AS CONCENTRAÇÕES SÉRICAS DE IMUNOGLOBULINA NÃO SE CORRELACIONAM COM APENDICITE AGUDA
Resumo
As 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.
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Referências
1. Neufeld MY, Bauerle W, Eriksson E, Azar FK, Evans HL, Johnson M, Lawless RA, Lottenberg L, Sanchez SE, Simianu VV, Thomas CS, Drake FT. Where did the patients go? Changes in acute appendicitis presentation and severity of illness during the coronavirus disease 2019 pandemic: A retrospective cohort study. Surgery. 2021 Apr; 169(4):808-815. doi: 10.1016/j.surg.2020.10.035. Epub 2020 Dec 4. PMID: 33288212; PMCID: PMC7717883.
2. Carvalho N, Borges F, Costa B, Costa P. A etiologia da apendicite aguda. Será a alergia o elo perdido? Uma revisão narrativa. The aetiology of acute appendicitis. Is allergy the missing link? A narrative review. Revista Portuguesa de Cirurgia, [S.l.], n. 52, p. 1-10, mar. 2022. ISSN 2183-1165
3. Watson Ng WS, Hampartzoumian T, Lloyd AR, Grimm MC. A murine model of appendicitis and the impact of inflammation on appendiceal lymphocyte constituents. Clin Exp Immunol. 2007 Oct; 150(1):169-78. doi: 10.1111/j.1365-2249.2007.03463.x. Epub 2007 Aug 3. PMID: 17680826; PMCID: PMC2219294.
4. van den Boom AL, de Wijkerslooth EML, Mauff KAL, Dawson I, van Rossem CC, Toorenvliet BR, Wijnhoven BPL. Interobserver variability in the classification of appendicitis during laparoscopy. Br J Surg. 2018 Jul; 105(8):1014-1019. doi: 10.1002/bjs.10837. Epub 2018 Apr 16. PMID: 29663311; PMCID: PMC6033013.
5. Andreu-Ballester JC, Pérez-Griera J, Ballester F, Colomer-Rubio E, Ortiz-Tarín I, Peñarroja Otero C. Secretory immunoglobulin A (sIgA) deficiency in serum of patients with GALTectomy (appendectomy and tonsillectomy). Clin Immunol. 2007 Jun;123(3):289-97. doi: 10.1016/j.clim.2007.02.004. Epub 2007 Apr 20. PMID: 17449327
6. Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. Maternal Immunological Adaptation During Normal Pregnancy. Front Immunol. 2020 Oct 7;11:575197. doi: 10.3389/fimmu.2020.575197. PMID: 33133091; PMCID: PMC7579415.
7. Rolf Pieper, Lars Kager, Per Nasman, Lamps LW. Beyond acute inflammation a review of appendicitis and infections of the appendix. Diagnostic Histopathology 14:2, 2008
8. Cooley Butler, Surgical Pathology of Acute Appendicitis. Human Pathology -Vol 12, Nº 10 October 1981. 870-878
9. Rubér M, Berg A, Ekerfelt C, Olaison G, Andersson RE. Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis. Clin Exp Immunol. 2006 Jan;143(1):117-24. doi: 10.1111/j.1365-2249.2005.02957.x. PMID: 16367942; PMCID: PMC1809572.
10. Rubér M, Andersson M, Petersson BF, Olaison G, Andersson RE, Ekerfelt C. Systemic Th17-like cytokine pattern in gangrenous appendicitis but not in phlegmonous appendicitis. Surgery. 2010 Mar;147(3):366-72. doi: 10.1016/j.surg.2009.09.039. Epub 2009 Nov 5. PMID: 19892382.
