RESUMO Introdução: Pacientes com doença renal crônica (DRC) apresentam desequilíbrio na composição da microbiota intestinal, gerando toxinas urêmicas, como o p-cresil sulfato (PCS), pela fermentação bacteriana dos aminoácidos tirosina (Tyr) e fenilalanina (Phe) da dieta. Assim, a dieta pode ser determinante nos níveis de toxinas urêmicas produzidos pela microbiota intestinal. O objetivo deste estudo foi avaliar a possível relação entre a ingestão de Tyr e Phe e os níveis plasmáticos de PCS em pacientes com DRC não dialisados. Métodos: Foram avaliados 27 pacientes com DRC em tratamento conservador (estágios 3 e 4), sem intervenção nutricional prévia. A ingestão alimentar foi avaliada pelo recordatório alimentar de 24h (R-24h) de 3 dias, e a ingestão proteica também foi verificada através do Protein Nitrogen Appearance (PNA). Os níveis plasmáticos de PCS foram determinados por cromatografia líquida de fase reversa. Resultados: Os pacientes avaliados (TFG, 34,8 ± 12,4 mL/min, 54,2 ± 14,3 anos, IMC 29,3 ± 6,1 kg/m2) apresentaram ingestão média de proteína de 1,1 ± 0,5 g/kg/dia, Tyr de 4,5 ± 2,4 g/dia e Phe de 4,6 ± 2,5 g/dia. Os níveis plasmáticos de PCS (20,4 ± 15,5 mg/L) foram elevados e positivamente associados à ingestão de Tyr (r = 0,58, p = 0,002) e Phe (r = 0,53, p = 0,005), mesmo após ajustes pela TFG e idade. Conclusão: Este estudo sugere que a dieta é um importante modulador dos níveis plasmáticos de toxinas urêmicas produzidas pela microbiota intestinal em pacientes com DRC não dialisados.

ABSTRACT Background: Patients with chronic kidney disease (CKD) present an imbalance of the gut microbiota composition, leading to increased production of uremic toxins like p-cresyl sulfate (PCS), product from bacterial fermentation of the amino acids tyrosine (Tyr) and phenylalanine (Phe) from the diet. Thus, diet may be a determinant in the uremic toxins levels produced by the gut microbiota. The aim of this study was to evaluate the possible relationship between Tyr and Phe intake and PCS plasma levels in non-dialysis CKD patients. Methods: Twenty-seven non-dialysis CKD patients (stages 3 and 4) without previous nutritional intervention were evaluated. The dietary intake was evaluated using a 24-hour recall, 3-day food record and protein intake was also estimated by Protein Nitrogen Appearance (PNA). The plasma levels of PCS were measured using reverse phase high performance liquid chromatography. Results: The evaluated patients (GRF, 34.8 ± 12.4 mL/min, 54.2 ± 14.3 years, BMI, 29.3 ± 6.1 kg/m2) presented mean protein intake of 1.1 ± 0.5 g/kg/day), Tyr of 4.5 ± 2.4 g/day and Phe of 4.6 ± 2.5 g/day. PCS plasma levels (20.4 ± 15.5 mg/L) were elevated and positively associated with both, Tyr (r = 0.58, p = 0.002) and Phe intake (r = 0.53, p = 0.005), even after adjustments for eGFR and age. Conclusion: This study suggests that the diet is an important modulator of the uremic toxins plasma levels produced by the gut microbiota, in non-dialysis CKD patients.

