LUCAS CHAVES NETTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- High mortality of bloodstream infection outbreak caused by carbapenem-resistant P. aeruginosa producing SPM-1 in a bone marrow transplant unit(2017) CHAVES, Lucas; TOMICH, Lisia Moura; SALOMAO, Matias; LEITE, Gleice Cristina; RAMOS, Jessica; MARTINS, Roberta Ruedas; RIZEK, Camila; NEVES, Patricia; BATISTA, Marjorie Vieira; AMIGO, Ulysses; GUIMARAES, Thais; LEVIN, Anna Sara; COSTA, Silvia FigueiredoPurpose. Carbapenem resistance in P. aeruginosa is increasing worldwide. In Brazil, SPM-1 is the main P. aeruginosa carbapenemase identified. Little is known about the virulence factor in SPM-1 clones. Methodolgy. We describe a carbapenem-resistant P. aeruginosa bloodstream infection (CRPa-BSI) outbreak in a bone marrow transplant Unit (BMT). Twenty-nine CRPa-BSI cases were compared to 58 controls. Microbiological characteristics of isolates, such as sensitivity, carbapenemase gene PCR for P. aeruginosa, and PFGE are described, as well as the whole-genome sequence (WGS) of three strains. Results/Key findings. The cultures from environmental and healthcare workers were negative. Some isolates harboured KPC and SPM. The WGS showed that the 03 strains belonged to ST277, presented the same mutations in outer membrane protein, efflux pump, and virulence genes such as those involved in adhesion, biofilm, quorum-sensing and the type III secretion system, but differ regarding the carbapenemase profile. A predominant clone-producing SPM harbouring Tn 4371 was identified and showed cross-transmission; no common source was found. Overall mortality rate among cases was 79 %. The first multivariate analysis model showed that neutropenia (P=0.018), GVHD prophylaxis (P=0.016) and prior use of carbapenems (P=0.0089) were associated with CRPa-BSI. However, when MASCC >= 21 points and platelets were added in the final multivariate analysis, only prior use of carbapenems remained as an independent risk factor for CRPa-BSI (P=0.043). Conclusions. The predominant clone belonging to ST277 showed high mortality. Carbapenem use was the only risk factor associated with CRPa-BSI. This finding is a wake-up call for the need to improve management in BMT units.
- Severe COVID-19 patients show a dysregulation of the NLRP3 inflammasome in circulating neutrophils(2023) LEAL, Vinicius N. C.; ANDRADE, Milena M. S.; TEIXEIRA, Franciane M. E.; CAMBUI, Raylane A. G.; ROA, Mariela E. G. V.; MARRA, Leticia G.; YAMADA, Suemy M.; ALBERCA, Ricardo W.; GOZZI-SILVA, Sarah C.; YENDO, Tatiana M.; NETTO, Lucas C.; DUARTE, Alberto J. S.; SATO, Maria N.; PONTILLO, AlessandraSARS-CoV-2 triggers inflammasome-dependent release of pro-inflammatory cytokine IL-1 beta and pyroptosis, therefore, contributes to the huge inflammatory response observed in severe COVID-19 patients. Less is known about the engagement of inflammasome in neutrophils, main players in tissue injury and severe infection. We studied the activation of the inflammasome in neutrophils from severe COVID-19 patients and assessed its consequence in term of cells contribution to disease pathogenesis. We demonstrated that NLRP3 inflammasome is dramatically activated in neutrophils from severe COVID-19 patients and that the specific inhibition of NLRP3 reverts neutrophils' activation. Next, the stimulation of severe patients' neutrophils with common NLRP3 stimuli was not able to further activate the inflammasome, possibly due to exhaustion or increased percentage of circulating immature neutrophils. Collectively, our results demonstrate that the NLRP3 inflammasome is hyperactivated in severe COVID-19 neutrophils and its exhaustion may be responsible for the increased susceptibility to subsequent (and possibly lethal) infections. Our findings thus include a novel piece in the complex puzzle of COVID-19 pathogenesis.
