PsorÃase: estudo de alteraÃÃes de parÃmetros da imunidade celular e a influÃncia de sintomas de ansiedade




In the present study an evaluation is made of cell immunity (CI) and anxiety symptoms (AS) in individuals with and without psoriasis. The possible influence of AS on CI in the presence or absence of psoriasis was also investigated. From 2000 to 2003, 74 males were selected in the Department of Dermatology of the Hospital das ClÃnicas da Universidade Federal de Pernambuco, of whom 37 constituted the psoriasis group (PG) and 37 the control group (CG). Sociodemographic, clinical and laboratory features were taken into consideration when characterizing the sample. The sociodemographic and clinical data were obtained by a clinical examination and a questionnaire and the laboratory were obtained data by quantification of the peripheral blood cells by hemocytometry or flow cytometry and the cortisol assay by chemiluminescence.The peripheral blood mononuclear cells (PBMC) were isolated for Ficoll gradient and as a result the monocytes were obtained from these following adhesion on a plaque. The cell concentration was 2.0x106 cells per 2mL RPMI 1640 culture medium and the production of superoxide by monocytes was measured by spectrophotometry. For the statistical analysis four tests were used considering p<0.05: t-Student, chi square, Fisher and Analysis Of VAriance. The PG presented the highest age groups, 41-50 years (37.8%) and 51-62 years (29.7%), with the largest percentage of its members (24.3%) having graduated from college or University, the majority of whom (40.5%) were from the countryside of Pernambuco or from another state of Brazil. Regarding to the dermatological features, it was more frequently to notice individuals with disseminated lesions (67.6%), the onset of the disease from 1 to 5 years, over half (56.8%) of these individuals progressed with periods of recurrence, the most frequent duration of the current lesions being up to six months (35.1%). The family history of psoriasis was reported by 35.1% of the individuals and the occurrence of a major event leading to the onset of the disorder was reported by 14 members (37.8%) of the PG. This event, however, had occurred over one year previously (64.3%). Regarding to the psychiatric features, the PG presented the highest percentage (48.6%) of AS. As regards the laboratory features, most of the PG individuals presented values within the normal range, such as leukocyte count = 89.2%, total lymphocytes = 100%, CD19+B cells = 94.6%, CD3+T cells = 94.6%, CD4+T cells = 91.9%, CD8+T cells = 94.6%, CD4+T:CD8+T ratio = 59.5% and cortisol level = 11.73 mcg/dL. There was a greater production of superoxide in the PG (17.51 Â 5.56 nmol/106cells in the 1st hour and 29.94 Â 9.02 nmol/106cells in the 2nd hour) than in the CG (14.48 Â 4.15 nmol/106cells in the 1st hour and 25.79 Â 8.29 nmol/106cells in the 2nd hour). As for the AS, in neither group, with or without psoriasis, there was no change in superoxide production (in the 1st and 2nd hours) or in the level of cortisol. Only the average value of the CD4+T: CD8+T ratio in the PG was lower (1.44) than in the control groups with or without AS and in the GP with no AS. In conclusion, monocytic hyperactivity with an increased production of superoxide is observed in psoriasis. This may partly explain the inflammatory nature of this disease. The anxiety symptoms (AS), when present in the PG, were associated with lower absolute value in the CD4+T: CD8+T ratio; this value, however, does not represent CI impairment


anxiety symptoms cell immunity superÃxido psorÃase medicina psoriasis imunidade celular superoxide sintomas de ansiedade

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