Glutathione Reductase (GR) plays a key role in the maintenance of GSH homeostasis, variations in its activity may indicate damage from environmental contaminants. Experimental planning is a strategy to reduces time and cost in enzymatic assays. In this work, DCCR experimental planning was used to standardize and to validate the measure of GR in Aegla singularis bioindicator. Samples of A. singularis were collected in three watersheds with different percentages of naturalness and land uses. At all, were selected 7 streams, in which collections were performed at one upstream (most preserved) and one downstream (less preserved) point. Effects of temperature, reading time, substrate (GSSG) and protein concentration in GR reaction medium were evaluated, being that the two latter variables were optimized by DCCR. GR was not affected by temperature (15 to 30 °C) or reading time (6 and 10 minutes). Increased concentrations of proteins from biological extract had negative correlation with GR, whereas higher concentrations of GSSG resulted in higher GR activity. Environmental validation showed that GR in Aeglawas influenced primarily by the watershed of origin. DCCR planning was efficient to optimizing the use of GR as a biomarker of environmental quality.

OBJECTIVE: The aim of the present study was to investigate the association of the redox state via malondialdehyde (MDA) as a lipid peroxidation biomarker and hydrophilic antioxidant capacity (HAC) with dietary, anthropometric, demographic, socio-economic and clinical variables as well as the serum concentrations of vitamins in children aged 20-36 months. This cross-sectional study was conducted from May 2013 to May 2014 and included a total of 100 children. METHODS: The variables studied included anthropometric measurements, dietary intake by the Food Frequency Questionnaire (FFQ), socio-demographic features, clinical attributes, serum redox status, and serum vitamin concentrations. RESULTS: Children with a family income above the minimum wage and adequate body mass index (BMI) presented higher HAC. The MDA concentration was higher in children older than 24 months. Breastfeeding for up to 120 days provided greater antioxidant capacity. Children classified in the 2nd tertile for “fruit and vegetables” and “milk and dairy products” consumption showed lower levels of MDA. There was a positive correlation of MDA with serum vitamin A levels. These results show that among children in the 20-36 months age group, family income, breastfeeding, BMI and intake of fruits and vegetables can have an influence on the imbalance of the redox state. CONCLUSION: One strategy to prevent the imbalance between oxidants and antioxidants could be for health professionals to raise awareness among families, as such knowledge could repress/prevent the progression/initiation of several diseases in adult life.

A eosinofilia no sangue e em tecidos está habitualmente associada a condições alérgicas, infecciosas, inflamatórias, neoplásicas, endocrinológicas, uso de medicamentos e exposição a agentes tóxicos. No entanto, pode ocorrer proliferação eosinofílica primária, sem causa aparente ou por expansão clonal da célula-tronco hematopoética. As neoplasias mielo ou linfoproliferativas associadas a rearranjos gênicos como PDGFRα, PDGFRβ e FGFR1 constituem condições raras nas quais ocorre mieloproliferação crônica, alterações no sangue periférico e na medula óssea e lesão tecidual de diferentes órgãos, a partir da liberação de citocinas e fatores humorais pelos grânulos eosinofílicos. A presença do rearranjo PDGFRα relaciona-se comumente à leucemia eosinofílica crônica, com envolvimento de mastócitos e neutrófilos e, mais raramente, à leucemia mielóide aguda ou ao linfoma linfoblástico T, com eosinofilia. O rearranjo PDGFRα mais comum é aquele resultante da deleção intersticial no braço longo do cromossomo 4, que permite a formação de um neogene a partir da fusão dos genes FIP1L1 e PDGFRα. Este codifica uma tirosino-quinase constitutivamente ativa que é inibida pelo mesilato de imatinibe. Em 2002 foi relatado o uso bem sucedido de mesilato de imatinibe em baixas doses em um paciente com síndrome hipereosinofilica e, desde então, vem-se utilizando esta droga com respostas clínicas rápidas, completas e duradouras. Descrevemos um caso de LEC com expressão do rearranjo FIP1L1-PDGFRα.

