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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">O penfigoide bolhoso &#40;PB&#41; &#233; doen&#231;a bolhosa autoimune cr&#244;nica caracterizada por bolhas subepid&#233;rmicas&#44; acometendo principalmente pessoas idosas&#46; A incid&#234;ncia de PB aumenta com a idade&#44; e 190 a 312 casos por milh&#227;o de pessoas com mais de 80 anos s&#227;o observados a cada ano&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> BP180 e BP230 s&#227;o os dois ant&#237;genos principais do PB&#46; O dom&#237;nio NC16A de BP180 desempenha pap&#233;is cruciais na patog&#234;nese do PB em decorr&#234;ncia de sua liga&#231;&#227;o direta ao autoanticorpo&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">BP180 &#233; expresso na pele e no sistema nervoso&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> A associa&#231;&#227;o entre PB e doen&#231;a neurol&#243;gica &#40;DN&#41; tem sido relatada&#44; principalmente acidente vascular encef&#225;lico &#40;AVE&#41;&#46; Cordel et al&#46; descobriram que 35&#37; dos pacientes com PB apresentavam DN concomitante&#44; dos quais 55&#37; apresentavam dem&#234;ncia e 42&#37; apresentavam AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> O estudo conduzido pelo Departamento de Dermatologia da Central European University indicou que a taxa de preval&#234;ncia de DN no PB foi de 27&#44;66&#37;&#44; e o AVE foi o mais comum&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> A exposi&#231;&#227;o do ep&#237;topos antig&#234;nicos neurais e reatividade cruzada de autoanticorpos na DN podem explicar a rela&#231;&#227;o entre PB e AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Entretanto&#44; at&#233; o momento&#44; apenas um estudo com uma pequena amostra encontrou anticorpos anti&#8208;BP180 em 14&#37; &#40;14&#47;100&#41; dos pacientes com AVE e 5&#37; &#40;5&#47;100&#41; dos controles utilizando ensaio imunossorvente ligado &#224; enzima &#40;ELISA&#44; <span class="elsevierStyleItalic">enzyme&#8208;linked immunosorbent assay</span>&#59; p &#60; 0&#44;05&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> Portanto&#44; para explorar melhor as correla&#231;&#245;es entre PB e AVE&#44; &#233; importante investigar a preval&#234;ncia de anticorpos anti&#8208;BP180 em pacientes com essa condi&#231;&#227;o&#46; Aqui&#44; os autores analisam a preval&#234;ncia do anticorpo anti&#8208;BP180 em 1&#46;183 pacientes com AVE e 855 controles em uma popula&#231;&#227;o chinesa de etnia Han&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materiais e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo Comit&#234; de &#201;tica do hospital&#46; Todos os indiv&#237;duos forneceram consentimento informado por escrito&#46; Todas as amostras foram coletadas em um hospital da Faculdade de Medicina entre fevereiro de 2019 e junho de 2020&#46; Foi coletado sangue venoso &#40;2<span class="elsevierStyleHsp" style=""></span>mL&#41; e o soro foi separado&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Um kit ELISA comercialmente dispon&#237;vel &#40;EUROIMMUN&#44; Alemanha&#41; foi utilizado para detectar autoanticorpos IgG anti&#8208;BP180 no soro dos pacientes e controles saud&#225;veis &#40;dom&#237;nio NC16A do BP180 humano&#41;&#46; A avalia&#231;&#227;o foi baseada no valor de corte de 20 RU&#47;mL&#58; &#8805; 20 era positivo&#59; &#60; 20 era negativo&#46; Os dados foram analisados pelo <span class="elsevierStyleItalic">software</span> SPSS 22&#46; Os dados qualitativos&#44; como sexo &#40;masculino&#47;feminino&#41;&#44; anticorpo BP180 &#40;positivo&#47;negativo&#41; foram analisados estatisticamente pelo teste do Qui&#8208;Quadrado&#46; Os dados quantitativos&#44; como idade&#44; que tiveram distribui&#231;&#227;o gaussiana&#44; foram analisados estatisticamente pelo teste <span class="elsevierStyleItalic">t</span> de Student&#44; n&#227;o pareado e bilateral&#46; Os dados quantitativos&#44; como os valores do anticorpo BP180&#44; que n&#227;o estavam de acordo com a distribui&#231;&#227;o gaussiana&#44; foram analisados estatisticamente pelo teste U de Mann&#8208;Whitney bilateral&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="par0030" class="elsevierStylePara elsevierViewall">Dos 1&#46;183 pacientes com AVE &#40;717 homens&#44; 466 mulheres&#44; m&#233;dia de idade de 64&#44;85 &#177; 13&#44;08 anos&#41;&#44; 970 tiveram isquemia cerebral &#40;IC&#41;&#44; 192 tiveram hemorragia intracerebral &#40;HIC&#41; e 21 tiveram ambos IC e HIC&#46; Os 855 controles saud&#225;veis inclu&#237;ram 523 homens e 332 mulheres&#44; com m&#233;dia de idade de 63&#44;99 &#177; 13&#44;03 anos&#46; N&#227;o houve diferen&#231;a significante na distribui&#231;&#227;o de idade e sexo entre o grupo AVE e o grupo controle &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Os valores de autoanticorpos anti&#8208;BP180 foram significantemente maiores no grupo AVE do que no grupo controle &#40;p &#60; 0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#59; <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A taxa de positividade para autoanticorpos anti&#8208;BP180 foi de 12&#44;51&#37; &#40;148&#41; nos pacientes com AVE e 4&#44;68&#37; &#40;40&#41; nos controles&#44; com diferen&#231;a significante &#40;p &#60; 0&#44;001&#59; OR &#61; 2&#44;65&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Em indiv&#237;duos positivos para autoanticorpo anti&#8208;BP180&#44; os valores tamb&#233;m foram maiores no grupo AVE &#40;37&#44;55 RU&#47;mL&#44; intervalo 20&#44;56&#8208;209&#44;90 RU&#47;mL&#41; em compara&#231;&#227;o com o grupo controle &#40;32&#44;18 RU&#47;mL&#44; intervalo 20&#44;25&#8208;191&#44;33 RU&#47;mL&#59; p &#60; 0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#59; <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#46; &#201; digno de nota que apenas dez &#40;6&#44;76&#37;&#41; pacientes com AVE e tr&#234;s &#40;7&#44;5&#37;&#41; controles apresentaram valores elevados &#40;&#62; 100 RU&#47;mL&#41;&#44; mas sem diferen&#231;a significante entre eles &#40;p &#61; 0&#44;87&#59; OR &#61; 1&#44;01&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">A an&#225;lise estratificada da taxa de positividade para os anticorpos anti&#8208;BP180 no grupo AVE n&#227;o mostrou diferen&#231;a significante em termos de idade&#44; sexo e subtipos de AVE &#40;p &#62; 0&#44;05&#41;&#46; Houve taxa de positividade semelhante entre os tr&#234;s subtipos de AVE &#40;p &#61; 0&#44;11&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discuss&#227;o</span><p id="par0045" class="elsevierStylePara elsevierViewall">O presente estudo&#44; realizado com amostra relativamente grande de pacientes com AVE&#44; sugeriu que o monitoramento do anticorpo anti&#8208;BP180 &#233; crucial para a preven&#231;&#227;o prospectiva do PB e fornece novos conhecimentos sobre a rela&#231;&#227;o entre AVE e PB&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">PB e AVE s&#227;o fatores de risco inter&#8208;relacionados&#44; mas sua rela&#231;&#227;o sequencial permanece controversa&#46; Uma hip&#243;tese &#233; que a DN precede o PB por meses ou anos&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> A les&#227;o neural exp&#245;e o BP180 do sistema nervoso central ao sistema imunol&#243;gico&#44; e essa exposi&#231;&#227;o pode induzir autoanticorpos que reagem de maneira cruzada com a zona da membrana basal da pele&#44; causando o PB&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> Outra hip&#243;tese &#233; que o AVE &#233; diferente da DN em geral&#44; faz parte das doen&#231;as cerebrovasculares e ocorre frequentemente ap&#243;s o PB&#46; Devido &#224; inflama&#231;&#227;o derivada do PB e ao aumento da eosinofilia no sangue e nos tecidos&#44; o estado de alta coagula&#231;&#227;o dos anticorpos antifosfol&#237;pides piora a aterosclerose existente&#44; promovendo a trombose e causando o AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">O presente estudo demonstrou que os valores de autoanticorpos anti&#8208;BP180 e a taxa de positividade foram maiores em pacientes com AVE do que nos controles&#46; O risco de preval&#234;ncia dos anticorpos anti&#8208;BP180 foi 2&#44;65 vezes maior no grupo AVE do que no grupo controle&#46; Entretanto&#44; para aqueles com anticorpo anti&#8208;BP180 positivo nos dois grupos&#44; n&#227;o houve ocorr&#234;ncia de PB no seguimento de seis meses at&#233; o momento&#44; o que &#233; consistente com os achados de Kokkonen et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> que relataram a presen&#231;a de anticorpos anti&#8208;BP180 em 18&#37; dos pacientes com Alzheimer e 3&#37; dos controles&#44; mas sem les&#245;es cut&#226;neas semelhantes ao PB&#46; Existem v&#225;rias raz&#245;es poss&#237;veis para esse achado&#46; Primeiro&#44; os valores dos anticorpos anti&#8208;BP180 em pacientes com AVE eram muito baixos para ativar a resposta imune do sistema complemento e outras citocinas&#44; e n&#227;o poderiam induzir o PB&#46; No presente estudo&#44; a maioria dos indiv&#237;duos positivos para anticorpos anti&#8208;BP180 apresentou valores baixos&#46; Em segundo lugar&#44; alguns pacientes podem passar despercebidos por terem les&#245;es at&#237;picas&#44; como prurido ou eritema&#44; sem bolhas&#46; Terceiro&#44; o tempo de seguimento n&#227;o foi suficientemente longo para o desenvolvimento de PB&#46; Portanto&#44; seria necess&#225;rio seguimento mais longo para saber se os indiv&#237;duos positivos para anticorpos anti&#8208;BP180 viriam a desenvolver PB&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Pacientes mais jovens