Systemic lupus Erythematosus

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Juan José Cano Fernández Valeria Guerra Espinosa

Transcript of Systemic lupus Erythematosus

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Juan José Cano FernándezValeria Guerra Espinosa

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Recent researchs support the important role of the cytokine genes in autoimmune diseases, high serum levels of TNF-alfa and IFN- gamma wich are a very important pro-inflammatory citokines have been reported in SLE, a complex disease that causes a high rate of mortality worldwide.

INTRODUCTION

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Is a prototypic autoinmune complex disease which is characterized by excessive production of autoantibodies against a broad range of self-antigens.

For SLE diagnosis, the patient must satisfy at least 4 criteria accordin to the SLE classification

Systemic lupus Erythematosus :

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Polymorphism is the occurrence of two or more clearly different morphs or forms, also referred to as alternative phenotypes, in the population of a species.

Is the variation of a gene in a population

Polymorphisms

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TNF- α Is a cell signaling

protein (cytokine) involved in systemic inflammation and is one of the cytokines

that make up the acute phase reaction.

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the regulation of immune cells endogenous pyrogeninduce fever apoptotic cell death inflammation inhibit viral replication respond to sepsis

Function

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IFN-Y Interferon gamma is a

cytokine that is the only member of the

type II class of interferons. The existence of this

interferon, which early in its history was

known as immune interferon

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innate and adaptive immunity against viral, bacterial and protozoal infections.

activator of macrophages and

inducer of Class II MHC

Function

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Polymorphisms

TNF- α IFN-Y

-308 G>A

+874 A>T

SLE

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This article is based on finding how the TNF-alfa and IFN-gamma are associated with immune factors especially in the systemic lupus erythematosus (SLE) and if this genes polymorphism could affect the susceptibility and severity of the diasease.

OBJECTIVE

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METODOS Y SUJETOS 125

PACIENTES CON LES (LN)

•72 Mujeres•53 Hombres•23.4 ± 4.4 años

112 PACIENTE

S SALUDAB

LES

•66 Mujeres •46 Hombres•28.3± 6.2 años

Centro de urología y nefrología, universidad

Mansoura ,Egipto.Diagnostico de los

pacientes: criterios de LES de la Universidad

Americana de Reumatología

237 PACIENTES EN TOTAL

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CLASIFICACION DE LUPUS NEFRITICO

CLASE I

Glomérulo normal

0 casos

CLASE II

Enfermedad mensagial

pura

8 casos

CLASE III CLASE IV CLASE V

Glomerulonefritis

membranosa

Glomerulonefritis proliferativa

local

Glomerulonefritis

proliferativa difusa

4 casos 88 casos 25 casos

Evaluar la severidad del LN

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1. Lisis celular de glóbulos rojos

2. Lisis nuclear

3. Precipitación de ADN

4. Precipitación de proteínas

5. Almacenamiento de ADN

EXTRACIÓN DE ADN

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PCR- Reacción en cadena de la Polimerasa

Amplificación directa de un

gen o un fragmento de

DNA

Incremento del numero de copias de una secuencia particular de DNA

1. Desnaturalización2. Hibridación con un

Primer3. Síntesis por la DNA

polimerasa

TNF-α GTNF-α AINF-γ TINF-γ A

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PCR- ARMS ARMSSistema de mutación refractaria a la

amplificación

Es un método ideal simple para detectar cambios simples en las bases o pequeñas

delaciones

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RESULTADOS

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TNF-αEl polimorfismo se detecto a 184Pb.

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IFN-YEl polimorfismo se detecto a 263PB

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Casos con LES mostraron aumento significativo de TNF- Y IFN- plasmático en comparación con

los controles

Debido a la alta frecuencia de

genotipos heterocigotos

los genotipos homocigóticos no

mostraron diferencia

significativa

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Author What they said Yes No

Guarniso-zuccardi et al

Individuals that carrying TNF-α -308ª, risk allele were significantly associated with SLE in European, South American and Mexican subjets but was not associated with SLE in Asian and African subjects

X

Kim et al Analysis of the relationship between the IFN-Y +874 A>T SNP and susceptibility to SLE.

x

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The polymorphisms in TNF-α and INF-Y genes increase the susceptibility of individuals to acquire systemic erythematosus lupus

The polymorphisms in TNF-α and INF-Y genes doesn’t generate alteration on the severity disease symptoms.

There are factors like different ethnic origin, diverse genetic and epigenetic interaction that could produce changes in the results.

The TNF-α and INF-Y could be a excellent pharmacology target for the SLE treatment.

CONCLUSSION

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