsArchive, 2017. https://scholarsarchive.byu.edu/etd/6902.
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OBJECTIVE: The key objective of the present investigation was to compare associations between sagittal abdominal diameter (SAD), waist circumference, and BMI to the oral glucose tolerance test (OGTT), along with fasting glucose, HbA1c, and HOMA-IR, in a nationally representative sample of U.S. adults. The study also analyzed the effect of multiple covariates on the anthropometric and glucose metabolism associations. METHODS: A cross-sectional design, including 3,582 subjects, was used. SAD was assessed using an abdominal caliper. All other data were collected following strict NHANES protocol. The OGTT was the primary variable used to index glucose metabolism. Fasting glucose, HbA1c, and HOMA-IR were also evaluated. RESULTS: Mean ± SE values were as follows: SAD: 22.3 ± 0.1 cm; waist circumference: 98.0 ± 0.4 cm; BMI: 28.6 ± 0.2 kg/m2; OGTT: 113.9 ± 1.0 mg/dL; fasting glucose: 99.6 ± 0.3 mg/dL; HbA1c: 5.4 ± 0.01%; HOMA-IR: 3.2 ± 0.1. SAD consistently emerged as the best predictor of all the indices of glucose metabolism, before and after adjusting for the covariates, and with the sample stratified by gender, race, or age. SAD was not a better predictor of OGTT among normal weight adults and non-Hispanic black adults. CONCLUSION: Obesity, especially abdominal obesity, is strongly related to glucose metabolism and type 2 diabetes. In the present study, SAD was the best anthropometric predictor of glucose metabolism, notwithstanding the high correlations among SAD, waist circumference, and BMI. Due to the ease of taking a SAD measurement, we recommend that healthcare providers consider the use of this simple and inexpensive method to more precisely predict diabetes risk, especially among overweight and obese adults.
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Miranda, Pedro Jeferson. "EMERGÊNCIA E FLUXO DE INFORMAÇÃO EM REDES COMPLEXAS". UNIVERSIDADE ESTADUAL DE PONTA GROSSA, 2014. http://tede2.uepg.br/jspui/handle/prefix/924.
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Previous issue date: 2014-09-03Fundação Araucária de Apoio ao Desenvolvimento Científico e Tecnológico do Paraná
The emergence is a phenomenon that gives sense to the qualitative unity of any substance, consisting the reflex in the ontological act of perception. It is the conceptual key that justifies the use of complex network models to describe systems, which also are complex in nature. Given this key concept, it was desired to apply it on real objects in order to create new analysis methodologies. For this, graph’s theory and random walk’s theory were used as fundamentals for two study cases. One of them consists on an analysis of the mythological social network of Odyssey of Homer. It was found that this network displays structural characteristic of real social network mixed with fictional aspects associated to mythological characters. Another study was the oral tolerance phenomenon modeled as a complex network associated with stochastic dynamics. We applied the random walk as a way to understand the relative importance of each immunological component. Finally, it becomes evidenced that the key concept of emergence allows new forms of analysis using complex network theory as a model which comprises the complexity inherent on the conception of real systems.
A emergência é fenômeno que dá unidade qualitativa a qualquer substância, constituindo o reflexo no ato ontológico da percepção. É a chave conceitual que justifica o uso do modelo em redes complexas para descrever sistemas, que também são complexos naturalmente. Dada essa chave conceitual, buscou-se utilizá-la na geração de novas análises. Para tanto é empregado a teoria de grafos e a caminhada aleatória em dois estudo de caso. Um deles constitui a análise de uma rede mitológica referente à Odisseia de Homero. Foi verificado que a rede mitológica apresenta padrões de redes sociais reais quando excetuados da rede as personagens mitológicas. Em segundo lugar, foi realizado um estudo da tolerância oral como um fenômeno de rede complexa, foi utilizada a caminhada aleatória como modelo estocástico de difusão de estímulos numa rede complexa. Com isso, foi possível conhecer a importância relativa de cada componente imunológica. Por fim, fica evidenciado que o conceito chave de emergência permite a concepção de novas formas de análise, fundamentalmente no uso de redes complexas como modelos que albergam a complexidade inerente na concepção de sistemas reais.
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TAVARES, Maria da Glória Rodrigues. "Alterações nas curvas glicêmicas de pacientes com Diabetes Mellitus gestacional pelo critério IADPSG e a repercussão no peso fetal ao nascimento". Universidade Federal do Maranhão, 2017. http://tedebc.ufma.br:8080/jspui/handle/tede/1901.
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Gestational Diabetes Mellitus (GDM) is classified as glucose intolerance, whose onset or detection occurs during pregnancy. One of the ways to identify GDM is 75g oral glucose tolerance test. According to the International Diabetes and Pregnancy Association Study Group(IADPSG), GDM is diagnosed when at least 1 of the three curve points are greater than or equal to 92, 180 and 153 mg / dl at time 0 , 1 and 2 hours respectively. A characteristic of this criterion is the diagnosis based on a single altered value. However, the mechanisms involved in impaired fasting glucose (IFG) are different from those found in impaired glucose tolerance (IGT) after oral glucose tolerance test (OGTT). So, differences in pregnancy outcomes are possible according to OGTT behavior. This work had as general objective to categorize pregnant women diagnosed with GDM, using the IADPSG criteria, according to the type of glycemic alteration found in the OGTT results, and to correlate with fetal weight birth. In order to do so, the cases of DMG treated at the University Hospital of the Federal University of Maranhão, from December 2013 to December 2015, were divided into 3 groups, according to the alterations found in the glycemic curve of the OGTT (Group 1: IFG isolated, Group 2: IGT only, Group 3: IFG and IGT). A total of 89 patients were studied, the majority belonging to groups 3 (54%). This same group had the highest glycemic averages at diagnosis and during follow-up, being the group with the highest occurrence of newborns large for gestational age (LGA), with 39.6%. Then group 1 with an occurrence of 27.3% of newborns LGAs. It was concluded that, as pregnant women with DMG with altered fasting glycemia in the OGTT, especially those with associated glucose intolerance, presented a higher risk for newborns large for gestational age.