com AVE s&#227;o significantemente mais propensos a desenvolver autorreatividade s&#233;rica para BP180 do que pacientes mais velhos com AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> No entanto&#44; neste estudo&#44; a taxa de positividade do anticorpo anti&#8208;BP180 n&#227;o foi significantemente diferente entre pacientes com AVE com idade &#8804; 60 e &#62; 60 anos&#46; Outro estudo sobre anticorpos anti&#8208;BP180 em popula&#231;&#245;es sem PB descobriu que a incid&#234;ncia dos anticorpos n&#227;o muda de maneira significante dependendo da idade ou do sexo&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> Portanto&#44; o AVE tem impacto mais significativo nos anticorpos anti&#8208;BP180 do que a idade e o sexo&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a estatisticamente significante na taxa de anticorpos anti&#8208;BP180 positivos entre os tr&#234;s subtipos de AVE&#46; Entretanto&#44; deve&#8208;se notar que a taxa de positividade em pacientes com IC e HIC foi quase o dobro daquela em pacientes com IC ou HIC isoladamente &#40;OR &#61; 1&#44;94&#41;&#46; Em estudos futuros&#44; os autores planejam aumentar o tamanho da amostra de pacientes com IC complicada com HIC&#44; com o objetivo de avaliar melhor a taxa de positividade do anticorpo anti&#8208;BP180 em pacientes com diferentes subtipos de AVE&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Uma limita&#231;&#227;o do presente estudo foi a aus&#234;ncia de crit&#233;rios quantitativos para a gravidade do AVE&#46; Assim&#44; a rela&#231;&#227;o entre a gravidade do AVE e os n&#237;veis de anticorpos anti&#8208;BP180 n&#227;o pode ser avaliada&#46; Mais pesquisas s&#227;o necess&#225;rias para testar se os n&#237;veis de anticorpos tamb&#233;m est&#227;o relacionados &#224; gravidade das manifesta&#231;&#245;es cl&#237;nicas do AVE&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Em resumo&#44; o presente estudo encontrou valores mais elevados e maior taxa de positividade do anticorpo anti&#8208;BP180 em pacientes com AVE em compara&#231;&#227;o com os controles&#44; indicando que pacientes com AVE podem ter maior risco de desenvolver PB&#46; &#201; necess&#225;rio um seguimento maior para determinar o desfecho dos pacientes positivos para anticorpos anti&#8208;BP180&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Suporte financeiro</span><p id="par0080" class="elsevierStylePara elsevierViewall">O presente estudo recebeu suporte financeiro do programa de promo&#231;&#227;o acad&#234;mica da Shandong First Medical University &#40;2019LJ002&#44; 2019RC007&#44; 2020RC001&#41;&#44; do Projeto de Apoio &#224; Inova&#231;&#227;o Tecnol&#243;gica da Juventude da Shandong Colleges and Universities &#40;2019KJL003&#41; e do Projeto de Inova&#231;&#227;o da Shandong Academy of Medical Sciences&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Contribui&#231;&#227;o dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Jing Wang&#58; An&#225;lise formal&#59; investiga&#231;&#227;o&#59; reda&#231;&#227;o &#8211; rascunho original&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hong Liu&#58; Administra&#231;&#227;o do projeto&#59; supervis&#227;o&#59; reda&#231;&#227;o &#8211; revis&#227;o e edi&#231;&#227;o&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Zhenzhen Wang&#58; Curadoria de dados&#59; metodologia&#59; software&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Qing Pan&#58; Valida&#231;&#227;o&#59; visualiza&#231;&#227;o&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Furen Zhang&#58; Conceitualiza&#231;&#227;o&#59; aquisi&#231;&#227;o de financiamento&#59; Recursos&#59; aprova&#231;&#227;o do manuscrito final&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflito de interesses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Foi relatada associa&#231;&#227;o significante entre penfigoide bolhoso &#40;PB&#41; e acidente vascular encef&#225;lico &#40;AVE&#41;&#46; Este estudo teve como objetivo avaliar o n&#237;vel de anticorpos anti&#8208;BP180 em pacientes com AVE para investigar a rela&#231;&#227;o entre PB e AVE na patog&#234;nese&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Amostras de soro foram coletadas de pacientes com AVE e controles pareados entre fevereiro de 2019 e junho de 2020&#46; Os n&#237;veis de anticorpos anti&#8208;BP180 foram medidos por ensaio imunossorvente ligado &#224; enzima &#40;ELISA&#44; <span class="elsevierStyleItalic">enzyme&#8208;linked immunosorbent assay</span>&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Um total de 1&#46;183 pacientes com AVE&#44; incluindo 970 com isquemia cerebral &#40;IC&#41;&#44; 192 com hemorragia intracerebral &#40;HIC&#41;&#44; 21 com IC e HIC&#44; e 855 controles foram inclu&#237;dos neste estudo&#46; Os valores dos autoanticorpos