- The impact of obesity in hospitalized patients with COVID-19: a retrospective cohort study(2024) CARRA, Fabio Alfano; MELO, Maria Edna de; STUMPF, Matheo A. M.; CERCATO, Cintia; FERNANDES, Ariana E.; MANCINI, Marcio C.; HIROTA, Adriana; KANASIRO, Alberto Kendy; CRESCENZI, Alessandra; FERNANDES, Amanda Coelho; MIETHKE-MORAIS, Anna; BELLINTANI, Arthur Petrillo; CANASIRO, Artur Ribeiro; CARNEIRO, Barbara Vieira; ZANBON, Beatriz Keiko; PINHEIRO, Bernardo; BATISTA, Senna Nogueira; NICOLAO, Bianca Ruiz; BESEN, Bruno Adler Maccagnan Pinheiro; BISELLI, Bruno; MACEDO, Bruno Rocha De; TOLEDO, Caio Machado Gomes De; CARVALHO, Carlos Roberto Ribeiro De; MOL, Caroline Gomes; STIPANICH, Cassio; BUENO, Caue Gasparotto; GARZILLO, Cibele; TANAKA, Clarice; FORTE, Daniel Neves; JOELSONS, Daniel; ROBIRA, Daniele; COSTA, Eduardo Leite Vieira; SILVA JUNIOR, Elson Mendes Da; REGALIO, Fabiane Aliotti; SEGURA, Gabriela Cardoso; LOURO, Giulia Sefrin; MARCELINO, Gustavo Brasil; HO, Yeh-Li; FERREIRA, Isabela Argollo; GOIS, Jeison Oliveira; SILVA-JR, Joao Manoel Da; JUNIOR, Jose Otto Reusing; RIBEIRO, Julia Fray; FERREIRA, Juliana Carvalho; GALLETI, Karine Vusberg; SILVA, Katia Regina; ISENSEE, Larissa Padrao; OLIVEIRA, Larissa Santos; TANIGUCHI, Leandro Utino; LETAIF, Leila Suemi; LIMA, Ligia Trombetta; PARK, Lucas Yongsoo; NETTO, Lucas Chaves; NOBREGA, Luciana Cassimiro; HADDAD, Luciana Bertocco Paiva; HAJJAR, Ludhmila Abrahao; MALBOUISSON, Luiz Marcelo Sa; PANDOLFI, Manuela Cristina Adsuara; PARK, Marcelo; CARMONA, Maria Jose Carvalho; ANDRADE, Maria Castilho Prandini H.; SANTOS, Mariana Moreira; BATELOCHE, Matheus Pereira; SUIAMA, Mayra Akimi; OLIVEIRA, Mayron Faria de; SOUSA, Mayson Laercio; GARCIA, Michelle Louvaes; HUEMER, Natassja; MENDES, Pedro Vitale; LINS, Paulo Ricardo Gessolo; SANTOS, Pedro Gaspar Dos; MOREIRA, Pedro Ferreira Paiva; GUAZZELLI, Renata Mello; REIS, Renato Batista Dos; DALTRO-OLIVEIRA, Renato; ROEPKE, Roberta Muriel Longo; PEDRO, Rodolpho Augusto Moura; KONDO, Rodrigo; RACHED, Samia Zahi; FONSECA, Sergio Roberto Silveira Da; BORGES, Thais Sousa; FERREIRA, Thalissa; JUNIOR, Vilson Cobello; SALES, Vivian Vieira Tenorio; FERREIRA, Willaby Serafim CassaBackground Obesity is believed to be a risk factor for COVID-19 and unfavorable outcomes, although data on this remains to be better elucidated.Objective To evaluate the impact of obesity on the endpoints of patients hospitalized due to SARS-CoV-2.Methods This retrospective cohort study evaluated patients hospitalized at a tertiary hospital (Hospital das Cl & iacute;nicas da Faculdade de Medicina da USP) from March to December 2020. Only patients positive for COVID-19 (real-time PCR or serology) were included. Data were collected from medical records and included clinical and demographic information, weight and height, SAPS-3 score, comorbidities, and patient-centered outcomes (mortality, and need for mechanical ventilation, renal replacement therapy, or vasoactive drugs). Patients were divided into categories according to their BMI (underweight, eutrophic, overweight and obesity) for comparison porpoise.Results A total of 2547 patients were included. The mean age was 60.3 years, 56.2% were men, 65.2% were white and the mean BMI was 28.1 kg/m(2). SAPS-3 score was a risk factor for all patient-centered outcomes (HR 1.032 for mortality, OR 1.03 for dialysis, OR 1.07 for vasoactive drug use, and OR 1.08 for intubation, p < 0.05). Male sex increased the risk of death (HR 1.175, p = 0.027) and dialysis (OR 1.64, p < 0.001), and underweight was protective for vasoactive drug use (OR 0.45, p = 0.027) and intubation (OR 0.31, p < 0.003).Conclusion Obesity itself was not an independent factor for worse patient-centered outcomes. Critical clinical state (indirectly evaluated by SAPS-3) appears to be the most important variable related to hard outcomes in patients infected with COVID-19.
