La inflamación desde una perspectiva inmunológica: desafío a la Medicina en el siglo XXl

Maricarmen González Costa, Alexander Ariel Padrón González

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Resumen

Introducción: La inflamación es una respuesta homeostática del organismo. Es uno de los principales motivos de consulta en Cuba y el mundo. Existe una percepción errónea de que es una entidad aislada y siempre patológica. Es un proceso dinámico, complejo, sistémico y multifactorial. Por eso constituye un reto el dilucidar los elementos, cambios tisulares que causa y cómo proceder en la clínica ante un cuadro inflamatorio.

Objetivo: Describir la inflamación, su clasificación, elementos involucrados y cambios sistémicos desde una perspectiva inmunológica.

Material y Métodos: Se realizó una revisión sobre el tema empleando la bibliografía actualizada y luego se consultaron artículos de libre acceso en las bases de datos Pubmed y Scielo en el período de enero de 2013 a diciembre de 2018.

Desarrollo: La inflamación puede clasificarse según el daño, tiempo o los efectores involucrados. Las principales moléculas son las citocinas como TNF-α, IFN-γ, IL-1β, IL-10, IL-6, TGF-β. Participan células como los neutrófilos, mastocitos, macrófagos, linfocitos T y las del endotelio vascular. Durante el proceso inflamatorio se modifican las funciones de casi todos los sistemas de órganos. En ciertos tipos de inflamación, es la respuesta adaptativa quien origina y perpetúa el proceso inflamatorio.

Conclusiones: En la actualidad se desconocen los acontecimientos que desencadenan inflamación crónica y cómo ocurre el daño tisular. El mayor desafío consiste en dilucidar las causas y mecanismos inmunológicos que conllevan a las manifestaciones inflamatorias sistémicas que se manifiestan como enfermedades neurológicas, cardiovasculares y autoinmunes, entre otras.

Palabras claves: Inflamación aguda, inflamación crónica, mediadores proinflamatorios, sepsis.

Palabras clave

Inflamación aguda; inflamación crónica; mediadores proinflamatorios; sepsis. acute inflammation; chronic inflammation; proinflammatory mediators; sepsis.

Referencias

Arts RW, Joosten L, Netea M. The potential role of trained immunity in autoimmune and autoinflammatory disorders. Front Immunol [Internet]. 2018 Feb [Cited 8/07/ 2018]; 9:298.Available from: https://www.frontiersin.org/articles/10.3389/fimmu.2018.00298/full

Balusu S, Van Wonterghem E, De Rycke R, Raemdonck K, Stremersch S, Gevaert K, et al. Identification of a novel mechanism of blood brain communication during peripheral inflammation via choroid plexus- derived extracellular vesicles. EMBO Mol Med [Internet]. 2016 Oct [Cited 15/06/2017]; 8(10): 1162-1183. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27596437

Cristobo Bravo T, Quirós Viqueira O, Rodríguez Bencomo D. Actualización en la detección y manejo de la sepsis en el menor de un año. AMC [Internet]. 2015 Oct [Citado 16/06/2017]; 19(5): 512-527. Disponible en:

http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552015000500011

Nardi MG, Farias Januario AG, Geremia Cassio F , Megiolaro F, Schneider K, Andreola Perazzoli MR, et al. Anti-inflammatory activity of berry fruits in mice model of inflammation is based on oxidative stress modulation. Pharm Res [Internet]. 2016 Mar [Cited 16/06/2017]; 8(1):S42–S49. Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821106/

Khawar Babar M, Hassan Abbasi M, Sheikh N. IL-32: a novel pluripotent inflammatory interleukin, towards gastric inflammation, gastric cancer, and chronic rhino sinusitis. Med Inflam [Internet]. 2016 Mar [Cited 16/06/2017];2016:8.Available from: http://dx.doi.org/10.1155/2016/8413768

Wang, Wen-Ying, Meng-Shan T, Jin-Tai Y, Tan L. Role of pro-Inflammatory cytokines released from microglia in Alzheimer’s disease. Ann Transl Med [Internet]. 2015 Jun [Cited 16/06/2017]; 3 (10):136. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486922/

