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Prática de enfermagem em transplante de células tronco hematopoéticas
Maria Ribeiro Lacerda,Joelma Beatriz Girett de Lima,Rute Barbosa
Revista Eletr?nica de Enfermagem , 2007,
Abstract: O transplante de células-tronco hematopoética (TCTH) é bastante complexo e requer uma assistência de enfermagem especializada. Desta forma, este texto tem como objetivo descrever de forma reflexiva a prática de enfermagem em transplante de células-tronco hematopoéticas. O papel do enfermeiro no cenário de TCTH é fundamental, envolve muitas responsabilidades no cuidado e inclui apoio aos pacientes e familiares, durante o transplante e na fase de recupera o, pelo monitoramento das altera es de suas condi es vitais e realiza o de uma série de interven es terapêuticas. O cuidado de enfermagem desenvolvido em STCTH é integral, centrado nas necessidades dos pacientes e na busca por um atendimento global, competente e individualizado. Membro essencial da equipe multidisciplinar, o enfermeiro trabalha junto com os demais profissionais, reunindo experiências e conhecimentos técnicos e científicos, para o benefício dos pacientes e familiares.
Self-Association of an Activating Natural Killer Cell Receptor, KIR2DS1  [PDF]
Michael Hayley, Sarah Bourbigot, Valerie Booth
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0023052
Abstract: As a major component of the innate immune system, natural killer cells are responsible for activating the cytolytic killing of certain pathogen-infected or tumor cells. The self-recognition of natural killer cells is achieved in part by the killer cell immunoglobulin-like receptors (KIRs) protein family. In the current study, using a suite of biophysical methods, we investigate the self-association of an activating KIR, KIR2DS1. This KIR is of particular interest because when in the presence of the HLA-Cw6 protein, KIR2DS1 becomes a major risk factor for psoriasis, an autoimmune chronic skin disease. Using circular dichroism spectroscopy, dynamic light scattering, and atomic force microscopy, we reveal that KIR2DS1 self-associates in a well-defined fashion. Our novel results on an activating KIR allow us to suggest a working model for the KIR2DS1- HLA class I molecular mechanism.
Different Evolution of Inhibitory and Activating Killer Immunoglobulin Receptors (KIR) in Worldwide Human Populations
Derek Middleton, Ashley Meenagh, Juan Ignacio Serrano-Vela, Juan MoscosoAntonio Arnaiz-Villen
The Open Immunology Journal , 2008, DOI: 10.2174/1874226200801010042]
Abstract: HLA class I molecules are ligands for natural killer cells’ inhibitory (KIR DL) and activating (KIR DS) receptors. KIR DL receptors have a greater avidity for HLA class I molecules than KIR DS receptors. Thus, there is a possibility that HLA molecules drive KIR receptor selection. We have used the percentage of individuals bearing the genes KIR 3DS1, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 2DL1, 2DL2, 2DL3, 2DL5 and 3DL1 in relatively well defined populations to test whether there is a different way of relating worldwide populations between KIR DS and KIR DL molecules. We have used ARLEQUIN, DISPAN and VISTA computer programs to construct dendrograms and correspondence analyses showing the genetic relationships among different human world populations. Analyses based on KIR DS or KIR haplotype B genes show that populations are related according to geography, like a good anthropological marker (i.e.: HLA or Y chromosome systems). The results based on KIR DL or KIR haplotype A genes do not show such a correlation. Results are discussed taking into account the linkage of both HLA and KIR systems to microbial diseases and the possible evolutionary shaping of both HLA and KIR receptors repertoire by pathogens.
Mourning of professionals in a hematopoietic stem cell transplantation unit Luto de profissionais em uma unidade de transplante de células-tronco hematopoéticas  [cached]
Renata Pereira Rodrigues,Renata Curi Labate
Ciência & Saúde , 2012,
Abstract: Introduction: The transplant of hematopoietic stem cells (HSCT) is a procedure that can either retrieve the patient's life or lead him/her to death. No avoiding death can bring to the professionals the experience of mourning and their limits. Objective: To understand the process of mourning experienced by health professionals who work in a HSCT Unit. Materials and Methods: This is a clinical-qualitative study with eight professionals from a HSCT Unit. Semi structured interviews were performed and the material was subjected to qualitative content analysis. Results: The results indicate that the professionals in a HSCT Unit experience the mourning when they observe slow processes of death and when the patient’s suffering becomes too intense. Conclusion: The process of mourning of the professional is still not recognized and there is little opportunity for public expression to facilitate the experience of mourning. Introdu o: O transplante de células-tronco hematopoéticas (TCTH) é um procedimento que pode tanto recuperar a vida do paciente quanto conduzi-lo ao óbito. N o conseguir evitar a morte pode trazer ao profissional à vivência do luto e de seus limites. Objetivo: Compreender o processo de luto vivenciado pelos profissionais da saúde de uma Unidade TCTH. Materiais e Métodos: Trata-se de um estudo clínico-qualitativo de 8 profissionais de uma unidade de TCTH. Foram realizadas entrevistas semidirigidas e o material foi submetido à análise qualitativa de conteúdo. Resultados: Os resultados indicam que os profissionais de uma unidade de TCTH vivenciam o luto quando verificam processos lentos de morte e quando o sofrimento do paciente se torna muito intenso. Conclus o: O processo do luto do profissional ainda n o é reconhecido e existe pouca oportunidade de express o pública para facilitar a vivência desse luto.