Diabetes Mellitus Gestacional (DMG) é classicamente definido como intolerância à glicose de gravidade variável, cujo início ou detecção ocorre durante a gravidez. Uma das formas de rastreá-la é através da curva glicêmica após sobrecarga oral de glicose, com 75g de dextrosol. Segundo o critério do International Association of Diabetes and Pregnancy Study Group (IADPSG), considera-se diagnóstico de DMG quando pelo menos um dos três pontos da curva encontra-se maior ou igual a 92, 180 e 153 mg/dl, nos tempos 0, 1, 2 horas respectivamente. Uma característica deste critério, é o diagnóstico baseado em apenas um único valor alterado, seja ele em jejum ou após a sobrecarga. No entanto, os mecanismos que levam à alteração da glicemia jejum (GJA) são diferentes daqueles encontrados na intolerância à glicose (ITG) após sobrecarga de glicose. Sendo assim, acredita-se poder haver diferenças, em relação aos desfechos fetais, a depender do perfil encontrado na curva glicêmica das gestantes com diagnóstico de DMG. Este trabalho teve como objetivo geral categorizar as gestantes diagnosticadas com DMG pelo teste de tolerância oral à glicose (TTOG), utilizando o critério do IADPSG, de acordo com o tipo de alteração glicêmica encontrada na curva de sobrecarga, e correlacionar com o peso fetal ao nascimento. Para isso, foram revisados os casos de DMG atendidos no Hospital Universitário da Universidade Federal do Maranhão (HUUFMA), no período de dezembro de 2013 a dezembro de 2015, estes foram divididos em 3 grupos, de acordo com as alterações encontradas na curva glicêmica do TOTG (Grupo 1: GJA isoladamente; Grupo 2: ITG isoladamente, Grupo 3: GJA e ITG). Foram estudadas 89 pacientes, a maioria pertencente ao grupo 3 (54%). Este mesmo grupo apresentou as médias glicêmicas mais elevadas ao diagnóstico e durante o seguimento, sendo o grupo com maior ocorrência de recém-nascidos grandes para idade gestacional (GIG), com 39,6%. Em seguida o grupo 1 com uma ocorrência de 27,3% de recém nascidos GIGs. Concluiu-se que as gestantes com DMG com alteração na glicemia de jejum no TTOG, principalmente aquelas com intolerância à glicose associada, apresentaram maior risco para recém-nascidos grandes para idade gestacional.
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Sirimarco, Mariana Pinto. "Avaliação dos protocolos de diagnóstico e de controle da hiperglicemia materna impacto na prevalência de Diabetes Melito Gestacional (DMG) e de Hiperglicemia Gestacional Leve (HGL) e nos resultados perinatais /". Botucatu, 2016. http://hdl.handle.net/11449/137866.
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Orientador: Iracema de Mattos Paranhos CalderonResumo: JUSTIFICATIVA – desde agosto de 2011 o Serviço Especializado de Diabetes e Gravidez da Faculdade de Medicina de Botucatu/Unesp (SEDG-FMB/Unesp) adotou o novo protocolo diagnóstico para o DMG recomendado pela ADA/IADPSG. Entretanto, o Perfil Glicêmico (PG) continuou associado ao TOTG 75g, para diagnosticar a Hiperglicemia Gestacional Leve (HGL), reconhecida e tratada em nosso Serviço como se fosse DMG. A controvérsia sobre o custo-benefício do novo protocolo da ADA/IADPSG e a dúvida sobre a necessidade de manutenção do PG no protocolo do Serviço justificam o presente estudo. OBJETIVOS – avaliar o impacto do novo protocolo da ADA/IADPSG na prevalência de HGL e de DMG, na ocorrência de resultados perinatais adversos (RPNA) e na associação TOTG 75g e PG para diagnóstico de HGL no SEDG-FMB/Unesp. MÉTODO – estudo de corte transversal, incluindo gestantes, e seus recém-nascidos (RN), submetidas aos protocolos diagnósticos e que realizaram pré-natal e parto no Serviço, antes (janeiro de 2008 a 14 de agosto de 2011) e após (15 de agosto de 2011 a dezembro de 2014) à mudança do protocolo, definindo uma amostra por conveniência. Considerando os dois períodos, foram comparadas a prevalência de DMG e de HGL e a ocorrência de RN-GIG, macrossomia, primeira cesárea e tempo de internação dos RN. Na análise estatística foram utilizados análise de Poison e teste t-Student, teste do Qui-quadrado ou Exato de Fischer e cálculo de risco (RR e IC 95%) para os desfechos avaliados. O limite de signifi... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: BACKGROUND - since August 2011 the Specialized Center of Diabetes and Pregnancy of the Botucatu Medical School / Unesp (SEDG-FMB / Unesp) has adopted a new diagnostic protocol for Gestational Diabetes Mellitus (GDM) recommended by the ADA / IADPSG guidelines. However, the glycemic profile (GP) remained associated with the 75g OGTT to diagnose Mild Gestational Hyperglycemia Lite (MGH), recognized and treated in our department as if it were GDM. The controversy over the cost-effectiveness of the new ADA / IADPSG guideline and doubt about the need for GP maintenance in the service protocol justify this study. OBJECTIVES - To assess the impact of the new ADA / IADPSG guideline in the prevalence of MGH and GDM, in the incidence of adverse perinatal outcomes (APNO) and in the association 75g OGTT and PG for diagnosis of MGH at the SEDG-FMB / Unesp. METHOD - cross-sectional study, including pregnant women and their newborns (NB) that underwent diagnostic protocols and had their prenatal care and delivery at the service before (January 2008 to August 14, 2011) and after (15 August 2011 to December 2014) the protocol modification, defining a convenience sample. Considering the two periods, the prevalence of GDM and MGH and the occurrence of LGA-NB, macrosomia, first cesarean delivery and NB hospital stay were compared. For statistical analysis, Poison analysis and Student's t test, chi-square or Fisher's exact test were used and risk estimate (RR and 95% CI) for the assessed outcomes.... (Complete abstract click electronic access below)
Mestre
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Guillemette, Laetitia. "Implication du TNFα dans la résistance à l’insuline pendant la grossesse". Mémoire, Université de Sherbrooke, 2015. http://hdl.handle.net/11143/6009.