- Safety and immunogenicity of CoronaVac in people living with HIV: a prospective cohort study(2022) NETTO, Lucas C.; IBRAHIM, Karim Y.; PICONE, Camila M.; ALVES, Ana Paula P. S.; V, Eliane Aniceto; SANTIAGO, Mariana R.; PARMEJANI, Patricia S. S.; AIKAWA, Nadia E.; MEDEIROS-RIBEIRO, Ana C.; PASOTO, Sandra G.; YUKI, Emily F. N.; SAAD, Carla G. S.; PEDROSA, Tatiana; LARA, Amanda N.; CENEVIVA, Carina; BONFA, Eloisa; KALLAS, Esper G.; I, Vivian Avelino-SilvaBackground People living with HIV might have a poor or delayed response to vaccines, mainly when CD4 cell counts are low, and data concerning COVID-19 vaccines in this population are scarce. This prospective cohort study assessed the safety and immunogenicity of the inactivated SARS-CoV-2 vaccine CoronaVac in people with HIV compared with people with no known immunosuppression. Methods In this prospective cohort study, adults (aged >= 18 years) living with HIV who were regularly followed up at the University of Sao Paulo HIV/AIDS outpatient clinic in Sao Paulo, Brazil, were included in the study. Eligibility for people with HIV was independent of antiretroviral use, HIV viral load, or CD4 cell count. Adults with no known immunosuppression with CoronaVac vaccination history were included as a control group. CoronaVac was given intramuscularly in a two-dose regimen, 28 days apart. Blood was collected before vaccine administration and 6 weeks after the second dose (day 69). Immunogenicity was assessed at baseline (day 0), before second vaccine (day 28), and 6 weeks after second vaccine dose (day 69) through SARS-CoV-2 IgG titre and seroconversion, neutralising antibody (NAb) positivity and percentage activity, and factor increase in IgG geometric mean titres (FI-GMT). We investigated whether HIV status and CD4 count (<500 or 500 cells per mu L) were associated with CoronaVac immunogenicity by use of multivariable models adjusted for age and sex. Findings Between Feb 9, 2021, and March 4, 2021, 776 participants were recruited. Of 511 participants included, 215 (42%) were people with HIV and 296 (58%) were people with no known immunosuppression. At 6 weeks after the second vaccine dose (day 69), 185 (91%) of 204 participants with HIV and 265 (97%) of 274 participants with no known immunosuppression had seroconversion (p=0.0055). 143 (71%) of 202 participants with HIV were NAb positive compared with 229 (84%) of 274 participants with no known immunosuppression (p=0.0008). Median IgG titres were 48.7 AU/mL (IQR 26.6.88.2) in people with HIV compared with 75.2 AU/mL (50.3.112.0) in people with no known immunosuppression (p<0.0001); and median NAb activity was 46.2% (26.9.69.7) compared with 60.8% (39.8.79.9; p<0.0001). In people with HIV who had CD4 counts less than 500 cells per .L seroconversion rates, NAb positivity, and NAb activity were lower than in those with CD4 counts of at least 500 cells per .L. In multivariable models for seroconversion, NAb positivity, IgG concentration, and NAb activity after a complete two-dose regimen, adjusted for age and sex, people with HIV who had CD4 counts of at least 500 cells per .L and people with no known immunosuppression had higher immunogenicity than did people with HIV with CD4 counts less than 500 cells per .L. No serious adverse reactions were reported during the study. Interpretation Immunogenicity following CoronaVac in people with HIV seems strong but reduced compared with people with no known immunosuppression. Our findings highlight the need for strategies to improve vaccine immunogenicity in people with HIV. Funding Fundacao de Amparo a Pesquisa do Estado de S.o Paulo (FAPESP), Conselho Nacional de Desenvolvimento Cientifico e Tecnol.gico (CNPq), and B3.Bolsa de Valores do Brasil.