Killer Immunoglobulin-like Receptor (KIR) and HLA Genotypes Affect the Outcome of Allogeneic Kidney Transplantation  [PDF]
Izabela Nowak, Maria Magott-Procelewska, Agnieszka Kowal, Maciej Miazga, Marta Wagner, Wanda Niepiek?o-Miniewska, Ma?gorzata Kamińska, Andrzej Wi?niewski, Edyta Majorczyk, Marian Klinger, Wioleta ?uszczek, Andrzej Pawlik, Rafa? P?oski, Ewa Barcz, David Senitzer, Piotr Ku?nierczyk
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044718
Abstract: Background Recipient NK cells may detect the lack of recipient's (i.e., self) HLA antigens on donor renal tissue by means of their killer cell immunoglobulin-like receptors (KIRs). KIR genes are differently distributed in individuals, possibly contributing to differences in response to allogeneic graft. Methodology/Principal Findings We compared frequencies of 10 KIR genes by PCR-SSP in 93 kidney graft recipients rejecting allogeneic renal transplants with those in 190 recipients accepting grafts and 690 healthy control individuals. HLA matching results were drawn from medical records. We observed associations of both a full-length KIR2DS4 gene and its variant with 22-bp deletion with kidney graft rejection. This effect was modulated by the HLA-B,-DR matching, particularly in recipients who did not have glomerulonephritis but had both forms of KIR2DS4 gene. In contrast, in recipients with glomerulonephritis, HLA compatibility seemed to be much less important for graft rejection than the presence of KIR2DS4 gene. Simultaneous presence of both KIR2DS4 variants strongly increased the probability of rejection. Interestingly, KIR2DS5 seemed to protect the graft in the presence of KIR2DS4fl but in the absence of KIR2DS4del. Conclusions/Significance Our results suggest a protective role of KIR2DS5 in graft rejection and an association of KIR2DS4 with kidney rejection, particularly in recipients with glomerulonephritis.
Influence of Interleukin IL-2 and IL-12 + IL-18 on Surface Expression of Immunoglobulin-Like Receptors KIR2DL1, KIR2DL2, and KIR3DL2 in Natural Killer Cells  [PDF]
Slawomir Chrul,Ewa Polakowska,Agnieszka Szadkowska,Jerzy Bodalski
Mediators of Inflammation , 2006, DOI: 10.1155/mi/2006/46957
Abstract: Natural killer (NK) cells express killer cell inhibitory receptors (KIRs) that recognize polymorphic class I MHC molecules. In the present study, we analyze the modulatory effect of IL-2 alone or a combination of IL-12 with IL-18 on surface expression of killer cell immunoglobulin-like receptors KIR2DL1, KIR2DL2, and KIR3DL2 in NK cells. Thus, it was found that IL-2 causes a significant increase in the proportion of cells with given studied receptors. Stimulation by a mixture of IL-12 and IL-18 caused significant increase in the fraction of cells with the KIR2DL1 and KIR2DL2, however no significant change in the percentage of cells with KIR3DL2 receptor on their surface was observed. The results of the study show the presence of KIRs on both resting and activated NK cells, this may suggest that KIRs have also an important role in the regulatory processes after activation of this subpopulation of cells.
Expression Patterns of Killer Cell Immunoglobulin-Like Receptors (KIR) of NK-Cell and T-Cell Subsets in Old World Monkeys  [PDF]
Meike Hermes, Christina Albrecht, Annette Schrod, Markus Brameier, Lutz Walter
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0064936
Abstract: The expression of killer cell immunoglobulin-like receptors (KIR) on lymphocytes of rhesus macaques and other Old World monkeys was unknown so far. We used our recently established monoclonal anti-rhesus macaque KIR antibodies in multicolour flow cytometry for phenotypic characterization of KIR protein expression on natural killer (NK) cells and T cell subsets of rhesus macaques, cynomolgus macaques, hamadryas baboons, and African green monkeys. Similar to human KIR, we found clonal expression patterns of KIR on NK and T cell subsets in rhesus macaques and differences between individuals using pan-KIR3D antibody 1C7 and antibodies specific for single KIR. Similar results were obtained with lymphocytes from the other studied species. Notably, African green monkeys show only a low frequency of KIR3D expressed on CD8+ αβT cells. Contrasting human NK cells are KIR-positive CD56bright NK cells and frequencies of KIR-expressing NK cells that are independent of the presence of their cognate MHC class I ligands in rhesus macaques. Interestingly, the frequency of KIR-expressing cells and the expression strength of KIR3D are correlated in γδ T cells of rhesus macaques and CD8+ αβT cells of baboons.