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Résumé : Le diabète gestationnel (DG), qui peut entraîner des conséquences importantes pour la mère et l’enfant, résulte d’un défaut de compensation de la sécrétion d’insuline par rapport à la résistance à l’insuline. Comme la grossesse représente en elle-même un modèle d’augmentation physiologique de la résistance à l’insuline, il est intéressant d’étudier et de caractériser les facteurs qui sont impliqués dans la résistance à l’insuline et, ultimement, dans le DG, chez la femme enceinte. Le Tumor necrosis factor alpha (TNFα) est soupçonné d’être un de ces facteurs, suite aux études effectuées chez les animaux et les populations humaines non enceintes, mais les résultats obtenus en grossesse sont encore controversés. Nous avons émis l’hypothèse que les niveaux circulants de TNFα sont associés au DG et à la résistance à l’insuline dans une large cohorte de femmes enceintes. Nous avons aussi investigué les variations des niveaux de TNFα en réponse à l’hyperglycémie provoquée par voie orale (HGPO) chez des femmes enceintes. Nous avons montré que de hauts niveaux de TNFα étaient liés à une résistance à l’insuline augmentée au 2e trimestre de la grossesse et ce, indépendamment de l’âge, de l’adiposité, de l’âge gestationnel, des triglycérides et des niveaux circulants d’adiponectine dans notre cohorte. De plus, les niveaux de TNFα varient différemment au cours de l’HGPO selon le statut de résistance à l’insuline. En effet, les niveaux de TNFα augmentent à 1h puis diminuent à 2h chez les femmes les plus sensibles à l’insuline, alors qu’ils diminuent tout au long du test chez les femmes les plus résistantes à l’insuline, mais restent en tout temps supérieurs aux niveaux mesurés chez les femmes les plus sensibles à l’insuline. Toutefois, les niveaux de TNFα n’étaient pas différents entre les femmes avec DG et celles normoglycémiques. De façon intéressante, la variation du TNFα pendant l’HGPO chez les femmes DG est similaire à celle chez les femmes avec haute résistance à l’insuline. Ces résultats suggèrent donc que le TNFα est indépendamment associé à la résistance à l’insuline en grossesse et que les voies inflammatoires peuvent contribuer aux dysfonctions glycémiques retrouvées en DG. // Abstract : Gestational diabetes mellitus (GDM), which can exert important impacts on mothers and offspring, results from an imbalance between insulin secretion capacity and insulin resistance. Pregnancy is a state of physiologically increased insulin resistance, providing a unique model to study and characterize biological factors linked to insulin resistance in humans and, ultimately, GDM, in pregnant women. Based on animal studies and analyses in non-pregnant populations, tumor necrosis factor alpha (TNFα) is suspected of being involved in insulin resistance, but results obtained from pregnant populations are still controversial. Our hypothesis was that circulating TNFα would be associated with GDM and insulin resistance in a large cohort of pregnant women. We also investigated dynamic variations of TNFα levels over the course of an oral glucose tolerance test (OGTT) in pregnant women. We showed that higher TNFα levels were associated with higher insulin
resistance at 2nd trimester of pregnancy, independent of age, adiposity, gestational age,
triglycerides and adiponectin levels in our cohort. Furthermore, TNFα levels varied
differently over the course of the OGTT according to insulin resistance status: they rose at 1h and then decreased at 2h in insulin sensitive women, whereas they consistently
decreased in insulin resistant women over the course of the test (even though they remained statistically higher than insulin sensitive women’s levels at each time point throughout the OGTT). However, TNFα levels were not different between GDM and non-GDM women. Interestingly, variation of TNFα levels over the course of the OGTT in GDM women followed the same pattern as the variation observed in OGTT in women classified with high insulin resistance. Those results suggest that circulating TNFα is independently associated with insulin resistance in pregnancy and that inflammatory pathways might contribute to glycemic dysregulation observed in GDM.
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Turfkruyer, Mathilde. "Impact de la vitamine A du lait maternel sur le développement de la tolérance orale chez le nouveau-né et la prévention des maladies allergiques". Electronic Thesis or Diss., Nice, 2014. http://www.theses.fr/2014NICE4103.
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La constante augmentation des allergies en début de vie suggère une déficience de régulation immunitaire au cours de cette période. La tolérance orale est un mécanisme clé de régulation au niveau de l’intestin pour le maintien de l’homéostasie immunitaire. L’objectif de ma thèse a été de déterminer dans un modèle murin les mécanismes à l’origine de la tolérance orale en début de vie afin de mieux prévenir le développement d’allergies. L’induction de tolérance orale en début de vie n’est efficace qu’à partir de la 3ème semaine de vie. Le défaut de tolérance orale observé au cours des 2 premières semaines de vie est la conséquence d’un défaut de capture de l’antigène et d’expression de la RALDH (enzyme de conversion du rétinol en acide rétinoïque) par les cellules dendritiques CD103+ mésentériques, résultant en une ignorance de l’antigène. Les taux de rétinol sanguins en période néonatale sont très bas, et un enrichissement du lait maternel en vitamine A permet de corriger cette déficience néonatale ainsi que le défaut de présentation antigénique des cellules dendritiques CD103+. Cet enrichissement permet également de prévenir l’apparition de l’allergie dès les premiers jours de vie. De manière surprenante, alors que chez la souris adulte, la tolérance orale dépend de la génération de lymphocytes T régulateurs, la tolérance orale observée chez les souriceaux âgés de 3 semaines et chez les nouveau-nés ayant reçu de la vitamine A, dépend de la génération de lymphocytes Th1Increased prevalence of allergies in early life suggests a deficiency of immune regulation during this period. Oral tolerance is a key immuno-regulatory mechanism in the gut for immune homeostasis. The principal objective of my thesis was to determine in a murine model the mechanisms at the origin of oral tolerance in early life to better prevent allergy development. We found that induction of oral tolerance in early life is effective only from the 3rd week of life. The defect of oral tolerance observed during the first 2 weeks of life is the consequence of a defect in antigen capture and RALDH expression (enzyme which converts retinol in retinoic acid) by mesenteric CD103+ dendritic cells. Serum levels of retinol in neonatal period are very low, and an enrichment of the maternal milk with vitamin A allows to correct this neonatal deficiency as well as the defect of antigen presentation by the CD103+ dendritic cells. This enrichment also allows allergy prevention from the first days of life. To our surprise, while in adult mice, oral tolerance depends on the generation of regulatory T lymphocytes, oral tolerance observed in the 3 week-old mice and in the newborn which received vitamin A, depends on the generation of Th1 lymphocytes. These results demonstrate that vitamin A levels in early life are directly correlated with Th1 differentiation induced by oral administration of allergen, necessary for allergy prevention. This knowledge should now be taken into account for the implementation of allergy prevention strategies, more specific and better adapted to the neonatal period, such as a supplementation with vitamin A
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Sirimarco, Mariana Pinto [UNESP]. "Avaliação dos protocolos de diagnóstico e de controle da hiperglicemia materna: impacto na prevalência de Diabetes Melito Gestacional (DMG) e de Hiperglicemia Gestacional Leve (HGL) e nos resultados perinatais". Universidade Estadual Paulista (UNESP), 2016. http://hdl.handle.net/11449/137866.