anti&#8208;BP180 foram significantemente maiores nos pacientes com AVE do que nos controles &#40;p &#60; 0&#44;001&#41;&#46; As taxas de positividade para autoanticorpos anti&#8208;BP180 foram de 12&#44;51&#37; &#40;148&#41; em pacientes com AVE e 4&#44;68&#37; &#40;40&#41; nos controles &#40;p &#60; 0&#44;001&#59; OR &#61; 2&#44;65&#41;&#46; Em indiv&#237;duos positivos para autoanticorpos anti&#8208;BP180&#44; os valores foram significantemente maiores em pacientes com AVE do que em controles &#40;p &#60; 0&#44;001&#41;&#46; No entanto&#44; apenas dez &#40;6&#44;76&#37;&#41; pacientes com AVE e tr&#234;s controles &#40;7&#44;5&#37;&#41; apresentaram valores elevados &#40;&#62; 100 RU&#47;mL&#59; p &#61; 0&#44;87&#41;&#46; A an&#225;lise estratificada mostrou que as taxas de indiv&#237;duos positivos para anticorpos anti&#8208;BP180 eram independentes de idade&#44; sexo e subtipos de AVE no grupo com AVE&#46; Taxas positivas em pacientes com IC e HIC foram quase duas vezes maiores do que aquelas em pacientes com IC ou HIC isoladamente &#40;p &#61; 0&#44;11&#59; OR &#61; 1&#44;94&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Limita&#231;&#245;es do estudo</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Este estudo teve tamanho de amostra limitado e faltaram crit&#233;rios quantitativos para a gravidade do AVE&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Os valores dos anticorpos anti&#8208;BP180 e a taxa de positividade foram maiores nos pacientes com AVE do que nos controles&#44; sugerindo que os pacientes com AVE podem ter maior risco de desenvolver PB&#46;</p></span>"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Os n&#250;meros e porcentagens do anticorpo anti&#8208;BP180 pelo teste ELISA s&#227;o baseados no valor de corte de &#8805; 20 RU&#47;mL&#46; Os valores de p&#44; X<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a>&#44; OR e IC95&#37; s&#227;o indicados para cada compara&#231;&#227;o&#46; Um valor de p &#62; 0&#44;05 foi considerado como n&#227;o indicando signific&#226;ncia estat&#237;stica&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">IC&#44; isquemia cerebral&#59; HIC&#44; hemorragia intracerebral&#59; OR&#44; <span class="elsevierStyleItalic">odds ratio</span>&#59; IC95&#37;&#44; intervalo de confian&#231;a de 95&#37;&#46;</p>"
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Resultados do teste ELISA com taxa positiva de anticorpos anti&#8208;BP180 no grupo acidente vascular encef&#225;lico &#40;AVE&#41;</p>"
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Artigo original
Análise da resposta autoimune ao BP180 em pacientes chineses com acidente vascular encefálico
Jing Wanga,b, Hong Liua, Zhenzhen Wanga, Qing Pana, Furen Zhanga,
Autor para correspondência
zhangfuren@hotmail.com

Autor para correspondência.
a Shandong Provincial Hospital for Skin Diseases, Faculdade de Medicina Cheeloo, Shandong University, Jinan, Shandong, China
b Departamento de Dermatologia e Venereologia, the Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
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          "pt" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Resultados do teste ELISA nos grupos de acidente vascular encef&#225;lico &#40;AVE&#41; e controle&#46; Os pontos indicam o valor do &#237;ndice de cada amostra&#46; &#40;A&#41; Valores de anticorpos anti&#8208;BP180 de 1&#46;183 pacientes com AVE e 855 controles&#46; As linhas pontilhadas representam o valor de corte de 20 RU&#47;mL&#46; &#40;B&#41; Valores positivos para anticorpos anti&#8208;BP180 de 148 pacientes com AVE e 40 controles&#46; As linhas pretas representam a mediana&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">O penfigoide bolhoso &#40;PB&#41; &#233; doen&#231;a bolhosa autoimune cr&#244;nica caracterizada por bolhas subepid&#233;rmicas&#44; acometendo principalmente pessoas idosas&#46; A incid&#234;ncia de PB aumenta com a idade&#44; e 190 a 312 casos por milh&#227;o de pessoas com mais de 80 anos s&#227;o observados a cada ano&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> BP180 e BP230 s&#227;o os dois ant&#237;genos principais do PB&#46; O dom&#237;nio NC16A de BP180 desempenha pap&#233;is cruciais na patog&#234;nese do PB em decorr&#234;ncia de sua liga&#231;&#227;o direta ao autoanticorpo&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">BP180 &#233; expresso na pele e no sistema nervoso&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> A associa&#231;&#227;o entre PB e doen&#231;a neurol&#243;gica &#40;DN&#41; tem sido relatada&#44; principalmente acidente vascular encef&#225;lico &#40;AVE&#41;&#46; Cordel et al&#46; descobriram que 35&#37; dos pacientes com PB apresentavam DN concomitante&#44; dos quais 55&#37; apresentavam dem&#234;ncia e 42&#37; apresentavam AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> O estudo conduzido pelo Departamento de Dermatologia da Central European University indicou que a taxa de preval&#234;ncia de DN no PB foi de 27&#44;66&#37;&#44; e o AVE foi o mais comum&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> A exposi&#231;&#227;o do ep&#237;topos antig&#234;nicos neurais e reatividade cruzada de autoanticorpos na DN podem explicar a rela&#231;&#227;o entre PB e AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Entretanto&#44; at&#233; o momento&#44; apenas um estudo com uma pequena amostra encontrou anticorpos anti&#8208;BP180 em 14&#37; &#40;14&#47;100&#41; dos pacientes com AVE e 5&#37; &#40;5&#47;100&#41; dos controles utilizando ensaio imunossorvente ligado &#224; enzima &#40;ELISA&#44; <span class="elsevierStyleItalic">enzyme&#8208;linked immunosorbent assay</span>&#59; p &#60; 0&#44;05&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> Portanto&#44; para explorar melhor as correla&#231;&#245;es entre PB e AVE&#44; &#233; importante investigar a preval&#234;ncia de anticorpos anti&#8208;BP180 em pacientes com essa condi&#231;&#227;o&#46; Aqui&#44; os autores analisam a preval&#234;ncia do anticorpo anti&#8208;BP180 em 1&#46;183 pacientes com AVE e 855 controles em uma popula&#231;&#227;o chinesa de etnia Han&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Materiais e m&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo Comit&#234; de &#201;tica do hospital&#46; Todos os indiv&#237;duos forneceram consentimento informado por escrito&#46; Todas as amostras foram coletadas em um hospital da Faculdade de Medicina entre fevereiro de 2019 e junho de 2020&#46; Foi coletado sangue venoso &#40;2<span class="elsevierStyleHsp" style=""></span>mL&#41; e o soro foi separado&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Um kit ELISA comercialmente dispon&#237;vel &#40;EUROIMMUN&#44; Alemanha&#41; foi utilizado para detectar autoanticorpos IgG anti&#8208;BP180 no soro dos pacientes e controles saud&#225;veis &#40;dom&#237;nio NC16A do BP180 humano&#41;&#46; A avalia&#231;&#227;o foi baseada no valor de corte de 20 RU&#47;mL&#58; &#8805; 20 era positivo&#59; &#60; 20 era negativo&#46; Os dados foram analisados pelo <span class="elsevierStyleItalic">software</span> SPSS 22&#46; Os dados qualitativos&#44; como sexo &#40;masculino&#47;feminino&#41;&#44; anticorpo BP180 &#40;positivo&#47;negativo&#41; foram analisados estatisticamente pelo teste do Qui&#8208;Quadrado&#46; Os dados quantitativos&#44; como idade&#44; que tiveram distribui&#231;&#227;o gaussiana&#44; foram analisados estatisticamente pelo teste <span class="elsevierStyleItalic">t</span> de Student&#44; n&#227;o pareado e bilateral&#46; Os dados quantitativos&#44; como os valores do anticorpo BP180&#44; que n&#227;o estavam de acordo com a distribui&#231;&#227;o gaussiana&#44; foram analisados estatisticamente pelo teste U de Mann&#8208;Whitney bilateral&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Resultados</span><p id="par0030" class="elsevierStylePara elsevierViewall">Dos 1&#46;183 pacientes com AVE &#40;717 homens&#44; 466 mulheres&#44; m&#233;dia de idade de 64&#44;85 &#177; 13&#44;08 anos&#41;&#44; 970 tiveram isquemia cerebral &#40;IC&#41;&#44; 192 tiveram hemorragia intracerebral &#40;HIC&#41; e 21 tiveram ambos IC e HIC&#46; Os 855 controles saud&#225;veis inclu&#237;ram 523 homens e 332 mulheres&#44; com m&#233;dia de idade de 63&#44;99 &#177; 13&#44;03 anos&#46; N&#227;o houve diferen&#231;a significante na distribui&#231;&#227;o de idade e sexo entre o grupo AVE e o grupo controle &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Os valores de autoanticorpos anti&#8208;BP180 foram significantemente maiores no grupo AVE do que no grupo controle &#40;p &#60; 0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#59; <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A taxa de positividade para autoanticorpos anti&#8208;BP180 foi de 12&#44;51&#37; &#40;148&#41; nos pacientes com AVE e 4&#44;68&#37; &#40;40&#41; nos controles&#44; com diferen&#231;a significante &#40;p &#60; 0&#44;001&#59; OR &#61; 2&#44;65&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Em indiv&#237;duos positivos para autoanticorpo anti&#8208;BP180&#44; os valores tamb&#233;m foram maiores no grupo AVE &#40;37&#44;55 RU&#47;mL&#44; intervalo 20&#44;56&#8208;209&#44;90 RU&#47;mL&#41; em compara&#231;&#227;o com o grupo controle &#40;32&#44;18 RU&#47;mL&#44; intervalo 20&#44;25&#8208;191&#44;33 RU&#47;mL&#59; p &#60; 0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#59; <a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#46; &#201; digno de nota que apenas dez &#40;6&#44;76&#37;&#41; pacientes com AVE e tr&#234;s &#40;7&#44;5&#37;&#41; controles apresentaram valores elevados &#40;&#62; 100 