pro inflamatorias dada su habilidad para estimular la expresión de genes .. antiinflamatorios (IL-4, IL, glucocorticoides) pue- den regular positivamente la . Palabras clave: Valor pronóstico, interleucina-6, IL-6, proteína C-reactiva, .. proinflamatorias, el efecto neto de esta proteína es antiinflamatorio por su. Citocinas, interleucinas y quimiocinas destrucción de celulas tumorales (IL-2); median la quimiotaxis (IL-8,15,16); Proinflamatorio (IL-1,6,17).
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The principal aim of the journal is to j original work in the broad field of Gastroenterology, as well as to provide information on the specialty and related areas that is up-to-date and relevant.
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There is evidence that patients with irritable bowel syndrome IBS have a low degree of inflammation in the intestinal mucosa. The aim of the study was to evaluate theprofile of pro- and anti-inflammatory cytokinesin plasmain Mexican pediatric patients with IBS. Fifteen patients with IBS according to Rome III criteria for childhood and 15 healthy children, matched by age and sex, were included in the study.
This study suggests that children with IBS have a state of altered immune regulation. Antiinflamatorixs is consistent with the theory of low-grade inflammatory state in these patients. There is no evidence of an inflammatory, anatomic, metabolic, or neoplastic process accompanying these characteristics and they should also be present at least once a week in the 2 months before diagnosis.
Multiple mechanisms are involved in its pathophysiology.
One of the first studied is visceral hypersensitivity, a consequence of an alteration in the brain-bowel axis that most likely is modulated by genetic factors that regulate the local inflammatory and immunologic responses to different processes such as infections, intestinal trauma, or allergy.
These, in turn, cause intestinal motility disorders that clinically manifest as diarrhea or constipation, associated or not, with abdominal pain. An infectious event can apparently precipitate IBS development in individuals with a psychosocial and genetic susceptibility, probably by conditioning a mild grade of intestinal mucosa inflammation that leads to immune system activation. The non-probability convenience sampling technique was used to create the study group and the controls. All the participants were residents of Mexico City and its Metropolitan Area.
No patients or controls were included in the study if they presented with malnutrition or overweight according to the World Health Organization and Centers for Disease Control tables, with any infectious gastrointestinal process, if they were carriers of any known allergic or immune alteration, or if they had received antibiotics, probiotics, analgesics, or anti-inflammatory agents in the month prior to their recruitment.
A hemogram, blood chemistry test, 3-sample stool ova and parasite exam, fecal Giardia intestinalis antigen test, and a urinalysis were ordered for all the participants, none of which showed any alterations. Symptomatology was present, through questioning, for at least 4 months prior to the study month interval.
To demonstrate the characteristics of their symptoms and corroborate the IBS diagnosis for pediatric patients according to the Rome III criteria, all the IBS patients or their relatives filled out a symptoms diary at least 2 months prior to their enrollment. They kept a daily record of the presence or absence of symptoms such as abdominal discomfort or pain, abdominal bloating, and bowel movement frequency and characteristics.
A 10 ml venous blood sample was collected in tubes with anticoagulant. Box Vantaa, Finland. The values obtained were correlated linearly with the standard concentrations, forming the calibration curve for each cytokine.
The sensitivity limit for each assay was the following: The samples were run in duplicate. Taking into account the difference found between the levels of the IL exemplified and IL cytokines in a previous study on adults by O?? The decision was made to include 15 patients in each group. Upon finding that the normality criteria were not met, the nonparametric Mann-Whitney U test was applied for independent group evaluation.
A power calculation of the differences was carried out to establish the probabilities of committing a type II error. The parents of all the study participants gave their informed consent and the participants above 8 years of age signed statements of informed consent. Interleucians mean age was There were no significant basal differences in relation to sex and age between the groups.
These results are shown in Table Cytokine plasma levels in IBS patients and controls. IBS is a functional gastrointestinal disorder that presents in both the adult and pediatric populations. M ratio of 4: The causes of IBS are not completely understood, but there proinflamatogias evidence of the participation of multiple pathophysiologic mechanisms, all of which are interrelated. They include genetic and psychosocial factors, visceral hypersensitivity, motility alterations, intestinal permeability, and inflammation.
A potential explanation of IBS pathophysiology is the low-grade inflammation status anntiinflamatorias the intestinal mucosa.
There is evidence that lends support to this theory of low-grade inflammation, as demonstrated in a recent systematic review on the participation of the inflammatory processes at the level of the intestinal mucosa.
Data also suggest that there is a state of immunologic activation manifested by increased cytokine production at the level of the mucosa, blood, and feces, which can be a product of the activation of mast cells and other immune system cells. Cytokines are proteins produced by the activation of immunologic cells that influence the activity, differentiation, and proliferation of other cells, modulating the innate and adaptive immune response.