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JUSTIFICATIVA – desde agosto de 2011 o Serviço Especializado de Diabetes e Gravidez da Faculdade de Medicina de Botucatu/Unesp (SEDG-FMB/Unesp) adotou o novo protocolo diagnóstico para o DMG recomendado pela ADA/IADPSG. Entretanto, o Perfil Glicêmico (PG) continuou associado ao TOTG 75g, para diagnosticar a Hiperglicemia Gestacional Leve (HGL), reconhecida e tratada em nosso Serviço como se fosse DMG. A controvérsia sobre o custo-benefício do novo protocolo da ADA/IADPSG e a dúvida sobre a necessidade de manutenção do PG no protocolo do Serviço justificam o presente estudo. OBJETIVOS – avaliar o impacto do novo protocolo da ADA/IADPSG na prevalência de HGL e de DMG, na ocorrência de resultados perinatais adversos (RPNA) e na associação TOTG 75g e PG para diagnóstico de HGL no SEDG-FMB/Unesp. MÉTODO – estudo de corte transversal, incluindo gestantes, e seus recém-nascidos (RN), submetidas aos protocolos diagnósticos e que realizaram pré-natal e parto no Serviço, antes (janeiro de 2008 a 14 de agosto de 2011) e após (15 de agosto de 2011 a dezembro de 2014) à mudança do protocolo, definindo uma amostra por conveniência. Considerando os dois períodos, foram comparadas a prevalência de DMG e de HGL e a ocorrência de RN-GIG, macrossomia, primeira cesárea e tempo de internação dos RN. Na análise estatística foram utilizados análise de Poison e teste t-Student, teste do Qui-quadrado ou Exato de Fischer e cálculo de risco (RR e IC 95%) para os desfechos avaliados. O limite de significância estatística foi de 95% (p < 0,05). RESULTADOS – o NOVO protocolo resultou em aumento no número de mulheres com DMG e deixou de identificar 17,3% do total de gestantes, que mantiveram o diagnóstico de HGL, apesar do TOTG 75g normal. O novo protocolo ADA/IADPSG não influenciou o desfecho perinatal. CONCLUSÕES – esses resultados reforçam a validade da manutenção do PG no protocolo diagnóstico do SEDG-FMB/Unesp. Para concluir sobre o custo-benefício do NOVO protocolo, são necessários grandes estudos, multicêntricos e com tamanho amostral adequado.
BACKGROUND - since August 2011 the Specialized Center of Diabetes and Pregnancy of the Botucatu Medical School / Unesp (SEDG-FMB / Unesp) has adopted a new diagnostic protocol for Gestational Diabetes Mellitus (GDM) recommended by the ADA / IADPSG guidelines. However, the glycemic profile (GP) remained associated with the 75g OGTT to diagnose Mild Gestational Hyperglycemia Lite (MGH), recognized and treated in our department as if it were GDM. The controversy over the cost-effectiveness of the new ADA / IADPSG guideline and doubt about the need for GP maintenance in the service protocol justify this study. OBJECTIVES - To assess the impact of the new ADA / IADPSG guideline in the prevalence of MGH and GDM, in the incidence of adverse perinatal outcomes (APNO) and in the association 75g OGTT and PG for diagnosis of MGH at the SEDG-FMB / Unesp. METHOD - cross-sectional study, including pregnant women and their newborns (NB) that underwent diagnostic protocols and had their prenatal care and delivery at the service before (January 2008 to August 14, 2011) and after (15 August 2011 to December 2014) the protocol modification, defining a convenience sample. Considering the two periods, the prevalence of GDM and MGH and the occurrence of LGA-NB, macrosomia, first cesarean delivery and NB hospital stay were compared. For statistical analysis, Poison analysis and Student's t test, chi-square or Fisher's exact test were used and risk estimate (RR and 95% CI) for the assessed outcomes. The statistical significance threshold was 95% (p <0.05). RESULTS - The new protocol resulted in a increase in the number of women with GDM, but failed to identify 17.3% of pregnant women who maintained the diagnosis of MGH, despite normal 75g OGTT. The new ADA / IADPSG guideline did not influence the perinatal outcome. CONCLUSIONS - These results reinforce the validity of maintaining the GP in the diagnosis protocol at the SEDG-FMB / Unesp. To conclude on the cost-effective of the new protocol, large multicenter studies with adequate sample size are required
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Heath, Ashleigh E. "Comparison of Screening Methods for Pre-diabetes and Type 2 Diabetes Mellitus by Race/Ethnicity and Gender". Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/iph_theses/202.
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INTRODUCTION/OBJECTIVES: Current screening guidelines for pre-diabetes and type 2 diabetes mellitus note that there are discrepancies in diagnosing the disease using the fasting plasma glucose test, oral glucose tolerance test, and HbA1c in high-risk populations. The objective of this study is to compare the effectiveness of screening methods for type 2 diabetes mellitus (T2DM) and pre-diabetes by race/ethnicity and gender.
METHODS: Secondary analyses of the National Health and Nutrition Examination Survey (NHANES, 2005-2008) were performed using SPSS 19.0. Screening outcomes were assessed and compared for a sample of n=10,566, NHW, NHB, MA, and Multiracial/other men and women. Analyses included cross tabulations, ANOVA and partial correlations to establish disease prevalence, effectiveness of screenings, and statistical significance.
RESULTS: It was found that the HbA1c test is comparable in precision, and is correlated with the FPG for racial and ethnic minorities. The specificities for detecting pre-diabetes using the HbA1c were higher (64-66%) for these groups than by using the standard, FPG screening method (42-49%). There were no strong, significant differences for screening effectiveness for men versus women.
DISCUSSION: This study revealed that the HbA1c test might be an effective method for screening for pre-diabetes in racial and ethnic minorities instead of the FPG test alone. Screening in high-risk populations will help delay the onset of T2DM, with increased prevention during the pre-clinical phase.
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Paiatto, Lisiery Negrini [UNESP]. "A modulação da resposta imune na colite experimental induzida por TNBS em camundongos da linhagem BALB/c: efeitos da tolerância oral e da transferência adotiva de células dendríticas CD11c+". Universidade Estadual Paulista (UNESP), 2017. http://hdl.handle.net/11449/151974.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
A quebra da tolerância imunológica a antígenos próprios é um mecanismo gerador comum às respostas imunes deletérias. Várias estratégias têm sido propostas para modular respostas autoimunes, entre as quais se destacam a administração oral de antígenos relacionados à doença, a transferência adotiva de células tolerogênicas e/ou o tratamento com citocinas reguladoras. Nesse contexto, tem sido mostrado que a ingestão de antígenos proteicos presentes na dieta pode gerar efeitos indiretos sobre o sistema imune do hospedeiro, caracterizados pela supressão da resposta imune a proteínas antigenicamente não relacionadas, conhecidos como supressão bystander. O presente projeto teve por objetivo analisar os efeitos indiretos da tolerância oral induzida pela ingestão de ovalbumina (OVA) e a transferência adotiva de células dendríticas isoladas de animais tolerantes a OVA (tDC) na colite induzida por TNBS em camundongos. Os resultados mostraram que o tratamento de camundongos com OVA por via oral, antes ou após a indução da colite e a transferência adotiva de tDC, foram capazes de reduzir sinais da doença, tais como a perda de peso, bem como preservar parcialmente a integridade do tecido colônico, quando comparados aos animais colíticos não tratados com OVA (controles). A supressão bystander relacionada ao consumo de OVA foi associada à expansão da frequência de células T reguladoras (regs) e de células T secretoras de interleucina (IL) -10, possíveis mecanismos de regulação das manifestações clínicas da colite induzida por TNBS. As DC obtidas de animais tolerantes a OVA apresentaram expressão aumentada de CD80, compatível com perfil tolerogênico. A transferência dessa população de células para animais colíticos foi capaz de reduzir os sinais clínicos e histológicos da colite, mimetizando os efeitos da tolerância oral. A transferência adotiva de tDC levou a redução da frequência de células Th17, redução de secreção de IL-17 e IL-9 e aumento de secreção de IL-10 e IL-4 in vitro. Até onde é de nosso conhecimento, não existem dados na literatura mostrando o efeito da tolerância oral e a transferência adotiva de tDC no tratamento de colite.
