relação entre avc e inflamação

SIRSSd da Resposta Inflamatoacuteria Sistecircmica

Trata-se de grave causa de mortalidade em UTI condicionando disfunccedilatildeo sistecircmica colapsando

muacuteltiplos oacutergatildeos `a partir de resposta imunoloacutegica a agente infeccioso reconhecido (SEPSE) ou natildeo

American College of Chest PhysiciansSociety of Critical Care Medicine (1992) Crit Care Med 20 864ndash874

Stechmiller JK Treloar D and Allen N (1997) Am J Crit Care 6 204ndash209

Satildeo reconhecidas formas mais frequumlentes de desencadeamento o Trauma Grave pancreatite e Cacircncer na ausecircncia de infecccedilatildeo

These markers include cell adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) and selectins cytokines such as tumour necrosis factor alpha (TNF-1048577) and interleukin 6 (IL-6) chemokines such as IL-

8 and C-reactive protein (CRP)

SAOS e Ativaccedilatildeo da Inflamaccedilatildeo

Liberaccedilatildeo de Proteases

Moleacuteculas de Adesatildeo -- ICAM-1 e selectinas

SIRSO Sistema Imunoloacutegico Inato proporciona

combate imediato a insultos toacutexicos mediado por ceacutelulas fagociacuteticas e por

moleacuteculas de defesa incluindo receptores transmembrana reconhecedores de

padrotildees (PRR)

SIRS Sd da Resposta Inflamatoacuteria Sistecircmica

Resulta da amplificaccedilatildeoreverberaccedilatildeo de resposta imunoloacutegica desencadeando disfunccedilatildeo sistecircmica podendo evoluir para colapso de muacuteltiplos oacutergatildeos

Polymorphisms in Toll-like receptor 4 and the systemic inflammatory response syndrome NJA Child IA Yang 652 Biochemical Society Transactions (2003) Volume 31 part 3

SIRSDentre os PRR temos um importante receptor o TLR4 (Receptor Tipo Toll) um homodiacutemero em que se ligam LPS da membrana de bacteacuterias gram negativas cuja ativaccedilatildeo parece ser responsaacutevel

pela SIRS

Produtos de degradaccedilatildeo por Proteases (Trauma Infecccedilatildeo e Inflamaccedilatildeo pH - heparanase plaquetaacuteria) do Proteoglican

Sulfato de Heparan contribuem para sinalizar a

SIRS atraveacutes do TLR4

TLR4 pode ser ativado por Elastase (Marcador)

pancreaacutetica e neutrofiacutelica indutoras de Sulfato de

Heparan levando a SIRS e ARDS

RECEPTORES TIPO TOLL

SIRS e Reserva Funcional Vasomotora

CO2 10-14h

iNOs

Citoquinas 8-10h

Vasodilataccedilatildeo Microcirculatoacuteria Residual

+

+

Martin NA Patwardhan RV Alexander MJ Africk CZ Lee JH Shalmon E Hovda DA Becker DP (1997) Characterization of cerebral hemodynamic phases following severe head trauma hypoperfusion hyperemia and vasospasm J Neurosurg 879ndash19

Wong ML Rettori V al Shekhlee A Bongiorno PB Canteros G McCann SM Gold PW Licinio J (1996) Inducible nitric oxide synthase gene expression in the brain during systemic inflammation Nat Med 2581ndash584

SIRSFatores de piora ou resoluccedilatildeo podem se relacionar a SNP no Asp 299-- Gly Casos com evoluccedilatildeo fatal se relacionam a este polimorfismo que diminui a concentraccedilatildeo

de TLR4 nos tecidos A eficiecircncia da moleacutecula hiperativada tambeacutem parece ser

nociva

SIRS sem infecccedilatildeo

TVC

Siacutendrome da Resposta Inflamatoacuteria Sistecircmica


AVCI grave

Grau AJ Buggle F Ziegler C Schwarz W Meuser J Tasman A-J Buumlhler A Benesch C Becher H Hacke W Association between acute cerebrovascular ischemia and chronic and recurrent infection Stroke 1997281724-1729


TVC


HSA

Y Yoshimoto Y Tanaka K Hoya Acute Systemic Inflammatory Response Syndrome in Subarachnoid Hemorrhage J Neurol Neurosurh 18(2) June 8 2001

Vasoespasmo grave

AVC E FENOcircMENO INFLAMATOacuteRIO

SIRS

Name RZ gender - female age 46 years medical record No 8253 Systemic clinical diagnosis - Central vestibular syndrome- Leucoaraiosis- Dyslipidemia- Systolic hypertension- Angina pectoris

Fatores de piora do Prognoacutestico

Name SI gender - male age 47 years medical record No 8985 Systemic clinical diagnosis - Recurrent ischemic stroke- Right side cerebellum infarction- Atheromatosis of carotid artery system- Old septal myocardial infarction- Sinus bradycardia- Mixed dyslipidemia- Transient ischemic attack in vertebralbasilar artery system



SIRS

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SIRS (2)



SIRS (3)



SIRS sem infecccedilatildeo (2)



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SIRS (4)

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These markers include cell adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1) and selectins cytokines such as tumour necrosis factor alpha (TNF-1048577) and interleukin 6 (IL-6) chemokines such as IL-

8 and C-reactive protein (CRP)


Liberaccedilatildeo de Proteases

Moleacuteculas de Adesatildeo -- ICAM-1 e selectinas




padrotildees (PRR)





pela SIRS









CO2 10-14h

iNOs

Citoquinas 8-10h


+

+





nociva


TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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padrotildees (PRR)





pela SIRS









CO2 10-14h

iNOs

Citoquinas 8-10h


+

+





nociva


TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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pela SIRS









CO2 10-14h

iNOs

Citoquinas 8-10h


+

+





nociva


TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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CO2 10-14h

iNOs

Citoquinas 8-10h


+

+





nociva


TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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nociva


TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

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SIRS (2)



SIRS (3)






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SIRS (4)

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TVC



AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

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SIRS (2)



SIRS (3)






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SIRS (4)

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AVCI grave



TVC


HSA


Vasoespasmo grave


SIRS






SIRS

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SIRS (2)



SIRS (3)






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SIRS (4)

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TVC


HSA


Vasoespasmo grave


SIRS






SIRS

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SIRS (2)



SIRS (3)






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SIRS (4)

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HSA


Vasoespasmo grave


SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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SIRS






SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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SIRS

Slide 4


SIRS (2)



SIRS (3)






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SIRS (4)

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relação entre avc e inflamação

Health & Medicine