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Doctoral Thesis
DOI
10.11606/T.5.2017.tde-13062017-162816
Document
Author
Full name
Aristides Tadeu Correia
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Pazetti, Rogerio (President)
Said, Marcelo Manzano
Fernandes, Paulo Manuel Pego
Macchione, Mariangela
Soto, Sônia de Fátima
Title in Portuguese
Efeitos do basiliximab com e sem a terapia tríplice na depuração mucociliar das vias aéreas de ratos: estudo experimental
Keywords in Portuguese
Basiliximab
Células caliciformes
Depuração mucociliar
Imunossupressores
Modelos animais
Mucina-5AC
Muco
Ratos
Transplante de pulmão
Abstract in Portuguese
Introdução: Uma imunossupressão eficaz é fundamental para a sobrevivência do paciente após o transplante de pulmão. Estudos prévios demonstraram que drogas imunossupressoras como ciclosporina A, tacrolimo, micofenolato de sódio e prednisona prejudicaram a depuração das vias aéreas de ratos. Para prevenir a rejeição aguda, o basiliximab tem sido utilizado como terapia de indução previamente ao transplante de pulmão em muitos centros ao redor do mundo. Entretanto, existem poucos trabalhos reportando seus efeitos adversos. Objetivo: Avaliar se o basiliximab isolado e em conjunto com a terapia tríplice (tacrolimo, micofenolato de sódio e prednisona) causa efeitos adversos no aparelho mucociliar traqueobrônquico, alterando a depuração mucociliar das vias aéreas de ratos. Método: Oitenta ratos foram distribuídos em quatro grupos conforme o tratamento: Controle, Basiliximab, Tríplice e Basiliximab+Tríplice; e dois subgrupos de acordo com o tempo de tratamento: 7 e 15 dias. Após o período de tratamento, os animais foram eutanasiados e as seguintes análises foram realizadas: análise do lavado broncoalveolar, frequência de batimento ciliar (FBC), velocidade de transporte mucociliar (VTMC), transportabilidade do muco in vitro, histologia, expressão do gene Muc5ac, concentração da proteína mucina do gene Muc5ac e avaliação de apoptose celular no epitélio das vias aéreas. Resultados: Não houve alteração do número de leucócitos no lavado broncoalveolar e da FBC entre os grupos. Já a VTMC foi menor nos grupos Basiliximab e Basiliximab+Tríplice tratados por 7 dias, enquanto nos animais tratados por 15 dias a velocidade foi menor nos grupos Trípice e Basiliximab+Tríplice. O transporte do muco in vitro foi menor no grupo Basiliximab+Tríplice tratado por 15 dias. A porcentagem dos mucos ácido e neutro não foi diferente entre os grupos tratados por 7 e 15 dias, o mesmo ocorreu para a expressão e concentração da proteína mucina do gene Muc5ac. Os grupos Tríplice e Basiliximab+Tríplice tratados por 7 e 15 dias, respectivamente, apresentaram número maior de células apoptóticas no epitélio da via aérea. Conclusão: A droga basiliximab, isolada e em conjunto com a terapia tríplice, prejudicou o aparelho mucociliar traqueobrônquico de ratos, especificamente a depuração mucociliar
Title in English
Effects of basiliximab with and without triple therapy on mucociliary clearance of the airway of rats: experimental study
Keywords in English
Basiliximab, Models animal
Goblet cells
Immunosuppressive agents, Mucociliary clearance
Lung transplantation
Mucin 5AC
Mucus
Rats
Abstract in English
Introduction: Optimal immunosuppression is critical to the survival of the patient after lung transplantation. Previous studies showed that immunosuppressive drugs such as cyclosporine, tacrolimus, sodium mycophenolate and prednisone impaired mucociliary clearance of rats. To prevent acute rejection, basiliximab has been used as induction therapy before lung transplantation in many centers around the world. However, there are few studies reporting its side effects. Objective: Evaluate if basiliximab alone and in combination with triple therapy (tacrolimus, sodium mycophenolate and prednisone) causes adverse effects on the tracheobronchial mucociliary apparatus by impairing airways mucociliary clearance of rats. Method: Eighty rats were divided into four groups according to treatment: Control, Basiliximab, Triple and Basiliximab+Triple; and according to the treatment time: 7 and 15 days. After the treatment period, the animals were euthanized and the following analyzes were performed: bronchoalveolar lavage, ciliary beating frequency (CBF), mucociliary transport velocity (MCTV), mucus transportability rate in vitro, hystology, Muc5ac gene expression, concentration of the mucin protein of the Muc5ac gene and evaluation of cellular apoptosis in the airway epithelium. Results: There was no alteration in the number of leukocytes in the bronchoalveolar lavage fluid and the CBF between groups. The MCTV was lower in the Basiliximab and Basiliximab+Triple groups treated for 7 days, while the velocity was lower in the Triple and Basiliximab+Triple groups treated for 15 days. The mucus transportability rate in vitro was lower in the Basiliximab+Triple group treated for 15 days. There was no difference in percentage of both acidic mucus and neutral mucus between groups treated for 7 and 15 days. Also, there was no difference in the expression and concentration of the mucin of the Muc5ac gene. The Triple and Basiliximab+Triple groups treated for 7 and 15 days, respectively, had a higher number of apoptotic cells in the airway epithelium. Conclusion: The basiliximab, alone and in conjunction with triple therapy, impaired the tracheobronchial mucociliary apparatus of rats, specifically the mucociliary clearance
 
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Publishing Date
2017-06-14
 
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