RESUMO Objetivo: Investigar a correlação entre achados de TCAR e a atividade metabólica pulmonar nas regiões correspondentes por meio de PET/TC com 18F-FDG e marcadores inflamatórios em pacientes com doença pulmonar intersticial (DPI) associada à esclerose sistêmica (ES). Métodos: Estudo transversal envolvendo 23 pacientes adultos com DPI associada à ES sem outras doenças do tecido conjuntivo. O estudo também envolveu PET/TC com 18F-FDG, TCAR, dosagem sérica de quimiocinas, dados clínicos e testes de função pulmonar. Resultados: Nessa coorte de pacientes com doença de longa duração (11,8 ± 8,7 anos), 19 (82,6%) apresentaram o padrão de pneumonia intersticial não específica. A mediana dos valores padronizados de captação foi maior nas áreas de faveolamento (1,95; p = 0,85). Os níveis séricos de soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, C-C motif chemokine ligand 2 (CCL2) e C-X-C motif chemokine ligand 10 foram maiores nos pacientes com ES que nos controles. Os níveis séricos de CCL2 - um marcador de atividade fibroblástica - correlacionaram-se com áreas de opacidade em vidro fosco (OVF) pura na TCAR (p = 0,007). A PET/TC com 18F-FDG mostrou atividade metabólica significativa para todos os padrões de TCAR. A correlação entre níveis séricos de CCL2 e OVF na TCAR sugere que os fibroblastos desempenham um papel fundamental nessas áreas, acrescentando novas informações para a compreensão dos mecanismos que envolvem elementos celulares e moleculares e sua expressão na TCAR em pacientes com DPI associada à ES. Conclusões: A PET/TC com 18F-FDG aparentemente não consegue diferenciar a intensidade da atividade metabólica nos diferentes padrões de TCAR em pacientes com ES crônica. A associação entre CCL2 e OVF pode estar relacionada à atividade fibroblástica nessas áreas; entretanto, a expressão suprarregulada de CCL2 no tecido pulmonar de pacientes com ES deve ser investigada para que se compreenda melhor essa associação.

ABSTRACT Objective: To investigate the correlation of HRCT findings with pulmonary metabolic activity in the corresponding regions using 18F-FDG PET/CT and inflammatory markers in patients with systemic sclerosis (SSc)-associated interstitial lung disease (ILD). Methods: This was a cross-sectional study involving 23 adult patients with SSc-associated ILD without other connective tissue diseases. The study also involved 18F-FDG PET/CT, HRCT, determination of serum chemokine levels, clinical data, and pulmonary function testing. Results: In this cohort of patients with long-term disease (disease duration, 11.8 ± 8.7 years), a nonspecific interstitial pneumonia pattern was found in 19 (82.6%). Honeycombing areas had higher median standardized uptake values (1.95; p = 0.85). Serum levels of soluble tumor necrosis factor receptor 1, soluble tumor necrosis factor receptor 2, C-C motif chemokine ligand 2 (CCL2), and C-X-C motif chemokine ligand 10 were higher in SSc patients than in controls. Serum levels of CCL2-a marker of fibroblast activity-were correlated with pure ground-glass opacity (GGO) areas on HRCT scans (p = 0.007). 18F-FDG PET/CT showed significant metabolic activity for all HRCT patterns. The correlation between serum CCL2 levels and GGO on HRCT scans suggests a central role of fibroblasts in these areas, adding new information towards the understanding of the mechanisms surrounding cellular and molecular elements and their expression on HRCT scans in patients with SSc-associated ILD. Conclusions: 18F-FDG PET/CT appears to be unable to differentiate the intensity of metabolic activity across HRCT patterns in chronic SSc patients. The association between CCL2 and GGO might be related to fibroblast activity in these areas; however, upregulated CCL2 expression in the lung tissue of SSc patients should be investigated in order to gain a better understanding of this association.