11. Guo X, Meng G, Liu F, Zhang Q, Liu L, Wu H, Du H, Shi H, Xia Y, Liu X, Li C, Bao X, Su Q, Gu Y, Fang L, Yu F, Yang H, Yu B, Sun S, Wang X, Zhou M, Jia Q, Chen X, Huang G, Song K, Niu K. Serum levels of immunoglobulins in an adult population and their relationship with type 2 diabetes. Diabetes Res Clin Pract. 2016 May; 115:76-82. doi: 10.1016/j.diabres.2016.03.007. Epub 2016 Mar 12. PMID: 27242126.
12. Salminen P. Acute Appendicitis Incidence-Predisposing Factors, From Microbiota to Socioeconomic Status? JAMA Surg. 2020 Apr 1;155(4):338-339. doi: 10.1001/jamasurg.2019.6031. PMID: 32129802.
13. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015 Sep 26; 386(10000):1278-1287. doi: 10.1016/S0140-6736(15)00275-5. Erratum in: Lancet. 2017 Oct 14; 390(10104):1736. PMID: 26460662
14. Carvalho N, Barros A, Coelho HO, Moita CF, Neves-Costa A, Pedroso D, Borges FC, Moita LF, Costa PM. A Th2 Cytokine Profile in Appendicular Lavage Fluid Suggests Allergy as a Possible Etiology for Acute Appendicitis. Mediators Inflamm. 2019 Oct 28; 2019:8146257. doi: 10.1155/2019/8146257. PMID: 31772507; PMCID: PMC6854935.
15. Landry ML. Immunoglobulin M for Acute Infection: True or False? Clin Vaccine Immunol. 2016 Jul 5;23(7):540-5. doi: 10.1128/CVI.00211-16. PMID: 27193039; PMCID: PMC4933779.
16. Kumar Y, Lakshmi PVM, Minz RW, Chhabra S, Saikia B (2015) Evaluation of Serum Immunoglobulins IgG, IgA, IgM and Total IgE in Chronic Alcoholics: A Community-based Study. Immunochem Immunopathol 1: 102. doi: 10.4172/2469- 9756.1000102
17. Fuller JM, Keyser JW. Serum immunoglobulins after surgical operation. Clin Chem. 1975 May; 21(6):667-71. PMID: 1122610.
18 Khamis RY, Hughes AD, Caga-Anan M, Chang CL, Boyle JJ, Kojima C, Welsh P, Sattar N, Johns M, Sever P, Mayet J, Haskard DO. High Serum Immunoglobulin G and M Levels Predict Freedom From Adverse Cardiovascular Events in Hypertension: A Nested Case-Control Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial. EBioMedicine. 2016 Jul; 9:372-380. doi: 10.1016/j.ebiom.2016.06.012. Epub 2016 Jun 20. PMID: 27333022; PMCID: PMC4972545.
19. Lamps LW. Infectious Causes of Appendicitis. Infect Dis Clin North Am. 2010;24(4):995-1018. doi:10.1016/j.idc.2010.07.012
20. Aspasia Katragkou, Emmanuel Roilides, and Thomas J. Walsh. Role of Immunoglobulin Therapy to Prevent and Treat Infections. Management of Infections in the Immunocompromised Host, 2018. Jun 19: 339-358
21. Latiff AH, Kerr MA. The clinical significance of immunoglobulin A deficiency. Ann Clin Biochem. 2007 Mar;44(Pt 2):131-9. doi: 10.1258/000456307780117993. PMID: 17362578.
22. Woof JM, Kerr MA. The function of immunoglobulin A in immunity. J Pathol. 2006 Jan;208(2):270-82. doi: 10.1002/path.1877. PMID: 16362985
23. Vernersson, M., 2002. The rise and fall of IgE. Acta Universitatis Upsaliensis.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and
Technology. 742. 61 pp. Uppsala. ISBN 91-554-5388-0.
24. Pate MB, Smith JK, Chi DS, Krishnaswamy G. Regulation and dysregulation of immunoglobulin E: a molecular and clinical perspective. Clin Mol Allergy. 2010 Feb 23;8:3. doi: 10.1186/1476-7961-8-3. PMID: 20178634; PMCID: PMC2837605.