Chronic eosinophilia is habitually associated with allergic, infectious, inflammatory, neoplastic and endocrine conditions and exposure to certain drugs and toxic agents. However, eosinophilic proliferation may be primary, without identifiable causes, or provoked by clonal hematopoietic stem cell proliferation. Gene fusions involving PDGFR-α, PDGFR-β, and FGFR1 predispose patients to rare conditions with chronic myeloproliferation or lymphoproliferation, alterations in peripheral blood and bone marrow and diffuse tissue injury due to the release of cytokines and humoral factors from eosinophilic granules. The presence of the PDGFR-α rearrangement is commonly related to chronic eosinophilic leukemia, with alterations in peripheral mastocytes and neutrophils, and rarely to acute myeloid leukemia or T lymphoblastic lymphoma with eosinophilia. The most prevalent PDGFR-α rearrangement is one resulting from an interstitial deletion in the long arm of chromosome 4, that allows the formation of a neogene from the fusion of the FIP1L1 and PDGFRα genes. This codes a constitutively active tyrosine kinase, which can be inhibited by imatinib mesylate. In 2002, the successful treatment of a patient using imatinib to treat hypereosinophilic syndrome was reported. Since then, this drug has been utilized with fast, complete and lasting clinical responses. Here we describe a case of chronic eosinophilic syndrome with expression of the FIP1L1-PDGFR-α rearrangement.

Objetivou-se analisar o efeito de suplementação energética sobre o consumo e a fermentação ruminal de proteínas em dois níveis de proteína dietética (6 e 20%). Quatro novilhos mestiços fistulados no rúmen foram utilizados em um quadrado latino e os tratamentos arranjados em um fatorial 2 × 2, em que as dietas testadas constituíram-se de: A. só feno; B. feno + 2,8 kg de farelo de soja; C. feno + 2,8 kg de fubá de milho; e D. feno + 2,8 kg de farelo de soja + 2,8 kg de fubá de milho. Foram realizados quatro períodos experimentais constituídos de 18 dias, sendo sete dias para adaptação dos animais, sete dias para determinação do consumo de matéria seca e quatro dias para coleta de amostras. As coletas foram feitas através de fístula ruminal nos tempos zero, dois, quatro e seis horas após a alimentação, sendo utilizadas para determinações das concentrações de amônia, pH e AGV do líquido ruminal. Não houve interações entre o fubá de milho e o farelo de soja, assim como não ocorreu efeito do tempo de coleta sobre os parâmetros estudados. O farelo de soja reduziu a relação acetato:propionato (A:P) em 13%, aumentou o consumo de matéria seca total (CMSt) em 41,2%, sem alterar o consumo de forragem e o pH, e aumentou as concentrações de amônia (790%), propionato (48%), AGV total (39%), isobutirato (165%), isovalerato (208%) e valerato (201%). O fubá de milho não afetou a fermentação de proteína, embora tenha causado aumento no CMSt (35%) e decréscimo no pH ruminal (6%) e na relação A:P (18%).

The objective was to evaluate the effect of energetic supplementation on feed intake and ruminal fermentation of proteins in two protein levels in the diet (6 and 20%). There were used four rumen fistulated crossbred steers in a Latim square and the treatments were arranjed in a 2 × 2 factorial, in which the combinations were: A. only hay; B. hay + 2.8 kg of soybean meal; C. hay + 2.8 kg of corn meal; and D. hay + 2.8 kg of soybean meal + 2.8 kg of corn meal. Four experimental periods of 18 days were used, in which seven was for adaptation, seven for determination of dry matter intake and four for sampling. Ruminal samples were collected at 0, 2, 4 and 6 hours after feeding for determination of ammonia, pH and VFA. There was no interaction between corn meal and soybean meal, as well as no sampling time effect on the evaluated parameters. Soybean meal decreased 13% acetate:propionate (A:P) ratio and increased 41.2% DMI, with no effect on forage intake and pH and increased ammonia (790%), propionate (48%), total VFA (39%), isobutyrate (165%), isovalerate (208%) and valerate (201%). Corn meal did not affect protein fermentation, although it caused increase in DMI (35%) and decrease in ruminal pH (6%) and A:P ratio (18%).