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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.4 São Paulo  1997

http://dx.doi.org/10.1590/S0004-282X1997000500018 

Avaliação da síntese intratecal de imunoglobulinas no transplante de medula óssea

 

Immunoglobulins intrathecal synthesis evaluation in bone marrow transplantation

 

 

Sérgio Monteiro de AlmeidaI; José Antonio LivramentoI; Ricardo PasqüiniII; Viviana Boccardi PalouIII; Aparecido Mendes de OliveiraIV; Elvira Missako DoiV; Margaret OnoV; Mirna Cigemi AsoV; Eurípides FerreiraVI

INeurologista
IIProfessor Titular, Disciplina de Hematologia
IIIBiologista
IVBiomédico

VBioquímica
VIProfessor Adjunto, Disciplina de Imunologia

 

 


RESUMO

O envolvimento da doença do enxerto contra o hospedeiro crônica (DECH-C) no sistema nervoso central tem sido especulado. Há uma série de semelhanças clínicas e fisiopatológicas entre DECH-C e doenças auto-imunes, o que leva a questionar sobre a síntese intratecal de imunoglobulinas. Este estudo avalia esta síntese, em particular durante a DECH-C, de forma quantitativa e qualitativa, a fim de observar sua incidência e possível fisiopatologia. Foram estudadas amostras pareadas de LCR e soro de 33 pacientes com leucemia mielóide crônica submetidos a transplante de medula óssea (TMO) alogênico, com doador aparentado, HLA idêntico. As amostras foram coletadas nos períodos pré TMO, pós TMO e concomitante à DECH-C. Não foi evidenciada produção intratecal de IgG ou IgA nas várias fases do TMO. Apenas casos isolados evidenciaram síntese, inclusive de IgM, durante a DECH-C.

Palavras-chave: doença do enxerto contra o hospedeiro, barreira hemato-encefálica, auto-imunidade, imunoglobulinas, líquido cefalorraquidiano, transplante de medula óssea.


ABSTRACT

The central nervous system involvement in chronic graft versus host disease (GVHD) has been suggested. Chronic GVHD resembles auto immune connective tissue disorders. In order to investigate the immunoglobulin intra blood brain barrier (BBB) synthesis during chronic GVHD, and contribute to understanding the pathophysiology of the disease, we studied 33 patients who underwent allogeneic bone marrow transplants (BMT) from HLA identical related donors. Immunoglobulin intra BBB synthesis was investigated quantitative and qualitatively. The samples were collected pre BMT, pos BMT and during chronic GVHD. There were no evidence of immunoglobulin intra BBB synthesis, and no oligoclonal bands were found. Only isolated cases suggested IgG and IgA intra BBB synthesis, and in one case IgM during GVHD.

Key words: graft-versus-host disease, blood-brain barrier, auto immunity, immunoglobulins, cerebrospinal fluid, bone marrow transplantation.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

Agradecimento - Ao Prof. Dr. Lineu César Werneck.

 

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Aceite: 20-agosto-1997.

 

 

Projeto realizado com apoio da FAPESP (932705-6) e CAPES.
Estudo realizado na disciplina de Neurologia e Serviço de TMO do Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR), Disciplina de Imunologia da Escola Paulista de Medicina - Universidade Federal de São Paulo (EPM-UNIFESP) e Centro de Investigações em Neurologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Dr. Sérgio Monteiro de Almeida - Especialidade de Neurologia, Hospital de Clínicas UFPR- Rua General Carneiro 181, sala 1238 - 80060-900 Curitiba PR - Brasil.

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