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Although caloric restriction (CR) apparently has beneficial effects on the immune system, its effects on the immunological function of the intestinal mucosa are little known. The present study explored the effect of CR on the innate and adaptive intestinal immunity of mice. Balb/c mice were either fed ad libitum (control) or on alternate days fed ad libitum and fasted (caloric restriction). After 4 months, an evaluation was made of IgA levels in the ileum, the gene expression for IgA and its receptor (pIgR), as well as the expression of two antimicrobial enzymes (lysozyme and phospholipase A2) and several cytokines of the intestinal mucosa. CR increased the gene expression of lysozyme and phospholipase A2. The levels of IgA were diminished in the ileum, which apparently was a consequence of the reduced transport of IgA by pIgR. In ileum, CR increased the gene expression for most cytokines, both pro- and anti-inflammatory. Hence, CR differentially modified the expression of innate and adaptive immunity mediators in the intestine.

Se midió la sensibilidad y especificidad del somatotipo y de un cuestionario de imagen corporal para predecir obesidad. En un estudio transversal participaron 294 estudiantes universitarios del norte de México de ambos sexos (143 mujeres de 18 años a 35 años). Se midió el somatotipo por antropometría y se administró en cuatro ocasiones el cuestionario de imagen corporal de Gardner, adjuntando las siguientes preguntas: ¿Cómo me veo? ¿Cómo quisiera estar? ¿Cómo creo que me ven los demás? y ¿Cómo me ven los demás? El somatotipo y la imagen corporal predijeron de manera correcta entre el 90% y 95% de los casos con y sin obesidad; presentaron, además, ~86% de capacidad discriminante para determinar obesidad. La endomorfia, la ectomorfia y el ¿Cómo me ven los demás? presentaron la más alta sensibilidad y especificidad (~90%). Concluimos que el somatotipo y el cuestionario de imagen corporal son dos instrumentos válidos, sensibles y específicos para conocer el grado de obesidad.

Objective: We report an atypical case of autoimmune hypoglycemia due to anti-insulin receptor antibodies after initiation of human monoclonal antibody denosumab and review the literature on this unusual disorder. Methods: We cite the history of a 30-year-old female treated for systemic lupus erythematosus (SLE) who presented with persistent hypoglycemia. This manifestation first appeared after administration of the anti-osteoporotic drug denosumab. Results: The patient's laboratory evaluation initially showed suppression of insulin and C-peptide levels. After ruling out all possible causes of hypoglycemia with decreased insulin levels, we resolved that the temporal relationship between the administration of denosumab and the occurrence of symptoms suggested the involvement of this drug in the disorder. However, in the course of the disease, laboratory tests showed a switch to hyperglycemia accompanied by markedly elevated insulin and C-peptide levels. A diagnosis of type B insulin resistance was made after a positive anti-insulin receptor antibody test. After immunosuppressive treatment with rituximab, cyclophosphamide, and prednisone, our patient achieved normalization of insulin and C-peptide levels and remission of symptoms. Conclusion: We describe an atypical case of type B insulin resistance in association with SLE, hypoglycemia, and suppressed insulin levels with no clinical or biochemical signs of insulin resistance on initial presentation. Although it has already been described that there are some factors that may induce the appearance of anti-insulin receptor antibodies, this is the first reported case of autoimmune hypoglycemia that may have been triggered by administration of a human monoclonal antibody such as denosumab.