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| Author(s): |
Diane Belchior Paraiba
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2008-08-21 |
| Examining board members: |
Marcello Delano Bronstein;
Edmund Chada Baracat;
Eduardo Ferreira Borba Neto;
Cibele Nunes Peroni;
Luiz Roberto Salgado
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| Advisor: | Marcello Delano Bronstein; Carlos Roberto Jorge Soares |
| Abstract | |
INTRODUCTION: Studies point to a prevalence of 20-30% of discrete hyperprolactinemia in patients with systemic lupus erythematosus (SLE), suggesting a possible implication of prolactin (PRL) in the pathogenesis of this disorder. As the lymphocytic PRL gene expression is found in the majority of the immune cells, where it acts as citokine, by paracrine and autocrine regulation, the lymphocytic source of this PRL has been suggested. OBJECTIVES: 1) to study the lymphocytic PRL gene expression of patients with active and inactive SLE and normal controls, as well as its biological activity in bioassays using Nb2 (heterologous) and Ba/F-LLP cells (homologous); 2) To assess serum PRL level and the prevalence of macroprolactinemia in our population with SLE. METHODS: group 1, composed of 73 patients (66 women and 7 men), 28 patients with active and 45 with inactive SLE, where the serum PRL level and prevalence of macroprolactinemia were evaluated; group 2, a subset of group 1, with 30 patients: 18 with active and 12 with inactive SLE and 10 normal individuals as control group, from whom lymphocytes were extracted from peripheral blood and were set on culture for 72 hours. After that, the supernatant was taken as lymphocytic PRL samples in bioassays with Nb2 cells (heterologous) and Ba/FLLP (homologous) in order to assess its bioactivity. Total RNA from these lymphocytes was extracted and a comparison was made between lymphocytic PRL gene expression of patients with active and inactive SLE by real time RT-PCR, using normal pool as calibrator. RESULTS: mild hyperprolactinemia was found in 21.9% (16 of 73 patients of group 1), 7 of 28 patients in activity (25%), and 9 of 45 in inactivity (20%). Macroprolactinemia was found in 3 patients, all with inactive SLE. Regarding serum PRL levels group 1 (active SLE) had median of 10.8 (4.9 38.9) ng/mL and the group 1 (inactive SLE) median of 7.6 (1.9 49.6) ng/mL, without significant difference between the two sub-groups (p=0.123). However, when only monomeric PRL level was considered, the median of group 1 (inactive SLE) dropped to 7.3 ng/mL (1.9 20.6) ng/mL and, when compared again with group 1 (active SLE), we observed that beyond a bigger percentage of the cases in activity to present hyperprolactinemia, the medium of serum PRL level in patients with active SLE is significantly greater of that in the ones in inactivity (p= 0.016). The bioassays with the samples of group 2 (sub-group of group 1): The assays with Nb2 cells showed similar lymphocytic PRL bioactivity. They did not have significant difference between patients with SLE active and inactive and these with normal control group. The assays with Ba/F-LLP cells did not show adequate sensitivity, so not trustworthy for lymphocytic PRL evaluation. The real time RT-PCR also presented similar gene expression between patients (group 2). CONCLUSIONS: The gene lymphocytic PRL expression and its bioactivity were similar in patients with SLE in activity and inactivity of illness and the normal controls. The prevalence of hyperprolactinemia in our population of patients with SLE was of 21.9%, being greater in patients with active SLE. The macroprolactinemia was found only in patients with inactive SLE, suggesting a possible protective effect of this finding. (AU) | |