Avaliação dos efeitos causados pela Escherichia coli enteroagregativa (CEPA 239-1) na evolução clonal e resposta próinflamatória de células intestinais in vitro e sua modulação com alanil-glutamina

Abstract

Death from acute diarrhea has been reduced since 80´s. However diarrhoeal diseases account for nearly 1.34 million deaths a year among children under-five years of age, making them the second most common cause of child deaths worldwide. As mortality acute diarrhea was reduced, persistent diarrhea (PD) has become a major enteric diseases infant collaborating to morbidity of affected populations. Small intestinal mucosa injury that becomes prolonged has been named as a central mechanism in the pathophysiology of PD. The protein malnutrition and infection by Escherichia coli enteroaggregative (EAEC) are strongly associated with development PD. The present study investigated the effect of supplementation of Alanyl-Glutamine on monolayer of intestinal cells in the absence of infection, evaluated some parameters of the injury caused by EAEC (strain 239-1) on the intestinal mucosa in vitro and modulation of such injury by Alanyl-Glutamine 10mM. The result show that effects of supplementation of Alanyl-Glutamine 10mM is no different from effects free glutamine 4mM. Compared to E. coli HS, EAEC infection reduced the number of migrating cells, increased the percentage of necrosis, decreased the proliferation and transcription-reverse from small GTPases (RhoA, Rac1 and Cdc42), within 6 hours of contact. The contact EAEC reduced transcription of IL-8 (6h and 0h), NF-κB (6h) and TLR5 (6h and 12h) and increased TNF-α expression. The treatment of infection with Ala-Gln 10mM altered the following parameters: reduced the percentage of necrosis, increase of cell migration, although it has not caused changes in the transcription of Rho GTPases genes, increased transcription IL-8, NF-κB (6h) e TLR5 (6h and 12h). Treatment with dipeptidio significantly reduced the secretion of TNF-α (12h) while increased protein expression of IL-6 (6 e 12h). In conclusion, found that glutamine deprivation decreases cellular response against the infectious stimulus. The EAEC appears to minimize the innate host immune defenses by reducing the transcription of NF-kB and TLR5 and limit the increased transcription of IL-8. The Ala-Gln seems to make the cell more reactive against injurious stimuli, increasing their responsiveness through increased transcriptional IL-8, NF-kB and TLR5. Moreover increased protein expression of IL-6 appears to be one of the mechanisms by which promotes Ala-Gln protective effect on the intestinal epithelial barrier.