- A common variant close to the ""tripwire"" linker region of NLRP1 contributes to severe COVID-19(2023) LEAL, Vinicius N. C.; PAULINO, Leandro M.; CAMBUI, Raylane A. G.; ZUPELLI, Thiago G.; YAMADA, Suemy M.; OLIVEIRA, Leonardo A. T.; DUTRA, Valeria de F.; BUB, Carolina B.; SAKASHITA, Araci M.; YOKOYAMA, Ana Paula H.; KUTNER, Jose M.; VIEIRA, Camila A.; SANTIAGO, Wellyngton M. de S.; ANDRADE, Milena M. S.; TEIXEIRA, Franciane M. E.; ALBERCA, Ricardo W.; GOZZI-SILVA, Sarah C.; YENDO, Tatiana M.; NETTO, Lucas C.; DUARTE, Alberto J. S.; SATO, Maria N.; VENTURINI, James; PONTILLO, AlessandraObjective and design The heterogeneity of response to SARS-CoV-2 infection is directly linked to the individual genetic background. Genetic variants of inflammasome-related genes have been pointed as risk factors for several inflammatory sterile and infectious disease. In the group of inflammasome receptors, NLRP1 stands out as a good novel candidate as severity factor for COVID-19 disease. Methods To address this question, we performed an association study of NLRP1, DPP9, CARD8, IL1B, and IL18 single nucleotide variants (SNVs) in a cohort of 945 COVID-19 patients. Results The NLRP1 p.Leu155His in the linker region, target of viral protease, was significantly associated to COVID-19 severity, which could contribute to the excessive cytokine release reported in severe cases. Conclusion Inflammasome genetic background contributes to individual response to SARS-CoV-2.
bookPart Infecção pelo Vírus da Imunodeficiência Humana (HIV) e Síndrome da Imunodeficiência Adquirida (Aids)(2016) SEGURADO, Aluísio Augusto Cotrim; FREITAS, Angela Carvalho; ATOMIYA, Angela Naomi; WüNSCH, Celia Torrens; NOVAES, Christina Terra Gallafrio; HIGASHINO, Hermes Ryoiti; BERMUDEZ, Jose Ernesto Vidal; CHAVES NETTO, Lucas; VICENTINE, Margarete Paganotti; BOULOS, Maria Ivete Castro; LOPES, Max Igor Banks Ferreira; VASCONCELOS, Ricardo de Paula; SANTOS, Sigrid de Sousa dos; MELLO, Valéria Antakly de; AVELINO-SILVA, Vivian Helena IidaconferenceObject SYNDECAN-1 AS A BIOMARKER OF SEVERITY IN ACUTE YELLOW FEVER(2019) SOUSA, Francielle Tramontini Gomes de; MANULI, Erika R.; ZANELLA, Luiz G.; HO, Yeh-Li; NETTO, Lucas Chaves; MARMORATO, Mariana P.; DIAS, Juliana Z.; THOMAZELLA, Mateus V.; CORREIA, Carolina A.; SILVEIRA, Cassia G.; COSTA, Priscilla R.; PEREIRA, Geovana M.; FERREIRA, Midia S.; ROMANO, Camila M.; KALLAS, Esper G.; HARRIS, Eva; SABINO, Ester C.conferenceObject TOLL-LIKE RECEPTOR SIGNALING PATHWAY IS DIFFERENTIALLY MODULATED IN PATIENTS WITH DENGUE WITHOUT WARNING SIGNS AND DENGUE WITH WARNING SIGNS(2018) BRUNIALTI, Milena K. C.; CERQUEIRA, Natalia; MAESTRI, Alvino; CHAVES, Lucas; LEVI, Jose E.; PANNUTI, Claudio S.; KALLAS, Esper G.; BURATTINI, Marcelo N.; SALOMAO, Reinaldo- Treatment of severe forms of paracoccidioidomycosis: is there a role for corticosteroids?