RU&#47;mL&#41;&#44; mas sem diferen&#231;a significante entre eles &#40;p &#61; 0&#44;87&#59; OR &#61; 1&#44;01&#59; <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">A an&#225;lise estratificada da taxa de positividade para os anticorpos anti&#8208;BP180 no grupo AVE n&#227;o mostrou diferen&#231;a significante em termos de idade&#44; sexo e subtipos de AVE &#40;p &#62; 0&#44;05&#41;&#46; Houve taxa de positividade semelhante entre os tr&#234;s subtipos de AVE &#40;p &#61; 0&#44;11&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discuss&#227;o</span><p id="par0045" class="elsevierStylePara elsevierViewall">O presente estudo&#44; realizado com amostra relativamente grande de pacientes com AVE&#44; sugeriu que o monitoramento do anticorpo anti&#8208;BP180 &#233; crucial para a preven&#231;&#227;o prospectiva do PB e fornece novos conhecimentos sobre a rela&#231;&#227;o entre AVE e PB&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">PB e AVE s&#227;o fatores de risco inter&#8208;relacionados&#44; mas sua rela&#231;&#227;o sequencial permanece controversa&#46; Uma hip&#243;tese &#233; que a DN precede o PB por meses ou anos&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> A les&#227;o neural exp&#245;e o BP180 do sistema nervoso central ao sistema imunol&#243;gico&#44; e essa exposi&#231;&#227;o pode induzir autoanticorpos que reagem de maneira cruzada com a zona da membrana basal da pele&#44; causando o PB&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> Outra hip&#243;tese &#233; que o AVE &#233; diferente da DN em geral&#44; faz parte das doen&#231;as cerebrovasculares e ocorre frequentemente ap&#243;s o PB&#46; Devido &#224; inflama&#231;&#227;o derivada do PB e ao aumento da eosinofilia no sangue e nos tecidos&#44; o estado de alta coagula&#231;&#227;o dos anticorpos antifosfol&#237;pides piora a aterosclerose existente&#44; promovendo a trombose e causando o AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">O presente estudo demonstrou que os valores de autoanticorpos anti&#8208;BP180 e a taxa de positividade foram maiores em pacientes com AVE do que nos controles&#46; O risco de preval&#234;ncia dos anticorpos anti&#8208;BP180 foi 2&#44;65 vezes maior no grupo AVE do que no grupo controle&#46; Entretanto&#44; para aqueles com anticorpo anti&#8208;BP180 positivo nos dois grupos&#44; n&#227;o houve ocorr&#234;ncia de PB no seguimento de seis meses at&#233; o momento&#44; o que &#233; consistente com os achados de Kokkonen et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> que relataram a presen&#231;a de anticorpos anti&#8208;BP180 em 18&#37; dos pacientes com Alzheimer e 3&#37; dos controles&#44; mas sem les&#245;es cut&#226;neas semelhantes ao PB&#46; Existem v&#225;rias raz&#245;es poss&#237;veis para esse achado&#46; Primeiro&#44; os valores dos anticorpos anti&#8208;BP180 em pacientes com AVE eram muito baixos para ativar a resposta imune do sistema complemento e outras citocinas&#44; e n&#227;o poderiam induzir o PB&#46; No presente estudo&#44; a maioria dos indiv&#237;duos positivos para anticorpos anti&#8208;BP180 apresentou valores baixos&#46; Em segundo lugar&#44; alguns pacientes podem passar despercebidos por terem les&#245;es at&#237;picas&#44; como prurido ou eritema&#44; sem bolhas&#46; Terceiro&#44; o tempo de seguimento n&#227;o foi suficientemente longo para o desenvolvimento de PB&#46; Portanto&#44; seria necess&#225;rio seguimento mais longo para saber se os indiv&#237;duos positivos para anticorpos anti&#8208;BP180 viriam a desenvolver PB&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Pacientes mais jovens com AVE s&#227;o significantemente mais propensos a desenvolver autorreatividade s&#233;rica para BP180 do que pacientes mais velhos com AVE&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> No entanto&#44; neste estudo&#44; a taxa de positividade do anticorpo anti&#8208;BP180 n&#227;o foi significantemente diferente entre pacientes com AVE com idade &#8804; 60 e &#62; 60 anos&#46; Outro estudo sobre anticorpos anti&#8208;BP180 em popula&#231;&#245;es sem PB descobriu que a incid&#234;ncia dos anticorpos n&#227;o muda de maneira significante dependendo da idade ou do sexo&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> Portanto&#44; o AVE tem impacto mais significativo nos anticorpos anti&#8208;BP180 do que a idade e o sexo&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">N&#227;o houve diferen&#231;a estatisticamente significante na taxa de anticorpos anti&#8208;BP180 positivos entre os tr&#234;s subtipos de AVE&#46; Entretanto&#44; deve&#8208;se notar que a taxa de positividade em pacientes com IC e HIC foi quase o dobro daquela em pacientes com IC ou HIC isoladamente &#40;OR &#61; 1&#44;94&#41;&#46; Em estudos futuros&#44; os autores planejam aumentar o