Padrón-Gonzalez AA, González-Costa M, Martínez-Infante A, Padrón-Morera PJ, Dorta-Contreras AJ. Variation of major immunoglobulins in septic shock. Intensive care unit, Leon Cuervo Rubio Hospital. 2015–2017. Front Abs Book [Internet]. 2018 May; (1): 594-598. [Cited 16/06/2017]. Available from: https://www.researchgate.net/publication/325805681_Variation_of_major_immunoglobulins_in_Septic_Shock_Intensive_Care_Unit_Leon_Cuervo_Rubio_Hospital_2015-2017

Luft VC, Schmidt MI, Pankow JS, Couper D, Ballantyne CM, Hunter Young J, et al. Chronic inflammation role in the obesity-diabetes association: a case-cohort study. Diabetol Metab Syndr [Internet]. 2013 Jun[Cited 16/06/2017]; 5:31. Available from: https://dmsjournal.biomedcentral.com/articles/10.1186/1758-5996-5-31

Devarajan A, Shih D, Srinivasa T. Inflammation, infection, cancer and all the role of paraoxonases. Adv Exp Med Biol [Internet]. 2015 Apr [Cited 16/06/2017]; 824(33): 33-41. Available from: https://link.springer.com/chapter/10.1007/978-3-319-07320-0_5

Rojas W, Anaya JM, Cano LE, Aristizábal BH, Gómez LM, Lopera D. Inmunología de Rojas. Medellín: Editorial Fondo CIB; 2015, p.104-126.

Franceschi C, Campisi J. Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J Gerontol A Biol Sci Med Sci [Internet]. 2014 Jun[Cited 16/06/2017]; 69(1): 4-9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24833586

Cheah M,Chen JY, Sahoo D, Contreras-Trujillo H, Volkmer AK, Scheeren FA, Volkmer JP, Weissman IL. CD14-expressing cancer cells establish the inflammatory and proliferative tumor microenvironment in bladder cancer. Proc Natl Acad Sci [Internet]. 2015 Apr [Cited 8/07/2017]; 112(15): 4725-4730.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403197/

Pérez Martín OG, Vega García IG. La Inmunología en el humano sano para estudiantes de Ciencias Médicas. La Habana: Editorial Ciencias Médicas; 2016.p.81-82.

Sousa C, Biber K, Michelucci A. Cellular and molecular characterization of microglia: a unique immune cell population. Front Immunol [Internet]. 2017 Mar [Cited 15/06/2017]; 8:198. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5332364/

Padrón-González A, González-Losada C, Dorta-Contreras J. Empleo del Reibergrama en manifestaciones neurológicas del dengue. Rev haban cienc mèd [Internet]. 2017 Sep [Citado 8/07/2018]; 16(5). Disponible en:

http://www.revhabanera.sld.cu/index.php/rhab/article/view/2004/1863

Abbas A, Lichtman A, Pillai S. Cellular and molecular immunology. España: Ediciones Elsevier; 2015, p.13-33.

Padrón-González A, Dorta-Contreras J. Activación del complemento por la vía de las lectinas: rol en las enfermedades reumáticas. Rev Cub Reum [Internet]. 2017 Dec [Citado 13/05/2018]; 19(3),(supl 1): [aprox: 3 pant]. Disponible en:

http://www.revreumatologia.sld.cu/index.php/reumatologia/rt/printerFriendly/585/html

Padrón-González A, Dorta-Contreras J. Vía de las lectinas, una ruta del complemento en construcción. Arch Alerg Inmunol Clin [Internet]. 2018 Abr [Citado 8/07/2018]; 49(1): 0005-0012. Disponible en:

http://www.archivos.org.ar/contenido/art.php?recordID=MTA5MQ

Giang J, J-Seelen MA, A van Doorn, Rissmann R, Prens P, Damman J. Complement activation in inflammatory skin diseases. Front Immunol [Internet]. 2018 Apr [Cited 8/07/2018]; 9:00639. Available from:

https://www.frontiersin.org/articles/10.3389/fimmu.2018.00639/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_608868_35_Immuno_20180419_arts_A