The breakdown of immune tolerance to self antigens is a common mechanism for deleterious immune responses. Several interventions have been proposed to modulate autoimmune responses, such as oral administration of disease-related antigens, adoptive transfer of tolerogenic cells and/or treatment with regulatory cytokines. In this context, it has been demonstrated that the ingestion of protein antigens can generate indirect effects on the immune system of the host, characterized by suppression of the immune response to antigenically unrelated proteins, known as bystander suppression. The present project aims to analyze the indirect effects of oral tolerance induced by ovalbumin (OVA) and by adoptive transfer of tolerant dendritic cells (tDC) in TNBS induced colitis in mice. Our results showed that the treatment of oral OVA mice before or after induction of colitis and the adductive transfer of tDC were able to reduce the signs of the disease, such as weight loss, as well as partially preserve the integrity of the Compared to non-OVA treated animals (controls). The bystander suppression related to OVA consumption appears to favor the expansion of regulatory (regs) T and interleukin (IL)-10 secreting T cells responsible for reducing the clinical manifestations of TNBS-induced colitis. On the other hand, DC obtained from OVA-tolerant animals showed increased expression of CD80. Administration of this cells population to colitic animals was able to reduce the clinical and histological signs of colitis, possibly by reducing Th17 cells, reduction of secretion of Il-17 and IL-9 and augment of IL-10 and IL-4. To the best of our knowledge, there are no data in the literature showing the effect of oral tolerance and the adoptive transfer of tDC in the treatment of colitis.
FAPESP: 2013/20258-2
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Sapienza, Andréia David. "Fatores preditores do uso de insulina em pacientes com diabetes melito gestacional diagnosticado pelo teste de tolerância à glicose oral de 100 gramas". Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-29042009-132253/.
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Objetivo: O objetivo desse estudo foi identificar a associação entre fatores clínicos e laboratoriais com o uso de insulina em gestantes com DMG no momento do diagnóstico e analisar os possíveis fatores preditores do uso de insulina. Método: Foram estudadas, de forma retrospectiva, 294 pacientes com diabetes melito gestacional (DMG) diagnosticado por meio do teste de tolerância à glicose oral de 100 gramas (TTGO-100g) entre 24 e 33 semanas completas de gestação, cujo seguimento pré-natal foi realizado ambulatorialmente pelo setor de Endocrinopatias e Gestação da Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 1 de julho de 2002 a 30 de junho de 2008. Os seguintes fatores clínicos e laboratoriais, que pudessem estar associados ao uso de insulina para controle glicêmico, foram analisados: idade materna, obesidade pré-gestacional - índice de massa corpórea (IMC) > 30 Kg/m2, antecedente familiar de diabetes melito (DM), tabagismo, hipertensão arterial, uso de corticosteróides sistêmicos, antecedente obstétrico de DMG e de macrossomia fetal, nuliparidade, multiparidade, antecedente obstétricos de natimortos e neomortos, idade gestacional no momento do diagnóstico, gemelidade, índice de líquido amniótico (ILA) aumentado ILA > 18 cm, polidrâmnio (ILA > 25 cm), número de valores anormais do TTGO-100g, glicemia de jejum anormal no TTGO- 100g glicemia de jejum > 95 mg/dL; média das quatro glicemias aferidas no TTGO-100g; valor da glicemia de jejum, de 1ª, 2ª e 3ª horas do TTGO-100g e hemoglobina glicada (HbA1c). A associação entre cada fator e a necessidade de insulinoterapia foi analisada individualmente (2 de Pearson / teste exato de Fisher e teste t de Student). O modelo de regressão logística para a análise multivariada foi usado para predizer a probabilidade desses fatores em relação ao uso de insulina. Resultados: Das 294 pacientes avaliadas, 39,8% (117/294) necessitaram de insulinoterapia para controle glicêmico. Observou-se correlação positiva entre o uso de insulina e obesidade pré-gestacional, antecedente familiar de DM, hipertensão arterial, antecedente obstétrico de DMG e de macrossomia fetal, número de valores anormais no TTGO-100g, glicemia de jejum > 95 mg/dL no TTGO-100g; média das quatro glicemias aferidas no TTGO-100g; valor da glicemia de jejum, de 1ª, 2ª e 3ª horas do TTGO-100g e HbA1c pela análise univariada (P<0,05). Na análise do modelo de regressão logística foram desenvolvidos dois modelos que incluíam os seguintes fatores preditores do uso de insulina: obesidade pré-gestacional, antecedente familiar de DM, número de valores anormais no TTGO-100g (só modelo 1) e valor da glicemia de jejum do TTGO-100g (só modelo 2). Os dois primeiros modelos foram novamente analisados, incluindo-se a variável HbA1c para verificação de sua contribuição na predição do uso de insulina. Curvas de probabilidade e escores foram construídos com base nas quatro combinações de fatores preditores. Conclusões: É possível estimar a probabilidade do uso de insulinoterapia para controle glicêmico em gestantes com DMG por meio de IMC pré-gestacional, antecedente familiar de DM, número de valores anormais do TTGO-100g, valor da glicemia de jejum no TTGO-100g e da HbA1c.Objective: To determine the association between clinical and laboratory parameters and insulin requirement in pregnancies complicated by gestational diabetes mellitus (GDM), and to evaluate possible factors predicting the need for insulin therapy. Methods: A total of 294 patients with GDM diagnosed by the 100- g/3-h oral glucose tolerance test (OGTT) between 24 and 33 complete weeks of gestation were retrospectively studied. These patients were under prenatal follow-up at the Obstetric Clinic of the University of Sao Paulo School of Medicine (HCFMUSP) between July 1, 2002 and June 30, 2008. The clinical and laboratory factors which could be associated to the need for insulin therapy were analyzed: maternal age, prepregnancy obesity body mass index (BMI) > 30 