(2012) BENARD, Gil; CAMPOS, Aleia F.; NETTO, Lucas C.; GONCALVES, Luiz G.; MACHADO, Luis R.; MIMICOS, Evanthia V.; FRANCA, Francisco O. S.; GRYSCHEK, Ronaldo C. B.Despite their immunosuppressive effects, corticosteroids have long been used as adjunct therapy (aCST) in the treatment of infectious diseases. The rationale is that in certain infections it is necessary to decrease the exacerbated host's inflammatory response, which can otherwise result in tissue damage and organ dysfunction. In fact, a major concern in treating paracoccidioidomycosis (PCM) is the host's intense inflammatory response to Paracoccidioides brasiliensis, which can be further intensified by antifungal therapy. Depending on its localization, this immunological phenomenon may be life threatening or result in permanent sequels, as is the case for some patients with cerebral or laryngeal involvement. However, the literature on aCST in paracoccidioidomycosis treatment is scarce and as a result we present our recent experience in the management of four patients with severe PCM manifestations, i.e., cerebral paracoccidioidal granuloma, laryngeal stenosis, compressive abdominal mass, and exacerbated inflammatory response with tissue destruction. In addition to the antifungal therapy, these patients required aCST, which probably promoted their clinical improvement and/or prevented serious complications. We suggest that aCST: (a) can potentially help in the management of selected cases of severe forms of PCM, particularly when there is a risk of acute complications, and (b) that it can be used safely provided that the risk-benefit ratio is carefully weighed. Well-controlled, prospective studies of aCST in the treatment of severe cases of paracoccidioidomycosis are needed to better define its role in the management of PCM.
- Pharmacokinetic and Pharmacodynamic Characteristics of Vancomycin and Meropenem in Critically Ill Patients Receiving Sustained Low-efficiency Dialysis(2020) OLIVEIRA, Maura Salaroli; MACHADO, Anna Silva; MENDES, Elisa Teixeira; CHAVES, Lucas; PERDIGAO NETO, Lauro Vieira; JR, Carlindo Vieira da Silva; SANTOS, Silvia Regina Cavani Jorge; SANCHES, Cristina; MACEDO, Etienne; LEVIN, Anna S.Purpose: Antibiotic dosing is challenge in critically ill patients undergoing renal replacement therapy. Our aim was to evaluate the pharmacokinetic and pharmacodynamic (PK/PD) characteristics of meropenem and vancomycin in patients undergoing SLED. Methods: Consecutive ICU patients undergoing SLED and receiving meropenem and/or vancomycin were prospectively evaluated. Serial blood samples were collected before, during, and at the end of SLED sessions. Antimicrobial concentrations were determined using a validated HPLC method. Noncompartmental PK analysis was performed. AUC was determined for vancomycin. For meropenem, time above MIC was calculated. Findings: A total of 24 patients receiving vancomycin and 21 receiving meropenem were included; 170 plasma samples were obtained. Median serum vancomycin and meropenem concentrations before SLED were 24.5 and 28.0 mu g/mL, respectively; after SLED, 14 and 6 mu g/mL. Mean removal was 42% with vancomycin and 78% with meropenem. With vancomycin, 19 (83%), 16 (70%), and 15 (65%) patients would have achieved the target (AUC(0-24) >400) considering MICs of 1, 2, and 4 mg/L, respectively. With meropenem, 17 (85%), 14 (70%), and 10 (50%) patients would have achieved the target (100% of time above MIC) if infected with isolates with MICs of 1, 4, and 8 mg/L, respectively. (C) 2020 Elsevier Inc.