Chen J, Wu Y, Yu J, Shen J. Association between tumor necrosis factor alpha rs1800629 polymorphism and risk of osteoarthritis in a Chinese population. Braz J Med Biol Res [Internet]. 2018 May [Cited 15/06/20]; 51(8): e7311. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999064/

Khawar B, Abbasi MH, Sheikh N. A panoramic spectrum of complex interplay between the immune system and IL-32 during pathogenesis of various systemic infections and inflammation. Europ Journ Med Res [Internet]. 2015 Ene [Cited 15/06/20]; 20(7): [aprox: 15 pant] Available from: http://doi.org/10.1186/s40001-015-0083-y

Chirco RK, Potempa LA. C-Reactive protein as a mediator of complement activation and inflammatory signaling in age-related macular degeneration. Front Immunol [Internet]. 2017 Mar [Cited 15/06/20]; 9:539.Available from: https://www.frontiersin.org/articles/10.3389/fimmu.2018.00539/full

Iglesias-González IM, Padilla-Docal B, Dorta-Contreras AJ, Junco-Calzadilla R, Ramírez Agüera PJ, Torres López D, Janero Valdés A. Reactantes de fase aguda en reumatología. Rev Cubana Reumatol [Internet]. 2014 Dec [Citado 27/03/2018]; 16(1):59-62. Available from:

http://www.revreumatologia.sld.cu/index.php/reumatologia/article/view/314

Christoph Klose Ch, Mahlakiv T, Moeller J, Rankin L, Flamar A-L, Kabata H, et al. The neuropeptide neuromedin U stimulates innate lymphoid cells and type 2 inflammation. Nature [Internet]. 2017 Sep [Cited 15/06/2018]; 549(7671): 282-286. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28869965

Dudeck J, Medyukhina A, Fröbel J, Svensson CM, Kotrba J, Gerlach M, et al. Mast cells acquire MHCII from dendritic cells during skin inflammation. J Exp Med [Internet]. 2017 Dec[Citado 2018 Jul 8]; 214(12): 3791-3811. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29084819

Xu Y, Chen G. Mast cell and autoimmune diseases. Mediators Inflamm [Internet]. 2015 Mar [Cited 8/07/2018]; 2015: 246126. Available from:

https://www.hindawi.com/journals/mi/2015/246126/

He J, Yuan G, Cheng F, Zhang J, Guo X. Mast cell and M1 macrophage infiltration and local pro-inflammatory factors were attenuated with incretin-based therapies in obesity-related glomerulopathy. Metab Syndr Relat Disord [Internet]. 2017 Sep[Cited 13/05/2018]; 15(7):344-353. Available from:

https://www.ncbi.nlm.nih.gov/pubmed/28737448

Bulfone-Paus S, Bahri R. Mast cells as regulators of T cell responses. Front Immunol [Internet]. 2015 Aug [Cited 15/06/2018]; 6:394. Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528181/

Lucke S, Hoene A, Walschus U, Anette KA, Pissarek JW, Schlosser M. Acute and chronic local inflammatory reaction after implantation of different extracellular porcine dermis collagen matrices in rats. Biomed Res Int [Internet]. 2015 Ene[Cited 8/07/2018];2015:10. Available from:

https://www.hindawi.com/journals/bmri/2015/938059/

Owen JA, Punt J, Sharon A. Kuby Inmunología. Ciudad de México: Editorial Mc Graw Hill Education; 2014, p.485-515.

Maeve Rea I, Gibson DS, McGilligan V, McNerlan SE, Denis Alexander H, Ross OA. Age and age-related diseases: role of inflammation triggers and cytokines. Front Immunol [Internet]. 2018 Apr [Cited 13/05/2018]; 9:586. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29686666

Zanoli L, Boutouyrie P, Fatuzzo P, Granata A, Lentini P, Oztürk K, et al. Inflammation and aortic stiffness: an individual participant data meta‐analysis in patients with inflammatory bowel disease. J Am Heart Assoc [Internet]. 2017 Ago [Cited 13/05/2018]; 6(10):12. Available from: https://www.ahajournals.org/doi/10.1161/JAHA.117.007003