Kg/m2, family history of diabetes mellitus (DM), smoking, hypertension, use of systemic corticosteroids, prior GDM, prior fetal macrosomia, nulliparity, multiparity, prior stillbirth, prior neonatal death, gestational age at diagnosis of GDM, multiple pregnancy, elevated amniotic fluid index (AFI) AFI > 18 cm, polyhydramnios (AFI > 25 cm), number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose > 95 mg/dL, mean of the four 100-g/3-h OGTT values, 100-g/3-h OGTT fasting/one/two/three plasma glucose values, and glycated hemoglobin (HbA1c). The association between each factor and the need for insulin therapy was then analyzed individually (Pearsons chi-square/Fishers exact or Student t test). The performance of these factors to predict the probability of insulin therapy was estimated using a logistic regression model. Results: Among the 294 patients studied, 39.8% (117/294) required insulin for glycemic control. Univariate analysis showed a positive correlation between insulin therapy and prepregnancy obesity, family history of diabetes, hypertension, prior GDM, prior fetal macrosomia, number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose > 95 mg/dL, mean of the four 100-g/3-h OGTT values, 100-g/3-h OGTT fasting/one/two/three plasma glucose values, and HbA1c (P < 0.05). Two logistic regression models were developed and included the following parameters: prepregnancy obesity, family history of diabetes, number of abnormal 100-g/3-h OGTT values (just model 1) and 100-g/3-h OGTT fasting plasma glucose (just model 2). The two first models were analysed another time including the variable HbA1c to verify its contribution on prediction of the need for insulin therapy. Probability curves and scores were constructed based on the four combinations of predictive factors. Conclusions: The probability of insulin therapy can be estimated in pregnant women with GDM based on prepregnancy obesity, family history of diabetes, number of abnormal 100-g/3-h OGTT values, 100-g/3-h OGTT fasting plasma glucose, and HbA1c concentration.
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Tenerz, Åke. "Diabetes mellitus and related glucometabolic disturbances in acute myocardial infarction : Diagnosis, prevalence and prognostic implications". Doctoral thesis, Uppsala University, Department of Medical Sciences, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3423.
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In patients with diabetes mellitus (DM), acute myocardial infarction (AMI) is a major cause of death. We have studied two populations with respect to the relationship between DM or related glucometabolic disturbances and AMI.
In the first population, the prevalence of DM and the importance of the glycaemic state for the long-term prognosis in non-diabetic patients were investigated in patients with AMI admitted to the Coronary Care Unite at Västerås Central Hospital.
In the second population, the prevalence of impaired glucose tolerance (IGT), DM and other metabolic abnormalities was investigated in patients with AMI and without known DM admitted to the Coronary Care Units at Västerås and Karolinska Hospital, Stockholm.
21% of the patients with AMI had previously known DM and 4% had newly detected DM if diagnosis is based upon fasting blood glucose (F-BG). The glycemic state, measured as HbA1c, at a 5.5 years follow-up was a risk factor for re-infarction and/or death in non-diabetic patients after AMI.
If an oral glucose tolerance test (OGTT) is performed, 40-45% of all patients with AMI have DM and in addition about 30% have IGT. Both an OGTT and a single post-challenge blood glucose value after 60 minutes performed at hospital discharge, were independent predictors of IGT or DM at follow-up. Insulin resistance, measured by homeostatic model assessment (HOMA-IR), decreased during hospital stay, with no further decrease from hospital discharge to follow-up.
In summary, the studies in this dissertation have revealed an unexpectedly high prevalence of abnormal glucose tolerance in patients with AMI. The glycaemic state, reflected by HbA1c, in non-diabetic patients after AMI has an impact on the long-term prognosis. Consequently, in all patients with AMI, HbA1c and casual blood glucose should be measured at admission and, at least, F-BG at hospital discharge.
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Holzner, Alexandra. "Der Weißbüschelaffe (Callithrix jacchus) und das Metabolische Syndrom: Einfluss von Geschlecht und pränataler Programmierung". Doctoral thesis, Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-214457.
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Das Metabolische Syndrom (MetSyn) ist gekennzeichnet durch eine Kombination verschiedener kardiovaskulärer Risikofaktoren: Glukoseintoleranz, Adipositas, Dyslipidämie sowie arterielle Hypertonie. Es gilt beim Menschen als eine der Hauptursachen für Herzkreislauferkrankungen und befindet sich weltweit auf enormem Vormarsch. Die Weichen für die Erkrankung werden zum Teil schon vor der Geburt durch eine veränderte Umwelt in utero gestellt. So können Stress oder eine Glukokortikoidbehandlung während der Schwangerschaft zu einem veränderten Phänotyp des Embryos/Fetus führen - mit Konsequenzen für das gesamte spätere Leben. Dieses Phänomen wird als pränatale Programmierung bezeichnet. Neben diesen epigenetischen Effekten spielen u. a. auch geschlechtsabhängige Faktoren eine Rolle für das Risiko, am MetSyn zu erkranken. Die vorliegende Arbeit befasst sich mit den Auswirkungen einer Glukokortikoidbehandlung in der frühen Trächtigkeit sowie dem Einfluss des Geschlechts auf kardiovaskuläre Risikofaktoren im Erwachsenenalter. Als Modelltier für die Studie wurde der Weißbüschelaffe eingesetzt. In einem 2002 stattgefundenen Vorversuch im Deutschen Primatenzentrum in Göttingen wurde tragenden Tieren (F0) eine Woche lang täglich oral Dexamethason verabreicht. Dieses synthetische Glukokortikoid kann die Plazentaschranke passieren. Die drei folgenden in Leipzig gehaltenen Generationen DexF1/2/3W (weibliche Tiere, n = 4/6/2) und DexF2/3M (männliche Tiere, n = 2/4) gingen in die