tamanho da amostra de pacientes com IC complicada com HIC&#44; com o objetivo de avaliar melhor a taxa de positividade do anticorpo anti&#8208;BP180 em pacientes com diferentes subtipos de AVE&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Uma limita&#231;&#227;o do presente estudo foi a aus&#234;ncia de crit&#233;rios quantitativos para a gravidade do AVE&#46; Assim&#44; a rela&#231;&#227;o entre a gravidade do AVE e os n&#237;veis de anticorpos anti&#8208;BP180 n&#227;o pode ser avaliada&#46; Mais pesquisas s&#227;o necess&#225;rias para testar se os n&#237;veis de anticorpos tamb&#233;m est&#227;o relacionados &#224; gravidade das manifesta&#231;&#245;es cl&#237;nicas do AVE&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Em resumo&#44; o presente estudo encontrou valores mais elevados e maior taxa de positividade do anticorpo anti&#8208;BP180 em pacientes com AVE em compara&#231;&#227;o com os controles&#44; indicando que pacientes com AVE podem ter maior risco de desenvolver PB&#46; &#201; necess&#225;rio um seguimento maior para determinar o desfecho dos pacientes positivos para anticorpos anti&#8208;BP180&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Suporte financeiro</span><p id="par0080" class="elsevierStylePara elsevierViewall">O presente estudo recebeu suporte financeiro do programa de promo&#231;&#227;o acad&#234;mica da Shandong First Medical University &#40;2019LJ002&#44; 2019RC007&#44; 2020RC001&#41;&#44; do Projeto de Apoio &#224; Inova&#231;&#227;o Tecnol&#243;gica da Juventude da Shandong Colleges and Universities &#40;2019KJL003&#41; e do Projeto de Inova&#231;&#227;o da Shandong Academy of Medical Sciences&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Contribui&#231;&#227;o dos autores</span><p id="par0085" class="elsevierStylePara elsevierViewall">Jing Wang&#58; An&#225;lise formal&#59; investiga&#231;&#227;o&#59; reda&#231;&#227;o &#8211; rascunho original&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Hong Liu&#58; Administra&#231;&#227;o do projeto&#59; supervis&#227;o&#59; reda&#231;&#227;o &#8211; revis&#227;o e edi&#231;&#227;o&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Zhenzhen Wang&#58; Curadoria de dados&#59; metodologia&#59; software&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Qing Pan&#58; Valida&#231;&#227;o&#59; visualiza&#231;&#227;o&#59; aprova&#231;&#227;o do manuscrito final&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Furen Zhang&#58; Conceitualiza&#231;&#227;o&#59; aquisi&#231;&#227;o de financiamento&#59; Recursos&#59; aprova&#231;&#227;o do manuscrito final&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflito de interesses</span><p id="par0110" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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          "titulo" => "Suporte financeiro"
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          "titulo" => "Contribui&#231;&#227;o dos autores"
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    "fechaRecibido" => "2021-11-15"
    "fechaAceptado" => "2022-01-07"
    "PalabrasClave" => array:1 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec1595220"
          "palabras" => array:3 [
            0 => "Acidente vascular encef&#225;lico"
            1 => "Anticorpos"
            2 => "Penfigoide bolhoso"
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    "resumen" => array:1 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Foi relatada associa&#231;&#227;o significante entre penfigoide bolhoso &#40;PB&#41; e acidente vascular encef&#225;lico &#40;AVE&#41;&#46; Este estudo teve como objetivo avaliar o n&#237;vel de anticorpos anti&#8208;BP180 em pacientes com AVE para investigar a rela&#231;&#227;o entre PB e AVE na patog&#234;nese&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Amostras de soro foram coletadas de pacientes com AVE e controles pareados entre fevereiro de 2019 e junho de 2020&#46; Os n&#237;veis de anticorpos anti&#8208;BP180 foram medidos por ensaio imunossorvente ligado &#224; enzima &#40;ELISA&#44; <span class="elsevierStyleItalic">enzyme&#8208;linked immunosorbent assay</span>&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Um total de 1&#46;183 pacientes com AVE&#44; incluindo 970 com isquemia cerebral &#40;IC&#41;&#44; 192 com hemorragia intracerebral &#40;HIC&#41;&#44; 21 com IC e HIC&#44; e 855 controles foram inclu&#237;dos neste estudo&#46; Os valores dos autoanticorpos anti&#8208;BP180 foram significantemente maiores nos pacientes com AVE do que nos controles &#40;p &#60; 0&#44;001&#41;&#46; As taxas de positividade para autoanticorpos anti&#8208;BP180 foram de 12&#44;51&#37; &#40;148&#41; em pacientes com AVE e 4&#44;68&#37; &#40;40&#41; nos controles &#40;p &#60; 0&#44;001&#59; OR &#61; 2&#44;65&#41;&#46; Em indiv&#237;duos