Fernández-Egea E, Vértes PE, Flint SM, Turner L, Mustafa S, Hatton A, et al. Peripheral immune cell populations associated with cognitive deficits and negative symptoms of treatment-resistant schizophrenia. PLoS ONE [Internet]. 2016 May [Cited 13/05/2018]; 11(5): e015563. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27244229

Navarro V, Sánchez-Mejías E, Jiménez S, Muñoz-Castro Cl, Sánchez-Varo R, Dávila JC, et al. Microglia in Alzheimer’s disease: activated, dysfunctional or degenerative. Front Aging Neurosci [Internet]. 2018 May[Cited 13/05/2018]; 10: 00140. Available from: https://www.frontiersin.org/articles/10.3389/fnagi.2018.00140/full

Slattery ML, Lundgreen A, Torres-Mejía G, Wolff RK, Hines L, Baumgartner K, John EM. Diet and lifestyle factors modify immune/inflammation response genes to alter breast cancer risk and prognosis: The Breast Cancer Health Disparities Study. Mutat Res [Internet]. 2014 Dec [Cited 13/05/2018]; 770:19-28. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201121/

Aghaeepour N, Ganio EA, Mcilwain D, Tsai AS, Tingle M, Van Gassen S, Gaudilliere DK. An immune clock of human pregnancy. Sci Immunol [Internet]. 2017 Sep [Cited 5/07/2018]; 2(15). Available from: https://biblio.ugent.be/publication/8550731

Huo Y, Xu Y, Wang J, Wang F, Liu Y, Zhang Y, Zhang B. Analysis of the serum reproductive system related autoantibodies of infertility patients in Tianjin region of China. Int J Clin Exp Med [Internet]. 2015 Aug [Cited 5/07/2018]; 8(8):14048-14053. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613051/

Giuliani E, ParkinKL, Lessey BA, Young SL, Fazleabas AT. Characterization of uterine NK cells in women with infertility or recurrent pregnancy loss and associated endometriosis. Am J Reprod Immunol [Internet]. 2014 Sep [Cited 5/06/2018]; 72(3): 262-269.Available from: https://www.ncbi.nlm.nih.gov/pubmed/24807109

Lutgen V, Narasipura SD, Sharma A, Min S, Al-Harthi L. β-Catenin signaling positively regulates glutamate uptake and metabolism in astrocytes. J Neuroinflamm [Internet]. 2016 Sep[Cited 22/01/2018]; 13(1): 242. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27612942

Hawkins RA, Viña JR. How Glutamate is managed by the blood–brain barrier. Biology (Basel). [Internet]. 2016 Oct[Cited 11/01/2018]; 5(4):37. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192417/

Bading H. Therapeutic targeting of the pathological triad of extrasynaptic NMDA receptor signaling in neurodegenerations. J Exp Med [Internet]. 2017 Mar [Cited 11/01/ 2018]; 214(3): 569-578.Available from:

https://www.ncbi.nlm.nih.gov/pubmed/28209726

Stefani MA, Modkovski R, Hansel G, Eduardo R Zimmer ER, Kopczynski A, Muller A, et al. Elevated glutamate and lactate predict brain death after severe head trauma. Ann Clin Transl Neurol [Internet]. 2017 Jun [Cited 21/01/2018]; 4(6): 392-402. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454398/

Zamfir Chiru AA, Popescu CR, Gheorghe DC. Melatonin and cancer. J Med Life [Internet]. 2014 Sep [Cited 21/01/2018]; 7(3): 373-4.Available from:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4233441/

Ferreira CS, Carvalho KC, Maganhin CC, Paiotti APR, Oshima CTF, Simões MJ, et al. Does melatonin influence the apoptosis in rat uterus of animals exposed to continuous light? Apoptosis [Internet]. 2016 Feb [Cited 21/01/ 2018]; 21(2): 155-62. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26542995

Padrón-González A, Martínez-Infante A. Estrés, psiconeuroendocrinoinmunología y enfermedades reumatológicas. Actualización del tema. Rev Cuba Reumatol [Internet]. 2018 Dec [Citado 7/12/2018]; 20(3): e628. Disponible en:

http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1817-59962018000300012&lng=en.



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