25. Carvalho N, Barros A, Coelho H, Cóias A, Botelho P, Cismasiu B, Moita L, Costa P. Increased IgE Deposition in Appendicular Tissue Specimens Is Compatible with a Type I Hypersensitivity Reaction in Acute Appendicitis. Mediators Inflamm. 2021 Oct 18;2021:4194859. doi: 10.1155/2021/4194859. PMID: 34707461; PMCID: PMC8545569.
26. Camilla Janefjord. Th1, Th2 and Treg associated factors in relation to allergy. Linköping University Medical Dissertations No. 947. ISBN: 91-85497-83-5
27. Dullaers M, De Bruyne R, Ramadani F, Gould HJ, Gevaert P, Lambrecht BN. The who, where, and when of IgE in allergic airway disease. J Allergy Clin Immunol. 2012 Mar;129(3):635-45. doi: 10.1016/j.jaci.2011.10.029. Epub 2011 Dec 9. PMID: 22168998.
28. Salö M, Gudjonsdottir J, Omling E, Hagander L, Stenström P. Association of IgE-Mediated Allergy With Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr. 2018 Oct 1;172(10):943-948. doi: 10.1001/jamapediatrics.2018.1634. PMID: 30083704; PMCID: PMC6233766.
29. Das NM, Thomas S, Aravindan KP. Morphology and serum IgE levels in recurrent acute appendicitis. Int. J. Adv. Res. 2016, 4(10), 855-859. DOI: 10.21474/IJAR01/1869
30. Gudjonsdottir J, Roth B, Lovén G, Ohlsson B, Hagander L and Salö M (2022) An Evaluation of Serum IgE and Th2-Associated Interleukins in Children With Uncomplicated and Complicated Appendicitis. Front. Pediatr. 10:884138. doi: 10.3389/fped.2022.884138
2. Carvalho N, Borges F, Costa B, Costa P. A etiologia da apendicite aguda. Será a alergia o elo perdido? Uma revisão narrativa. The aetiology of acute appendicitis. Is allergy the missing link? A narrative review. Revista Portuguesa de Cirurgia, [S.l.], n. 52, p. 1-10, mar. 2022. ISSN 2183-1165
3. Watson Ng WS, Hampartzoumian T, Lloyd AR, Grimm MC. A murine model of appendicitis and the impact of inflammation on appendiceal lymphocyte constituents. Clin Exp Immunol. 2007 Oct; 150(1):169-78. doi: 10.1111/j.1365-2249.2007.03463.x. Epub 2007 Aug 3. PMID: 17680826; PMCID: PMC2219294.
4. van den Boom AL, de Wijkerslooth EML, Mauff KAL, Dawson I, van Rossem CC, Toorenvliet BR, Wijnhoven BPL. Interobserver variability in the classification of appendicitis during laparoscopy. Br J Surg. 2018 Jul; 105(8):1014-1019. doi: 10.1002/bjs.10837. Epub 2018 Apr 16. PMID: 29663311; PMCID: PMC6033013.
5. Andreu-Ballester JC, Pérez-Griera J, Ballester F, Colomer-Rubio E, Ortiz-Tarín I, Peñarroja Otero C. Secretory immunoglobulin A (sIgA) deficiency in serum of patients with GALTectomy (appendectomy and tonsillectomy). Clin Immunol. 2007 Jun;123(3):289-97. doi: 10.1016/j.clim.2007.02.004. Epub 2007 Apr 20. PMID: 17449327
6. Abu-Raya B, Michalski C, Sadarangani M, Lavoie PM. Maternal Immunological Adaptation During Normal Pregnancy. Front Immunol. 2020 Oct 7;11:575197. doi: 10.3389/fimmu.2020.575197. PMID: 33133091; PMCID: PMC7579415.