These cytokines are present in the gastrointestinal mucosa, blood monocytes and plasmaand feces, and can be measured in these tissues or samples. Changes in the cytokine profile of patients with IBS can exacerbate changes in secretion, permeability, motility, and intestinal sensitivity, and produce symptoms of IBS. A clear cytokine profile in blood in patients with IBS does not yet antiinfamatorias.
Results are interlekcinas consistent in all the studies, which could be the result of measuring, methodology, and study population differences. At the time our study was conducted there was no information on the profile of these cytokines in pediatric patients. A recently published study that measured the cytokines in the supernatant of a non-stimulated peripheral blood mononuclear cell PBMC culture with lipopolysaccharides from Escherichia coli showed that IL levels were lower in pediatric patients with IBS The levels in both groups were very similar to those found in our study.
The low IL levels found in our population of children with IBS, compared with healthy controls, are consistent with those found in other studies on the adult population, including Mexican adults, as well as in another pediatric study. It acts together with IL-6 proinflamatoruas an inducer of Th cells, which produce IL and IL implicated in the production of inflammation at the tissular level; the Th cells are then modulated by IL There is also evidence that the differentiation of Th cells in the absence of IL leads to IL production, which is why these cells are poor inducers of inflammation.
The cytokine levels shown in our study, in the IBS patients as well as the controls, are very high in comparison with other similar studies.
However, this is probably due to the type of commercial kit utilized. Our study has the following limitations: IBS subtype comparisons could not be made because of the small sample size; the study was carried out on patients that were seen at a tertiary care hospital, rather than on an open population, and therefore our results cannot be generalized; celiac disease was not proinlfamatorias out appropriately in all the patients; and finally, cytokine measurement was not made directly from the colonic mucosa to determine if it was correlated with the serum levels.
Our results showed that children with IBS presented with an altered immune regulation state by showing plasma levels that were lower for IL and higher for IL These results suggest that the alteration in immune system modulation may be participating in the development of IBS in children.
Financial support was received from the Mexican federal government in relation to this study. The authors declare that there is no conflict of interest. Please cite this article as: See related content at DOI: Previous article Next article. January – March Pages Proinflammatory and anti-inflammatory cytokine profile in pediatric patients proinrlamatorias irritable bowel syndrome.
This item has received. Under a Creative Commons license. Background and objectives There is evidence that patients with irritable bowel syndrome IBS have a low degree of inflammation in the intestinal mucosa. The aim of the study was to evaluate theprofile of pro- and anti-inflammatory cytokinesin plasmain Mexican pediatric patients with IBS. Patients and methods Fifteen patients with IBS according to Rome III criteria for childhood and 15 healthy children, matched by age and sex, were included in the study.
Conclusions This study suggests that children with IBS have a state of altered immune regulation. All the participants were residents of Mexico City and its Metropolitan Area.
A hemogram, blood chemistry test, 3-sample stool ova and parasite exam, fecal Giardia intestinalis antigen test, and a urinalysis were ordered for all the participants, interleucinzs of which showed any alterations.
Evaluation of symptomatology Symptomatology was present, through questioning, for at least 4 months antiinflamatoriad to the study month interval. They kept a daily record of the presence or absence of symptoms such as abdominal discomfort or pain, abdominal bloating, and bowel movement frequency and characteristics.
Sample collection and the enzymatic immunoassay process A 10 ml venous blood sample was collected in tubes with anticoagulant.
The samples were run in duplicate. Statistical analysis Taking into account the difference found between the levels of the IL exemplified and IL ptoinflamatorias in a previous study on adults by O?? The decision was made to include 15 patients in each group. The parents of all the study participants gave their informed consent and the participants above 8 years of age signed statements of informed inetrleucinas.
There were no significant basal differences in relation to sex and age between the groups. These results are shown in Table 1.
Cytokine plasma levels in IBS patients and controls. Prroinflamatorias functional gastrointestinal disorders: Gastroenterology,pp. Is visceral hypersensitivity correlated with symptom severity in children with functional gastrointestinal disorders?. J Pediatr Gastroenterol Nutr, 46pp.
Interleucina 6 – Wikipedia, a enciclopedia libre
Mechanisms underlying visceral hypersensitivity in irritable bowel syndrome. Curr Gastroenterol Rep, 13pp. J Pediatr Gastroenterol Nutr, 48pp. Evolving concepts of the pathogenesis of irritable bowel syndrome: To treat the brain or the gut. Interleukin 10 genotypes in irritable bowel syndrome: Evidence ihterleucinas an inflammatory component?.