VILMA DOS SANTOS TRINDADE VIANA
Projetos de Pesquisa
Unidades Organizacionais
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Anti-DNase I Antibody A New Serological Reactivity in Primary Sjogren Syndrome(2020) GRIFFO, Priscilla; VIANA, Vilma V. S. T.; PASOTO, Sandra G.; LEON, Elaine P.; BONFA, EloisaBackground and Objective: Primary Sjogren syndrome (pSS) is a systemic autoimmune rheumatic disease that particularly affects exocrine glands. Dry eye is one of the most important features of this syndrome, and a recent study reported reduced deoxyribonuclease I (DNase I) activity in the tear of patients with dry eye. We therefore postulated that patients with pSS might have antibodies targeting DNAse I. Methods: We have evaluated in a cross-sectional study 85 patients with pSS (2002 American-European Consensus Group Criteria), 50 rheumatoid arthritis (RA) patients (1987 American College of Rheumatology Criteria) without sicca symptoms, and 88 healthy volunteers. IgG anti-DNase I was detected by enzyme-linked immunosorbent assay using as antigen bovine pancreas enzyme and confirmed by immunoblotting. Results: Age and sex were alike in the 3 groups (p > 0.05). Anti-DNase I was detected in 43.5% of the pSS patients. In contrast, this reactivity was absent in all RA patients (p = 0.0001). Additional comparison of pSS patients with (n = 37) or without (n = 48) anti-DNase I showed that the former group had higher IgG serum levels (2293.2 +/- 666.2 vs 1483.9 +/- 384.6 mg/dL, p = 0.0001) and greater rate of non-drug-induced leukopenia (43% vs 19%, p = 0.02). A multivariate logistic regression analysis identified that only IgG levels were independently associated with anti-DNase I. Conclusions: We describe a high frequency of anti-DNase I antibodies in pSS patients associated with higher serum IgG levels. The lack of this reactivity in RA patients without sicca symptoms suggests that this antibody may be helpful in the differential diagnosis of these diseases.
- Anti-ribosomal P protein: a novel antibody in autoimmune hepatitis(2013) CALICH, Ana L.; VIANA, Vilma S. T.; CANCADO, Eduardo; TUSTUMI, Francisco; TERRABUIO, Debora R. B.; LEON, Elaine P.; SILVA, Clovis A.; BORBA, Eduardo F.; BONFA, EloisaBackground Autoantibodies to ribosomal P proteins (anti-rib P) are specific serological markers for systemic lupus erythematosus (SLE) and are associated with liver involvement in this disease. The similarity in autoimmune background between autoimmune hepatitis (AIH) and SLE-associated hepatitis raises the possibility that anti-rib P antibodies might also have relevance in AIH. Aims To evaluate the frequency and clinical significance of anti-rib P antibodies in a large AIH cohort. Methods Sera obtained at diagnosis of 96 AIH patients and of 82 healthy controls were tested for IgG anti-ribosomal P protein by ELISA. All of the sera were also screened for other lupus-specific autoantibodies, three patients with the presence of anti-dsDNA (n=1) and anti-Sm (n=2) were excluded. Results Moderate to high titres (>40U) of anti-rib P antibody were found in 9.7% (9/93) of the AIH patients and none of the controls (P=0.003). At presentation, AIH patients with and without anti-rib P antibodies had similar demographic/clinical features, including the frequency of cirrhosis (44.4 vs. 28.5%, P=0.44), hepatic laboratorial findings (0.05). Importantly, at the final observation (follow-up period 10.2 +/- 4.9years), the AIH patients with anti-rib P had a significantly higher frequency of cirrhosis compared with the negative group (100 vs. 60%, P=0.04). Conclusion The novel demonstration of anti-rib P in AIH patients without clinical or laboratory evidence of SLE suggests a common underlying mechanism targeting the liver in these two diseases. In addition, this antibody appears to predict the patients with worse AIH prognoses.
