Brazilian SCD patients with the TNFA, IL1B, and HLA-DRB1 gene polymorphisms were at increased risk of becoming alloimmunized by RBC transfusions. These findings may contribute to the development of future therapeutic strategies for patients with SCD with higher susceptibility of alloimmunization.
A participação privada na prestação de serviços de apoio ao turismo em parques é estimulada por órgãos ambientais de diversos países como uma estratégia para aprimorar a implementação dessas áreas. O objetivo deste artigo é analisar os principais aspectos que orientam o planejamento, a implementação e o monitoramento das parcerias entre as esferas pública e privada, com ênfase nas concessões e nas iniciativas no âmbito federal e nos estados de Minas Gerais (MG), Rio de Janeiro (RJ) e São Paulo (SP). A partir de análise de referencial teórico-conceitual sobre valores públicos nas parcerias e uma abordagem qualitativa junto aos gestores, foram identificados alguns aspectos analíticos para subsidiar a compreensão sobre esse modelo de gestão. A possibilidade de avanço na gestão dos parques por meio de parcerias depende de características da governança estabelecida por meio de três elementos principais: a transparência, de modo a aumentar a capacidade de os reguladores e a sociedade controlarem o desempenho; a criação de uma comunicação eficaz, que estimule a confiança entre os setores envolvidos; e a participação social, que fortalece a accountability e aumenta a legitimidade do processo.
Antibodies that block factor VIII (FVIII) activity appear in some haemophilia A patients treated with FVIII replacement therapy and severely impaired treatment. To date, the mechanisms that lead to this immune response are unknown. In this work, haplotypes of cytokine interleukin 10 (IL-10) gene have been associated with the presence of FVIII inhibitors in a group of Brazilian haemophilia A patients. The coexistence of a haplotype defining high IL-10 synthesis and one defining an intermediate production of cytokines is found to be associated with the group of patients who have a history of inhibitor development. Additionally, the coexistence of haplotypes defining high and low IL-10 syntheses is strongly associated with the group of negative inhibitors. These results have shown that the simple association considering only the presence or the absence of a haplotype and the development of inhibitors in haemophilia A is not sufficient. Data obtained in this work sustain the idea that the genetic studies may partly explain why only approximately 25% of haemophilia A patients develop FVIII inhibitors. Other genetic issues and details of the protein replacement therapy should be considered to measure the chances of a patient to develop anti-FVIII antibodies.
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