La Laguna Negra ubicada en la zona amortiguadora del Nevado del Ruiz a 3853 m.s.n.m, es una laguna glaciar de origen volcánico ubicada a un costado de la carretera que conduce al PNN Los Nevados es un símbolo turístico y fuente de agua para la región, desde hace varios años muestra una considerable reducción de su espejo de agua lo que hace imperante su estudio antes que pueda desaparecer. El propósito de esta investigación limnológica fue describir su morfología, la riqueza y la abundancia de las plantas ribereñas y de la comunidad planctónica, la calidad del agua, los microorganismos y su relación con algunas variables fisicoquímicas. Se realizaron dos campañas de muestreo, la primera en el mes de Octubre de 2009 (periodo de lluvia) y la segunda en Marzo de 2010 (periodo seco); para el estudio del agua se realizó un muestreo sistemático dividiendo la laguna en nueve cuadrantes, muestreando en superficie y en profundidad (1m). Se tomaron muestras de agua para la observación de plancton, parámetros fisicoquímicos y análisis bacteriológicos. Se realizó un estudio batimétrico de la laguna y se encontró que tiene un área de 950 m² y una profundidad promedio de 1,0 m y una máxima de 1,8 m. Se encontró que en especial Carex sp. avanza sobre la laguna reduciendo su área de espejo. Para conocer sus variaciones y sus relaciones numéricas en dos ciclos hidrológicos se analizaron los resultados fisicoquímicos y biológicos de cada cuadrante, en superficie y en profundidad tanto para el primer y segundo muestreo y no se encontraron diferencias significativas entre los sitios muestreados ( p value 0,524ni entre los muestreos (P=0.1973); El análisis de varianza ANOVA de una via entre los cuadrantes, no mostró diferencias significativas. En el primer muestreo se encontraron coliformes fecales que superan los estándares permitidos lo que hace no potable para consumo humano sin previo tratamiento.

The Black Lagoon located in the buffer zone of Nevado del Ruiz at 3,853 m.a.s.l., is a glacial lake of volcanic origin located at the side of the road to the National Natural Snow-covered Mountains Park which is a touristic symbol and source of water for the region. For several years now, it has been showing a significant reduction of water in its water miror which makes its study imperative before it disappears. The purpose of this limnological research was to describe the morphology, wealth and abundance of riparian vegetation and plankton community, water quality, microorganisms and their relation with physical-chemical variables. Two sampling campaigns were carried out: the first in of October 2009 (rainy period) and the second in March 2010 (dry period). Systematic sampling was conducted for the water study by dividing the lagoon into nine quadrants, sampling both on surface and in depth (1m). Water samples were taken for observation of plankton, physical-chemical and bacteriological parameter analysis. A bathymetric study of the lagoon was carried out and it was found that the lagoon has an area of 950 m², an average depth of 1.0 m and a maximum depth of 1.8 m. It was found that specially Carex sp. progress on the lagoon reducing the water mirror area. To study their variations and numerical relationships in two hydrological cycles, the physical-chemical and biological results in each quadrant were analyzed both in surface and in depth for either, the first and the second sampling and no significant differences were found between the sampled sites (P= 0.524 and between the samples P =0.1973). The one-way ANOVA analysis between quadrants did not show significant differences. In the first sampling fecal coliforms were found exceeding permitted standards which makes water non-consumable for human consumption without previous treatment.

Toxoplasma gondii infection is an important mediator of ocular disease in Brazil more frequently than reported from elsewhere. Infection and pathology are characterized by a strong proinflammatory response which in mice is triggered by interaction of the parasite with the toll-like receptor (TLR)/MyD88 pathway. A powerful way to identify the role of TLRs in humans is to determine whether polymorphisms at these loci influence susceptibility to T. gondii-mediated pathologies. Here we report on a small family-based study (60 families; 68 affected offspring) undertaken in Brazil which was powered for large effect sizes using single nucleotide polymorphisms with minor alleles frequencies > 0.3. Of markers in TLR2, TLR5 and TLR9 that met these criteria, we found an association Family Based Association Tests [(FBAT) Z score = 4.232; p = 1.5 x 10-5; p corrected = 1.2 x 10-4] between the C allele (frequency = 0.424; odds ratio = 7; 95% confidence interval 1.6-30.8) of rs352140 at TLR9 and toxoplasmic retinochoroiditis in Brazil. This supports the hypothesis that direct interaction between T. gondii and TLR9 may trigger proinflammatory responses that lead to severe pathologies such as the ocular disease that is associated with this infection in Brazil.