positivos para autoanticorpos anti&#8208;BP180&#44; os valores foram significantemente maiores em pacientes com AVE do que em controles &#40;p &#60; 0&#44;001&#41;&#46; No entanto&#44; apenas dez &#40;6&#44;76&#37;&#41; pacientes com AVE e tr&#234;s controles &#40;7&#44;5&#37;&#41; apresentaram valores elevados &#40;&#62; 100 RU&#47;mL&#59; p &#61; 0&#44;87&#41;&#46; A an&#225;lise estratificada mostrou que as taxas de indiv&#237;duos positivos para anticorpos anti&#8208;BP180 eram independentes de idade&#44; sexo e subtipos de AVE no grupo com AVE&#46; Taxas positivas em pacientes com IC e HIC foram quase duas vezes maiores do que aquelas em pacientes com IC ou HIC isoladamente &#40;p &#61; 0&#44;11&#59; OR &#61; 1&#44;94&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Limita&#231;&#245;es do estudo</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Este estudo teve tamanho de amostra limitado e faltaram crit&#233;rios quantitativos para a gravidade do AVE&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Os valores dos anticorpos anti&#8208;BP180 e a taxa de positividade foram maiores nos pacientes com AVE do que nos controles&#44; sugerindo que os pacientes com AVE podem ter maior risco de desenvolver PB&#46;</p></span>"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Wang J&#44; Liu H&#44; Wang Z&#44; Pan Q&#44; Zhang F&#46; Analysis of the autoimmune response to BP180 in Chinese stroke patients&#46; An Bras Dermatol&#46; 2023&#59;98&#58;13&#8211;6&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Shandong Provincial Hospital for Skin Diseases&#44; Faculdade de Medicina Cheeloo&#44; Shandong University&#44; Jinan&#44; Shandong&#44; China&#46;</p>"
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        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "mostrarDisplay" => false
        "figura" => array:1 [
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Resultados do teste ELISA nos grupos de acidente vascular encef&#225;lico &#40;AVE&#41; e controle&#46; Os pontos indicam o valor do &#237;ndice de cada amostra&#46; &#40;A&#41; Valores de anticorpos anti&#8208;BP180 de 1&#46;183 pacientes com AVE e 855 controles&#46; As linhas pontilhadas representam o valor de corte de 20 RU&#47;mL&#46; &#40;B&#41; Valores positivos para anticorpos anti&#8208;BP180 de 148 pacientes com AVE e 40 controles&#46; As linhas pretas representam a mediana&#46;</p>"
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        "etiqueta" => "Tabela 1"
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        "detalles" => array:1 [
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          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A idade &#233; dada como m&#233;dia e desvio padr&#227;o&#46; Os valores s&#227;o dados como mediana &#40;intervalo&#41;&#46; BP180 &#43;&#47;&#8722; representou BP180 positivo &#40;&#8805; 20 RU&#47;mL&#41;&#47;BP180 negativo &#40;&#60; 20 RU&#47;mL&#41;&#46; Os valores de p foram calculados comparando&#8208;se os dados entre os dois grupos&#46; Um valor de p &#62; 0&#44;05 indicou aus&#234;ncia de signific&#226;ncia&#46; OR&#44; <span class="elsevierStyleItalic">odds ratio</span>&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">855&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Sexo&#44; M&#47;F&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">523&#47;332&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">64&#44;85 &#177; 13&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;99 &#177; 13&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BP180 &#40;RU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#8208;209&#44;90&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#8208;191&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BP180 &#40;&#8805; 20&#160;RU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&#44;55 &#40;20&#44;56&#8208;209&#44;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">32&#44;18 &#40;20&#44;25&#8208;191&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BP180 &#43;&#47;&#8722; &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">148&#47;1035 &#40;12&#44;51&#47;87&#44;49&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">40&#47;815 &#40;4&#44;68&#47;95&#44;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#44;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">20&#8208;100&#47;&#62; 100&#160;RU&#47;mL &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">138&#47;10 &#40;93&#44;24&#47;6&#44;76&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&#47;3 &#40;92&#44;5&#47;7&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;01&nbsp;\t\t\t\t\t\t\n
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Informação do artigo
ISSN: 26662752
Idioma original: Português
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