7. Rolf Pieper, Lars Kager, Per Nasman, Lamps LW. Beyond acute inflammation a review of appendicitis and infections of the appendix. Diagnostic Histopathology 14:2, 2008
8. Cooley Butler, Surgical Pathology of Acute Appendicitis. Human Pathology -Vol 12, Nº 10 October 1981. 870-878
9. Rubér M, Berg A, Ekerfelt C, Olaison G, Andersson RE. Different cytokine profiles in patients with a history of gangrenous or phlegmonous appendicitis. Clin Exp Immunol. 2006 Jan;143(1):117-24. doi: 10.1111/j.1365-2249.2005.02957.x. PMID: 16367942; PMCID: PMC1809572.
10. Rubér M, Andersson M, Petersson BF, Olaison G, Andersson RE, Ekerfelt C. Systemic Th17-like cytokine pattern in gangrenous appendicitis but not in phlegmonous appendicitis. Surgery. 2010 Mar;147(3):366-72. doi: 10.1016/j.surg.2009.09.039. Epub 2009 Nov 5. PMID: 19892382.
11. Guo X, Meng G, Liu F, Zhang Q, Liu L, Wu H, Du H, Shi H, Xia Y, Liu X, Li C, Bao X, Su Q, Gu Y, Fang L, Yu F, Yang H, Yu B, Sun S, Wang X, Zhou M, Jia Q, Chen X, Huang G, Song K, Niu K. Serum levels of immunoglobulins in an adult population and their relationship with type 2 diabetes. Diabetes Res Clin Pract. 2016 May; 115:76-82. doi: 10.1016/j.diabres.2016.03.007. Epub 2016 Mar 12. PMID: 27242126.
12. Salminen P. Acute Appendicitis Incidence-Predisposing Factors, From Microbiota to Socioeconomic Status? JAMA Surg. 2020 Apr 1;155(4):338-339. doi: 10.1001/jamasurg.2019.6031. PMID: 32129802.
13. Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015 Sep 26; 386(10000):1278-1287. doi: 10.1016/S0140-6736(15)00275-5. Erratum in: Lancet. 2017 Oct 14; 390(10104):1736. PMID: 26460662
14. Carvalho N, Barros A, Coelho HO, Moita CF, Neves-Costa A, Pedroso D, Borges FC, Moita LF, Costa PM. A Th2 Cytokine Profile in Appendicular Lavage Fluid Suggests Allergy as a Possible Etiology for Acute Appendicitis. Mediators Inflamm. 2019 Oct 28; 2019:8146257. doi: 10.1155/2019/8146257. PMID: 31772507; PMCID: PMC6854935.
15. Landry ML. Immunoglobulin M for Acute Infection: True or False? Clin Vaccine Immunol. 2016 Jul 5;23(7):540-5. doi: 10.1128/CVI.00211-16. PMID: 27193039; PMCID: PMC4933779.
16. Kumar Y, Lakshmi PVM, Minz RW, Chhabra S, Saikia B (2015) Evaluation of Serum Immunoglobulins IgG, IgA, IgM and Total IgE in Chronic Alcoholics: A Community-based Study. Immunochem Immunopathol 1: 102. doi: 10.4172/2469- 9756.1000102
17. Fuller JM, Keyser JW. Serum immunoglobulins after surgical operation. Clin Chem. 1975 May; 21(6):667-71. PMID: 1122610.
18 Khamis RY, Hughes AD, Caga-Anan M, Chang CL, Boyle JJ, Kojima C, Welsh P, Sattar N, Johns M, Sever P, Mayet J, Haskard DO. High Serum Immunoglobulin G and M Levels Predict Freedom From Adverse Cardiovascular Events in Hypertension: A Nested Case-Control Substudy of the Anglo-Scandinavian Cardiac Outcomes Trial. EBioMedicine. 2016 Jul; 9:372-380. doi: 10.1016/j.ebiom.2016.06.012. Epub 2016 Jun 20. PMID: 27333022; PMCID: PMC4972545.
