Browsing by Author "Trindade, Madalena"
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- IL-5 serum and appendicular lavage fluid concentrations correlate with eosinophilic infiltration in the appendicular wall supporting a role for a hypersensitivity type I reaction in acute appendicitisPublication . Carvalho, Nuno; Carolino, Elisabete; Coelho, Hélder; Cóias, Ana; Trindade, Madalena; Vaz, João; Cismasiu, Brigitta; Moita, Catarina; Moita, Luis; Costa, Paulo MatosAppendicitis is the most common abdominal surgical emergency, but its aetiology is not fully understood. We and others have proposed that allergic responses play significant roles in its pathophysiology. Eosinophils and Interleukin (IL)-5 are involved in a hypersensitivity type I reaction. Eosinophil infiltration is common in the allergic target organ and is dependent on IL-5. In the presence of an allergic component, it is expected that the eosinophil count and IL-5 local and systemic concentrations become elevated. To address this hypothesis, we designed a prospective study that included 65 patients with acute appendicitis (grouped as acute phlegmonous or gangrenous according to the histological definition) and 18 patients with the clinical diagnosis of acute appendicitis, but with normal histological findings (control group) were enrolled. Eosinophil blood counts and appendicular wall eosinophil infiltration were determined. IL-5 levels in the blood and appendicular lavage fluid were evaluated. Appendicular lavage fluid was collected by a new methodology developed and standardized by our group. Appendicular wall eosinophil infiltration was higher in acute phlegmonous appendicitis than in gangrenous appendicitis (p = 0.000). IL-5 blood levels were similar in both pathologic and control groups (p > 0.05). In the appendicular lavage fluid, higher levels of IL-5 were observed in the phlegmonous appendicitis group (p = 0.056). We found a positive correlation between the appendicular wall eosinophilic infiltration and the IL-5 concentrations, in both the blood and the appendicular lavage fluid, supporting the IL-5 reliance in eosinophil local infiltration. We observed the highest presence of eosinophils at phlegmonous appendicitis walls. In conclusion, the present data are compatible with a hypersensitivity type I allergic reaction in the target organ, the appendix, during the phlegmonous phase of appendicitis.
- Immunoglobulin serum concentrations do not correlate with acute appendicitisPublication . Carvalho, Nuno; Carolino, Elisabete; Carvalho, Isabel; Lisboa, Vanessa; Coelho, Hélder; Trindade, Madalena; Vaz, João; Moita, Luís; Costa, PauloAs imunoglobulinas são um componente central da imunidade humoral e as suas concentrações séricas são determinadas por rotina na prática clínica, pois fornecem informações importantes sobre o estado imunológico humoral. Num estudo prospetivo de centro único, avaliámos as concentrações séricas de IgA, IgE, IgG e IgM em doentes com apendicite aguda confirmada histologicamente (grupo de estudo, N=54) e comparámos com o grupo controle (N=69), doentes submetidos a apendicectomia, mas com achados histológicos normais, doentes submetidos a cirurgia de ambulatório e voluntários saudáveis. As concentrações séricas de imunoglobulinas foram normais em todos os casos, exceto para IgE, que estava elevada tanto no grupo estudo (20%) quanto no grupo controle (21%) (p= 0,609). Esses valores estão em boa concordância com a prevalência de alergias na população geral. O nosso estudo é o primeiro a abordar especificamente a resposta imune humoral de imunoglobulinas na apendicite aguda na literatura inglesa. Demonstrámos que a apendicite aguda não provoca uma resposta imune humoral específica.