Untersuchung ein. Tiere, die keine Nachkommen der F0-Generation darstellten, bildeten jeweils eine weibliche (ControlW, n = 11) und eine männliche (ControlM, n = 15) Kontrollgruppe und wurden ebenfalls herangezogen, um die Auswirkungen des Geschlechts auf die untersuchten Parameter zu ermitteln. Es wurde ein oraler Glukosetoleranztest (OGTT) durchgeführt (inklusive der Erfassung der Insulinwerte), der Quantitative Insulin Sensitivity Check Index (QUICKI – Maß für die Insulinsensitivität) berechnet sowie Lipidstoffwechselparameter bestimmt. Außerdem fanden wöchentlich Erfassungen des Körpergewichts statt. In mehreren Sitzungen pro Tier wurde der Blutdruck gemessen. Die statistische Auswertung erfolgte mittels Mann-Whitney-U-Test für unabhängige Stichproben. Unterschiede mit einer Irrtumswahrscheinlichkeit p ≤ 0,05 wurden als signifikant angesehen. Im OGTT wies DexF1W im Vergleich zu ControlW 120 Minuten nach oraler Glukoseapplikation eine signifikant niedrigere Insulinkonzentration auf. Da nach 30 und 120 Minuten auch die Glukosekonzentration signifikant erniedrigt war, ist jedoch nicht von einer klinischen Relevanz auszugehen. Weitere Auswirkungen der Dexamethasonapplikation auf die F1- bis F3-Generation konnten nicht beobachtet werden. Beim Vergleich der weiblichen und männlichen Nachkommen unbehandelter Weißbüschelaffen fiel auf, dass weibliche Tiere signifikant höhere Insulinkonzentrationen und damit eine signifikant größere Insulin-AUC (Fläche unter der Kurve) im OGTT zeigten. Ihr QUICKI war signifikant niedriger. Hyperinsulinämie und niedriger QUICKI stellen Symptome einer gestörten Glukoseregulation dar. Die weiblichen Tiere zeigten außerdem eine signifikante Erhöhung hinsichtlich Körpergewicht, VLDL-Triglycerid- und folglich Plasmatriglyceridkonzentrationen. Ihre HDL-Cholesterolwerte waren signifikant niedriger. Diese Kombination einer Hypertriglyceridämie mit niedrigem HDL-Cholesterol wird als atherogene Dyslipidämie bezeichnet. Eine gestörte Glukosehomöostase, eine Adipositas sowie eine atherogene Dyslipidämie stellen kardiovaskuläre Risikofaktoren und wichtige Komponenten des MetSyn dar. Zusammenfassend lässt sich sagen, dass beim Weißbüschelaffen eine Glukokortikoidbehandlung während der frühen Trächtigkeit nicht zum MetSyn der F1- bis F3-Generationen im Erwachsenenalter führte. Hingegen ergab die Untersuchung auf ein geschlechtsabhängiges Erkrankungsrisiko eine eindeutige Prädisposition bei den weiblichen Tieren. Die zu Grunde liegenden Mechanismen dieses Phänomens bleiben Gegenstand weiterer UntersuchungenThe metabolic syndrome (MetSyn) consists of a cluster of metabolic disorders, characterized by glucose intolerance, obesity, dyslipidemia and hypertension. In humans, it is a major cause for cardiovascular disease. Its worldwide prevalence is increasing. The way for the disease can be paved even before birth. An adverse intrauterine environment due to prenatal stress or an iatrogenic overexposure of the fetus to glucocorticoids can lead to an altered phenotype with consequences for later life. This phenomenon is called prenatal programming. In addition gender specific factors play a leading role for the risk of developing MetSyn. The aim of the present study was to investigate the influence of a glucocorticoid application in early pregnancy and gender on cardiovascular risk factors in adulthood. The common marmoset was used as model species. In a preliminary experiment (2002) at the german primate centre (Göttingen) animals (F0) were orally treated with dexamethasone for one week during early pregnancy. Dexamethasone is a synthetic glucocorticoid that can pass the placental barrier. The following three generation offspring, reared in Leipzig, DexF1/2/3W (female animal, n = 4/6/2) and DexF2/3M (male animal, n = 2/4) were regarded. Animals that were no descendants of the F0 generation built a female (ControlW, n = 11) and a male (ControlM, n = 15) control group and were also regarded for gender-specific risk for MetSyn. An oral glucose tolerance test (OGTT) was carried out (including measurements of insulin concentration), the Quantitative Insulin Sensitivity Check Index (QUICKI – measure of insulin sensitivity) was calculated and parameters of lipid metabolism were investigated. Furthermore, all animals were weighed weekly and blood pressure was monitored at a series of meetings. Statistical analysis was performed by Mann-Whitney-U-Test for independent samples. The level of significance was defined at p ≤ 0.05. DexF1W in comparison to ControlW had a significantly lower insulin concentration 120 minutes after glucose application in the OGTT and a significantly lower glucose concentration 30 and 120 minutes after reaching the sugar solution. These findings did not seem to be clinically relevant. Apart from that, no consequences could be determined in the F1-3 generation offspring after dexamethasone treatment in pregnancy. Regarding gender comparison of untreated common marmosets, female animals had significantly higher insulin concentrations in OGTT and therefore a significantly greater insulin AUC (area under the curve). QUICKI was significantly lower. Hyperinsulinemia and a low QUICKI are symptoms of an impaired glucose regulation. Furthermore, the female animals showed an increase in body weight, VLDL triglycerides and therefore total triglycerides. HDL cholesterol was significantly lower. Hypertriglyceridemia in combination with low HDL cholesterol is called atherogenic dyslipidemia. A disturbed glucose homeostasis, obesity and an atherogenic dyslipidemia are cardiovascular risk factors and important components of MetSyn. In summary, dexamethasone applied in early pregnancy did not lead to metabolic syndrome in the F1-F3 generation offspring of common marmoset in adulthood. However, the female gender was associated with a higher risk of developing the disease. The underlying mechanisms require further investigation
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Saaristo, T. (Timo). "Assessment of risk and prevention of type 2 diabetes in primary health care". Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514297113.