19. Lamps LW. Infectious Causes of Appendicitis. Infect Dis Clin North Am. 2010;24(4):995-1018. doi:10.1016/j.idc.2010.07.012
20. Aspasia Katragkou, Emmanuel Roilides, and Thomas J. Walsh. Role of Immunoglobulin Therapy to Prevent and Treat Infections. Management of Infections in the Immunocompromised Host, 2018. Jun 19: 339-358
21. Latiff AH, Kerr MA. The clinical significance of immunoglobulin A deficiency. Ann Clin Biochem. 2007 Mar;44(Pt 2):131-9. doi: 10.1258/000456307780117993. PMID: 17362578.
22. Woof JM, Kerr MA. The function of immunoglobulin A in immunity. J Pathol. 2006 Jan;208(2):270-82. doi: 10.1002/path.1877. PMID: 16362985
23. Vernersson, M., 2002. The rise and fall of IgE. Acta Universitatis Upsaliensis.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and
Technology. 742. 61 pp. Uppsala. ISBN 91-554-5388-0.
24. Pate MB, Smith JK, Chi DS, Krishnaswamy G. Regulation and dysregulation of immunoglobulin E: a molecular and clinical perspective. Clin Mol Allergy. 2010 Feb 23;8:3. doi: 10.1186/1476-7961-8-3. PMID: 20178634; PMCID: PMC2837605.
25. Carvalho N, Barros A, Coelho H, Cóias A, Botelho P, Cismasiu B, Moita L, Costa P. Increased IgE Deposition in Appendicular Tissue Specimens Is Compatible with a Type I Hypersensitivity Reaction in Acute Appendicitis. Mediators Inflamm. 2021 Oct 18;2021:4194859. doi: 10.1155/2021/4194859. PMID: 34707461; PMCID: PMC8545569.
26. Camilla Janefjord. Th1, Th2 and Treg associated factors in relation to allergy. Linköping University Medical Dissertations No. 947. ISBN: 91-85497-83-5
27. Dullaers M, De Bruyne R, Ramadani F, Gould HJ, Gevaert P, Lambrecht BN. The who, where, and when of IgE in allergic airway disease. J Allergy Clin Immunol. 2012 Mar;129(3):635-45. doi: 10.1016/j.jaci.2011.10.029. Epub 2011 Dec 9. PMID: 22168998.
28. Salö M, Gudjonsdottir J, Omling E, Hagander L, Stenström P. Association of IgE-Mediated Allergy With Risk of Complicated Appendicitis in a Pediatric Population. JAMA Pediatr. 2018 Oct 1;172(10):943-948. doi: 10.1001/jamapediatrics.2018.1634. PMID: 30083704; PMCID: PMC6233766.
29. Das NM, Thomas S, Aravindan KP. Morphology and serum IgE levels in recurrent acute appendicitis. Int. J. Adv. Res. 2016, 4(10), 855-859. DOI: 10.21474/IJAR01/1869
30. Gudjonsdottir J, Roth B, Lovén G, Ohlsson B, Hagander L and Salö M (2022) An Evaluation of Serum IgE and Th2-Associated Interleukins in Children With Uncomplicated and Complicated Appendicitis. Front. Pediatr. 10:884138. doi: 10.3389/fped.2022.884138
Publicado
2022-12-09
Como Citar
CARVALHO, Nuno et al.
AS CONCENTRAÇÕES SÉRICAS DE IMUNOGLOBULINA NÃO SE CORRELACIONAM COM APENDICITE AGUDA.
Revista Portuguesa de Cirurgia, [S.l.], n. 53, p. 37-45, dec. 2022.
ISSN 2183-1165.
Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/970>. Acesso em: 08 feb. 2023.
doi: https://doi.org/10.34635/rpc.970.
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