- Clinical and laboratory features of African-Brazilian patients with systemic sclerosis(2020) MENDES, Cristiane; VIANA, Vilma S. T.; PASOTO, Sandra G.; LEON, Elaine P.; BONFA, Eloisa; SAMPAIO-BARROS, Percival D.Objective African-Brazilians comprise a group of blacks and ""pardos."" As racial differences can be associated with distinct presentations, we evaluated the clinical and serological associations of African-Brazilians with systemic sclerosis (SSc). Methods Sera from 260 adult SSc patients (203 whites and 57 African-Brazilians) were evaluated. Patients with overlap syndromes were excluded. Clinical and demographic data were obtained from an electronic register database. Laboratory analysis included the following: anti-CENP-A/CENP-B, Scl70, RNA polymerase III, Ku, fibrillarin, Th/To, PM-Scl75, and PM-Scl100 by line immunoassay and anti-nuclear antibodies (ANA) by indirect immunofluorescence (IIF) on HEp-2 cells. Results African-Brazilian SSc patients presented shorter disease duration (12.8 +/- 6.5 vs. 15.9 +/- 8.1 years, p = 0.009), higher frequency of nucleolar ANA pattern (28% vs. 13%, p = 0.008), and lower frequencies of centromeric ANA pattern (14% vs. 29%, p = 0.026) and CENP-B (18% vs. 34%, p = 0.017), as well as an association with severe interstitial lung disease (58% vs. 43%; p = 0.044). Further comparison of ethnic groups according to subsets revealed that diffuse SSc African-Brazilian patients presented higher frequency of pulmonary hypertension (p = 0.017), heart involvement (p = 0.037), nucleolar ANA pattern (p = 0.036), anti-fibrillarin antibodies (p = 0.037), and higher mortality (48% vs. 19%; p = 0.009). A different pattern was observed for the limited subset with solely a lower frequency of esophageal involvement (p = 0.050) and centromeric ANA pattern (p = 0.049). Survival analysis showed that African-Brazilians had a higher mortality, when adjusted for age, gender, and clinical subset (RR 2.06, CI 95% 1.10-3.83, p = 0.023). Conclusion African-Brazilians have distinct characteristics according to clinical subset and an overall more severe SSc than whites, similar to the blacks from other countries.
conferenceObject Abatacept Related Infections: No Association with Gammaglobulin Reduction.(2014) DINIS, Valquiria; VIANA, Vilma S. T.; LEON, Elaine P.; SILVA, Clovis A.; SAAD, Carla G. S.; MORAES, Julio C. B.; BONFA, Eloisa; RIBEIRO, Ana C. M.- Abatacept induced long-term non-progressive reduction in gamma-globulins and autoantibodies: dissociation from disease activity control(2020) DINIS, Valquiria G.; VIANA, Vilma T.; LEON, Elaine P.; SILVA, Clovis A.; SAAD, Carla G.; MORAES, Julio C.; BONFA, Eloisa S.; MEDEIROS-RIBEIRO, Ana C.Objectives To evaluate long-term effects on gamma-globulins and autoantibodies of abatacept (ABA) versus tumor necrosis factor inhibitors (TNFi) in rheumatoid arthritis (RA) patients. Method Eighteen RA patients undergoing abatacept (ABA-RA) and 18 age/sex-matched patients treated with TNFi (TNFi-RA) were compared regarding clinical data, total gamma-globulins (TGG), specific subtypes (IgG, IgM, IgA), free light chains (FLC), IgM/IgG rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP3), and anti-mutated citrullinated vimentin (anti-MCV), assessed before and every 6 months, up to 24 months. Exclusion criteria: previous abatacept/rituximab or low TGG (< 0.7 g/dL). Results At baseline, female sex (78 vs. 78%), age (55 vs. 53 years), DAS28 (5.73 vs. 5.67), TGG (1.4 vs. 1.35 g/dL), IgG (1168 vs. 1079 mg/dL), IgM (107 vs. 113 mg/dL), IgA (333 vs. 322 mg/dL), kappa (342 vs. 249 mg/dL), lambda (170 vs. 150 mg/dL), IgM-RF (76 vs. 53 UI), IgG-RF (63 vs. 25 UI), anti-CCP3 (216 vs. 189 UI), and anti-MCV (202 vs. 102 UI) were comparable in ABA-RA and TNFi-RA (p > 0.05). Similar disease activity improvement was observed in both groups. In ABA-RA, significant decreases (p < 0.05) were observed in TGG (1.4 vs. 1.05 g/dL), IgG (1168 vs. 997), IgA (333 vs. 278 mg/dL), kappa (342 vs. 257 mg/dL), lambda (170 vs. 144 mg/dL), IgM-RF (76 vs. 37 UI), IgG-RF (65 vs. 24 UI), anti-CCP3 (216 vs. 183 UI), and anti-MCV (202 vs. 60 UI) at 6 months, without further decreases. In contrast, TNFi-RA showed no decrease in any of such parameters. ABA-RA also had more often transient IgG levels under the lower limit of normality (66.7% vs. 33.3%, p = 0.046). No severe infection occurred. DAS28, ESR, and CRP correlated significantly to gamma-globulins and FLC at baseline (p < 0.05), but these correlations were longitudinally lost in ABA-RA, but not in TNFi-RA. Conclusion ABA, but not TNFi, induces a safe, persistent, long-term, and non-progressive reduction in gamma-globulins and autoantibodies, including anti-MCV. This pattern is dissociated from disease activity control.