Killer Immunoglobulin-Like Receptor (KIR) Centromeric-AA Haplotype Is Associated with Ethnicity and Tuberculosis Disease in a Canadian First Nations Cohort  [PDF]
Kali Braun, Linda Larcombe, Pamela Orr, Peter Nickerson, Joyce Wolfe, Meenu Sharma
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0067842
Abstract: Killer immunoglobulin-like receptors (KIR) on natural killer (NK) cells interact with other immune cells to monitor the immune system and combat infectious diseases, such as tuberculosis (TB). The balance of activating and inhibiting KIR interactions helps determine the NK cell response. In order to examine the enrichment or depletion of KIRs as well as to explore the association between TB status and inhibitory/stimulatory KIR haplotypes, we performed KIR genotyping on samples from 93 Canadian First Nations (Dene, Cree, and Ojibwa) individuals from Manitoba with active, latent, or no TB infection, and 75 uninfected Caucasian controls. There were significant differences in KIR genes between Caucasians and First Nations samples and also between the First Nations ethnocultural groups (Dene, Cree, and Ojibwa). When analyzing ethnicity and tuberculosis status in the study population, it appears that the KIR profile and centromeric haplotype are more predictive than the presence or absence of individual genes. Specifically, the decreased presence of haplotype B centromeric genes and increased presence of centromeric-AA haplotypes in First Nations may contribute to an inhibitory immune profile, explaining the high rates of TB in this population.
Natural Killer KIR3DS1 Is Closely Associated with HCV Viral Clearance and Sustained Virological Response in HIV/HCV Patients  [PDF]
Antonio Rivero-Juarez, Rafael Gonzalez, Angela Camacho, Barbara Manzanares-Martin, Antonio Caruz, Antonio Martinez-Peinado, Julian Torre-Cisneros, Juan A. Pineda, José Pe?a, Antonio Rivero
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0061992
Abstract: Aim To evaluate the influence of the presence of the killer cell immunoglobulin-like receptor (KIR) 3DS1 on HCV treatment response in HIV/HCV genotype 1 co-infected patients Methods HIV/HCV co-infected patients were included. KIR3DS1, their specific HLA-B ligands and IL28B gene were genotyped. Reductions of plasma HCV RNA levels between baseline and week 1, week 2 and week 4 were analyzed for IL28B genotype and KIR3DS1 (HLA Bw4 or Bw6). Rapid and sustained virological response (RVR and SVR) rates were also analyzed. Results Sixty HIV/HCV genotype 1 co-infected patients were included. Patients with KIR3DS1 and Bw4 had higher rates of HCV viral decline than those who were not carriers of KIR3DS1 (week1: p = 0.01; week2: p = 0.038; week 4: p = 0.03). Patients carrying KIR3DS1/Bw4 had higher rates of RVR and SVR than those who did not carry KIR3DS1 (RVR: 46.15% versus 17.02%, p = 0.012; SVR: 63.6% versus 13 26.5%, p = 0.031). With respect to patients carrying the IL28B-CC genotype, those with KIR3DS1/Bw4 had greater rates of HCV viral clearance (week1: p<0.001; week2: p = 0.01; week 4: p = 0.02), RVR (p = 0.015) and SVR (p = 0.029) than those not carrying KIR3DS1. Conclusion Our results show that the KIR3DS1 genotype has a positive effect on HCV viral clearance during the first weeks of Peg-IFN/RBV treatment in HCV/HCV co-infected patients bearing genotype 1, and higher RVR and SVR rates.
Diversity of Killer Cell Immunoglobulin-Like Receptor (KIR) Genotypes and KIR2DL2/3 Variants in HCV Treatment Outcome  [PDF]
Jose Ramón Vidal-Casti?eira, Antonio López-Vázquez, Jesús Martínez-Borra, Pablo Martínez-Camblor, Jesús Prieto, Rosario López-Rodríguez, Paloma Sanz-Cameno, Juan de la Vega, Luis Rodrigo, Rosa Pérez-López, Ramón Pérez-álvarez, Carlos López-Larrea
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0099426
Abstract: The aim of this study was to analyse the distribution of KIR haplotypes and the KIR2DL2/3 alleles in chronic HCV-infected patients in order to establish the influence on the response to pegylated interferon plus ribavirin classical treatment. The alleles study of previously associated KIR2DL2/3 showed that KIR2DL2*001 was more frequent in non-SVR (NSVR) (42.2% vs. 27.5%, p<0.05) and KIR2DL3*001 was associated with sustained viral response (SVR) (41.6% vs. 61.2%, p<0.005). The KIR2DL3*001-HLA-C1 association was also significant (24.5% vs. 45.7%, p<0.001). From the frequencies of KIR obtained, 35 genotypes were assigned on the basis of previous studies. The centromeric A/A genotype was more frequent in SVR (44.1% vs. 34.5%, p<0.005) and the centromeric B/B genotype was found to be significantly more frequent in NSVR (20.9% vs. 11.2%, p<0.001). The logic regression model showed the importance of KIR genes in predicting the response to combined treatment, since the positive predictive value (PPV) was improved (from 55.9% to 75.3%) when the analysis of KIR was included in addition to the IFNL3 rs12979860 polymorphism. The study of KIR receptors may be a powerful tool for predicting the combined treatment response in patients with chronic HCV infection in association with the determination of IFNL3 polymorphism.
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