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Abstract Type 2 diabetes is one of the fastest increasing lifestyle diseases globally. Its cure is not yet possible, but there is firm evidence from scientific studies that it can effectively be prevented by lifestyle changes. There is limited evidence-based information on the prevention of diabetes in practice. This dissertation offers new desirable information on the issue. The aim of this dissertation study was to describe the prevalence of risk factors for type 2 diabetes and hidden glucose disorders predicting the development of diabetes in the Finnish adult population, and to analyse whether the risk for developing diabetes could be reduced by simple lifestyle counselling. Furthermore, the ability of the Finnish Diabetes Risk Score (FINDRISC) to detect glucose disorders leading to diabetes and undiagnosed diabetes was analysed. In the dissertation data from large Finnish population surveys (the FINRISK 2002 glucose tolerance survey and the FIN-D2D 2004−2005 survey) were analysed. In addition, a prospective design and large-scale intervention were included. We found that obesity and glucose disorders are very common in the Finnish middle-aged population. Prevalence of obesity was 24% for men and 28% for women, that of abnormal glucose metabolism 42% for men and 33% for women, and that of undiagnosed diabetes 9% for men and 7% for men. One quarter of individuals aged 45−64 years were at high risk for diabetes. Lifestyle interventions were offered to more than 10,000 high-risk individuals, 3,379 men and 6,770 women. Of the men, 43% were also at high risk for cardiovascular morbidity and 42% at high risk for cardiovascular mortality estimated through the FRAMINGHAM and SCORE risk engines, respectively. The FINDRISC, originally developed for predicting the risk of development of type 2 diabetes, also predicted the prevalence of diabetes in the population. The effect of lifestyle interventions on weight and its association with glucose tolerance was evaluated in individuals at high risk for diabetes in a one-year follow-up. In total 17.5% of them lost ≥ 5% weight. Their relative risk for diabetes decreased 69% compared with the group that maintained their weight. This study shows that FINDRISC predicts prevalent type 2 diabetes. A significant proportion of middle-aged Finnish population has a glucose disorder including undiagnosed type 2 diabetes. Lifestyle interventions in primary health care may promote weight loss, which decreases the risk of diabetesTiivistelmä Diabetes on yksi nopeimmin lisääntyvistä elintapasairauksista maailmassa. Sitä ei vielä voida parantaa, mutta tieteellisissä tutkimuksissa on kiistattomasti osoitettu, että sitä voidaan tehokkaasti ehkäistä elintapamuutoksilla. Diabeteksen ehkäisystä käytännössä on hyvin niukasti tutkimustietoa. Tämä väitöskirja tuo kaivattua lisätietoa aiheesta. Väitöstutkimuksen päätavoitteena oli selvittää diabeteksen riskitekijöiden ja piilevien diabetesta ennakoivien sokerihäiriöiden yleisyyttä suomalaisessa aikuisväestössä. Tämän ohella tavoitteena oli selvittää voidaanko yksinkertaisella elintapaneuvonnalla vähentää sellaisten henkilöiden sairastumisvaaraa, joilla oli suuri riski sairastua diabetekseen. Lisäksi arvioitiin diabetesriskitestin kykyä tunnistaa ennakoivat sokerihäiriöt ja aiemmin tunnistamaton diabetes. Tutkimuksessa käytettiin laajoja suomalaisia väestötutkimusaineistoja: FINRISKI-2002 -tutkimusta, sen alaotosta ja D2D-väestötutkimusta 2004–2005. Mukana oli myös pitkittäisasetelma ja laajamittainen interventio. Tutkimuksen perusteella huomasimme, että lihavuus ja sokerihäiriöt ovat hyvin yleisiä keski-ikäisillä suomalaisilla. Merkittävästi lihavia (BMI ≥ 30 kg/m2) oli 24 % miehistä ja 28 % naisista ja poikkeava sokeriaineenvaihdunta oli 42 %:lla miehistä ja 33 %:lla naisista. Tunnistamaton diabetes oli 9 %:lla miehistä ja 7 %:lla naisista. Suuressa diabetekseen sairastumisvaarassa oli neljäsosa 45−64-vuotiaista. Interventioon otettiin yli 10 000 suuressa diabeteksen sairastumisriskissä olevaa henkilöä, 3 379 miestä ja 6 770 naista. Miehistä 43 % oli suuressa sairastumisvaarassa myös sydän- ja verisuonisairauteen ja 42 % suuressa kuolemanvaarassa Framingham- ja SCORE-riskilaskureilla arvioituna. Tyypin 2 diabeteksen sairastumisriskin arviointiin kehitetty Riskitesti ennusti hyvin myös diabeteksen esiintymistä väestössä. Elintapainterventioiden vaikutusta painoon ja sokeriaineenvaihduntaan analysoitiin vuoden seurannassa sellaisilla henkilöillä, joilla oli suuri diabetesriski. Paino laski 5 % tai enemmän 17,5 %:lla, jolloin sairastumisriski diabetekseen väheni 69 % verrattuna ryhmään, jonka paino ei muuttunut. Tutkimuksen perusteella lihavuus, sokerihäiriöt ja tunnistamaton diabetes ovat yleisiä keski-ikäisessä väestössä. Riskitesti on hyvä työkalu myös diabeteksen seulonnassa. Perusterveydenhuollossa tarjottavalla elintapaneuvonnalla voidaan saada aikaan laihtuminen, joka vähentää sairastumisvaaraa diabetekseen
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DURUPT, LAURENCE. "Therapeutique orale a base de fer : biodisponibilite et tolerance". Strasbourg 1, 1987. http://www.theses.fr/1987STR10768.
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Staaf, Johan. "Childhood Obesity and Islet Function". Doctoral thesis, Uppsala universitet, Institutionen för medicinsk cellbiologi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-313310.
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The prevalence of childhood obesity and Type 2 Diabetes Mellitus (T2DM) has increased during recent decades. T2DM is accompanied with functional changes in the islets of Langerhans, which can be identified early in the pathogenesis. The aim of this thesis was to explore how metabolic changes caused by obesity early in life relate to islet function prior to overt T2DM. To address this, Uppsala Longitudinal Study of Childhood Obesity (ULSCO) was established (paper I). Initially, the association between palmitate and insulin secretion was investigated using a translational approach with obese and lean normoglycemic juveniles and isolated human islets (paper II). Secondly, dynamics of islet-hormones insulin and glucagon, and gut-hormones glucagon like-peptide 1 (GLP-1) and glicentin (paper III) and magnetic resonance imaging of pancreatic fat fraction (PFF) (paper IV) were studied in association to glucose tolerance and beta-cell function. Finally, a novel method of analysing shape features of oral glucose tolerance test (OGTT) curves was introduced and evaluated (paper V). Obese subjects had high prevalence of prediabetes and metabolic syndrome (MetS) (paper I). In obese pre-pubertal children with elevated palmitate levels, hyperinsulinemia was observed (paper II). In contrast, obese pubertal adolescents with similar palmitate levels showed moderate insulin levels during OGTT with delayed first phase insulin response. To explore mechanisms for these variations, isolated human islets were exposed to palmitate for different time periods in vitro. After 2 days accentuated insulin response was observed. Impaired beta-cell function and apoptosis were evident after 7 days, however. Hyperglucagonemia and disturbed GLP-1 and glicentin levels were associated with obesity and glycaemic status, with fasting glicentin being predictive of prediabetes (paper III). Furthermore, PFF was increased in obese subjects and associated to MetS and visceral adipose tissue, but not to beta-cell function (paper IV). OGTT curves were converted into geometric centres, centroids, which correlated with differences in glucose tolerance (paper V). In conclusion, the islet function in obese children was associated with elevated levels of palmitate, but not pancreatic fat. Fasting palmitate and glicentin levels, as well as centroid analyses of OGTT curves, could potentially identify obese children at risk of prediabetes and subsequent T2DM.