conferenceObject Long-Term Changes in Autoantibody Profile After Pandemic Unadjuvanted Influenza A/H1N1 Vaccine in Sjogren's Syndrome(2012) PASOTO, Sandra G.; RIBEIRO, Ana C.; VIANA, Vilma S. T.; LEON, Elaine P.; BUENO, Cleonice; NETO, Mauricio Levy; PRECIOSO, Alexander R.; TIMENETSKY, Maria do Carmo S.; BONFA, EloisaBackground/Purpose: Despite WHO recommendations about the A/California/7/2009/H1N1-like virus vaccination, there are no studies evalu- ating its possible influence on clinical manifestations and autoantibody profile in (primary) Sjögren’s syndrome (SS). Objectives: To evaluate short/long-term effect of influenza A/California/7/2009/H1N1-like virus vaccination on clinical manifestations and autoantibody profile in SS. Methods: Thirty-six SS patients (The American-European Consensus Group Criteria, 2002) and 36 gender-, age-, matched-healthy controls were evaluated before and 21-days after vaccination with unadjuvanted influenza A/H1N1-like virus regarding seroprotection/seroconversion, factor increase in geometric mean titre (FI-GMT) and side effects. New onset of parotiditis, arthritis, vasculitis, pneumonitis or neurological disorders and autoantibody profile [antinuclear antibodies (ANA), rheumatoid factor (RF), anti-dsDNA, anti-Ro(SS-A)/La(SS-B), anti-alpha-fodrin, anti-RNP, anti-Sm and anticar-diolipin] were assessed before, 21-days and 1-year after vaccination. Results: Patients and controls had similar rates of seroconversion (78 vs. 69%, p=0.42), seroprotection (83 vs. 72%, p=0.26) and FI-GMT (p=0.85). Pre-vaccination evaluation revealed that disease duration, glucocorticoid (mean dose 10.15.1 mg/day), methotrexate (up to 17.5 mg/week) or azathioprine (up to 100 mg/day) did not affect seroconversion (p> 0.05). Regarding short-term analysis, no change in the frequency or levels of autoantibodies was observed (p>0.05) and only mild side effects were observed in comparable rates to controls (p> 0.05). At 1-year follow-up, the rate of new disease flares was similar to the previous year (11 vs. 19%, p 0.51) and four seroconverted patients developed positivity to one of the following specificities: anti-Ro/SS-A, anti-La/SS-B, anti-alpha-fodrin, or IgM anticardiolipin. None developed other specific lupus autoantibodies. Of note, a significant increase in the mean levels of anti-Ro/SS-A (p< 0.0001) and anti-La/SS-B (p< 0.002) was detected after 1-year with no change in the other autoantibodies. Conclusion: This is the first study to indicate that influenza A/H1N1 vaccine induces long-term changes in autoantibody profile restricted to SS spectrum without a deleterious effect in disease course.conferenceObject Anti-Ribosomal P Antibodies in a Large Cohort of Autoimmune Hepatitis with No Evidence of Lupus: A Common Underlying Mechanism Targeting Liver?(2012) CALICH, Ana Luisa; VIANA, Vilma S. T.; CANCADO, Eduardo L.; TERRABUIO, Debora R.; TUSTUMI, Francisco; LEON, Elaine P.; SILVA, Clovis Artur; BORBA NETO, Eduardo F.; BONFA, Eloisa- Antibodies to cellular prion protein and its cognate ligand stress-inducible protein 1 in systemic lupus erythematosus(2020) CARVALHO, Jozelio F.; VIANA, Vilma S. T.; LEON, Elaine P.; BONFA, Eloisa; PASOTO, Sandra G.; MARTINS, Vilma R.Objectives This study aimed to determine the prevalence of autoantibodies to cellular prion protein (PrP(C)) and its cognate ligand stress-inducible protein 1 (STI-1) in sera from patients with systemic lupus erythematosus (SLE), and their possible correlation with clinical and serological SLE manifestations. Methods Sera were obtained from 103 consecutive SLE patients and 77 healthy controls. IgG antibodies to PrP(C) and to STI-1 were determined by ELISA using recombinant purified proteins, and the reactivities were confirmed by immunoblotting. A panel of lupus-related autoantibodies was investigated by well-standardized techniques. Clinical data were obtained by extensive chart review, and disease activity was scored using the SLE Disease Activity Index (SLEDAI). Results The frequency of anti-PrP(C) antibodies in SLE (7.8%) was similar to healthy controls (p = 0.56), but these antibodies were significantly associated with previous central nervous system (CNS) involvement when compared with patients without anti-PrP(C) (33.3% vs. 7.5%;p = 0.04). On the other hand, anti-STI-1 reactivity was more frequently observed in SLE patients than in healthy controls (12.6% vs. 2.6%;p = 0.026), and this reactivity was associated with a lower frequency of renal disease (23.1% vs. 54.4%;p = 0.04). These two antibody specificities were not associated with SLEDAI score or with the presence of lupus autoantibodies (p > 0.05). Conclusion This is the first evidence of reactivity to PrP(C) in SLE. The intriguing association of these antibodies and previous CNS involvement raises the possibility of a pathogenic role for them in SLE CNS damage.
conferenceObject Podocyte Injury in Membranous and Proliferative Lupus Nephritis: Distinct Underlying Mechanisms?(2012) REZENDE, Gabriela M.; VIANA, Vilma S. T.; MALHEIROS, Denise M.; LEON, Elaine P.; BORBA, Eduardo F.; SILVA, Neila A. S.; NORONHA, Irene L.; SILVA, Cleonice; BONFA, EloisaBackground/Purpose: Lupus nephritis (LN) is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE) with proteinuria being the predominant common manifestation and may therefore reflect podocyte injury. Podocytes are highly specialized cells that have a relevant role in the glomerular filtration barrier and alteration in the expression of their biomarkers has been shown to be associated with podocyte dysfunction in some glomerulopathies. A systematic analysis of podocyte-associated molecules encom-passing different subcellular compartments was performed in a large series of LN biopsies. Expression of Wilms tumor protein (WT1), Synaptopodin (Synpo) and glomerular epithelial protein 1 (GLEPP1) with nuclear, cytoplasmic and membrane distribution respectively, were evaluated attempting to identify if podocyte phenotype is distinct in proliferative and membranous nephritis. Possible association of molecular expression alterations with long term proteinuria severity and outcome in lupus was also investigated. Methods: Immunohistochemistry analysis was performed using monoclonal antibodies to WT1, Synpo and GLEPP1 proteins in 52 biopsies from patients with lupus nephritis fulfilling the revised ACR criteria for SLE. Demographic, clinical and laboratorial data at the time of biopsy were analyzed. Results: Thirty-nine (75%) biopsies were classified as proliferative LN and thirteen (25%) as pure membranous class V. Immunohistochemistry analysis in normal kidney revealed preserved staining of WT1, Synpo and GLEPP1 podocyte biomarkers along the capillary walls. Preserved and concomitant WT1 and Synpo staining was observed in a significant higher frequency in pure class V biopsies than in proliferative LN (69.23 vs. 2.56%, p 0.0001). Likewise, preserved GLEPP1 expression was also more frequent in pure class V LN (53.85 vs. 2.86%, p 0.0002). Proteinuria and serum albumin levels at the time of biopsy did not statistically differ in the two groups (p 0.87 and p 0.41) whereas in the mean long-term follow-up of four years a tendency of lower proteinuria (p 0.050) was observed in those patients with biopsies expressing preserved WT1/Synpo staining. Conclusion: This is the first study comparing proliferative and membranous lupus nephritis which evaluated simultaneously the expression of proteins in different subcellular podocyte compartments and provided novel evidence of preserved podocyte structural architecture predominantly in membranous lesions which may account for a better long term outcome of patients with this LN histological class. These findings suggest possible different underlying mechanisms for proteinuria in both conditions.