EMILIO ELIAS ABDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
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- Trisulfate Disaccharide Decreases Calcium Overload and Protects Liver Injury Secondary to Liver Ischemia/Reperfusion(2016) VASQUES, Enio Rodrigues; CUNHA, Jose Eduardo Monteiro; COELHO, Ana Maria Mendonca; SAMPIETRE, Sandra N.; PATZINA, Rosely Antunes; ABDO, Emilio Elias; NADER, Helena B.; TERSARIOL, Ivarne L. S.; LIMA, Marcelo Andrade; GODOY, Carlos M. G.; RODRIGUES, Tiago; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz A. C.Background Ischemia and reperfusion (I/R) causes tissue damage and intracellular calcium levels are a factor of cell death. Sodium calcium exchanger (NCX) regulates calcium extrusion and Trisulfated Disaccharide (TD) acts on NCX decreasing intracellular calcium through the inhibition of the exchange inhibitory peptide (XIP). Objectives The aims of this research are to evaluate TD effects in liver injury secondary to I/R in animals and in vitro action on cytosolic calcium of hepatocytes cultures under calcium overload. Methods Wistar rats submitted to partial liver ischemia were divided in groups: Control: (n = 10): surgical manipulation with no liver ischemia; Saline: (n = 15): rats receiving IV saline before reperfusion; and TD: (n = 15): rats receiving IV TD before reperfusion. Four hours after reperfusion, serum levels of AST, ALT, TNF-alpha, IL-6, and IL-10 were measured. Liver tissue samples were collected for mitochondrial function and malondialdehyde (MDA) content. Pulmonary vascular permeability and histologic parameters of liver were determined. TD effect on cytosolic calcium was evaluated in BRL3A hepatic rat cell cultures stimulated by thapsigargin pre and after treatment with TD. Results AST, ALT, cytokines, liver MDA, mitochondrial dysfunction and hepatic histologic injury scores were less in TD group when compared to Saline Group (p<0.05) with no differences in pulmonary vascular permeability. In culture cells, TD diminished the intracellular calcium raise and prevented the calcium increase pre and after treatment with thapsigargin, respectively. Conclusion TD decreases liver cell damage, preserves mitochondrial function and increases hepatic tolerance to I/R injury by calcium extrusion in Ca2+ overload situations.
bookPart Pancreatite Crônica(2013) ABDO, Emilio Elias; CUNHA, José Eduardo Monteiro daconferenceObject Heparin Fragments Effects in Liver Injury Secondary to Liver Ischemia/Reperfusion (I/R)(2014) VASQUES, Enio R.; CUNHA, Jose Eduardo M.; COELHO, Ana Maria M.; ABDO, Emilio E.; SAMPIETRE, Sandra N.; NADER, Helena B.; TERSARIOL, Ivarne S.; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz Augusto C.- Hypertonic saline solution decreases oxidative stress in liver hypothermic ischemia(2021) NUNES, Giolana; FIGUEIRA, Estela Regina Ramos; ROCHA-FILHO, Joel Avancini; LANCHOTTE, Cinthia; NACIF, Lucas Souto; FERREIRA, Diego Mendes; ROMANO, Vitor Carminatti; ABDO, Emilio Elias; D'ALBUQUERQUE, Luiz Augusto Carneiro; GALVAO, Flavio Henrique FerreiraBackground: Liver ischemia reperfusion injury is still an unsolved problem in liver surgery and transplantation. In this setting, hypothermia is the gold standard method for liver preservation for trans-plantation. Hypertonic saline solution reduces inflammatory response with better hemodynamic recovery in several situations involving ischemia reperfusion injury. Here, we investigated the effect of hypertonic saline solution in hypothermic liver submitted to ischemia reperfusion injury. Methods: Fifty male rats were divided into 5 groups: SHAM, WI (animals submitted to 40 minutes of partial warm liver ischemia and reperfusion), HI (animals submitted to 40 minutes hypothermic ischemia), HSPI (animals submitted to hypothermic ischemia and treated with 7.5% hypertonic saline solution preischemia), and HSPR (animals submitted to hypothermic ischemia and treated with hypertonic saline solution previously to liver reperfusion). Four hours after reperfusion, the animals were euthanized to collect liver and blood samples. Results: Aspartate aminotransferase and alanine aminotransferase, histologic score, and hepatocellular necrosis were significantly decreased in animals submitted to hypothermia compared with the warm ischemia group. Malondialdehyde was significantly decreased in hypothermic groups with a further decrease when hypertonic saline solution was administrated preischemia. Hypothermic groups also showed decreased interleukin-6, interleukin-10, and tumor necrosis factor-alpha concentrations and better recovery of bicarbonate, base excess, lactate, and glucose blood concentrations. Moreover, hypertonic saline solution preischemia was more effective at controlling serum potassium concentrations. Conclusion: Hypertonic saline solution before hypothermic hepatic ischemia decreases hepatocellular oxidative stress, cytokine concentrations, and promotes better recovery of acid-base disorders secondary to liver ischemia reperfusion.
- The Effects of Profound Hypothermia on Pancreas Ischemic Injury A New Experimental Model(2014) ROCHA-SANTOS, Vinicius; FERRO, Oscar Cavalcante; PANTANALI, Carlos Andres; SEIXAS, Marcel Povlovistsch; PECORA, Rafael Antonio Arruda; PINHEIRO, Rafael Soares; CLARO, Laura Carolina Lopez; ABDO, Emilio Elias; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz Augusto CarneiroObjective: Pancreatic ischemia-reperfusion (IR) has a key role in pancreas surgery and transplantation. Most experimental models evaluate the normothermic phase of the IR. We proposed a hypothermic model of pancreas IR to evaluate the benefic effects of the cold ischemic phase. Methods: We performed a reproducible model of hypothermic pancreatic IR. The ischemia was induced in the pancreatic tail portion (1-hour ischemia, 4-hour reperfusion) in 36 Wistar rats. They are divided in 3 groups as follows: group 1 (control), sham; group 2, normothermic IR; and group 3, hypothermic IR. In group 3, the temperature was maintained as close to 4.5-C. After reperfusion, serum amylase and lipase levels, inflammatory mediators (tumor necrosis factor alpha, interleukin 6), and pancreas histology were evaluated. Results: In pancreatic IR groups, amylase, cytokines, and histological damage were significantly increased when compared with group 1. In the group 3, we observed a significant decrease in tumor necrosis factor alpha (P = 0.004) and interleukin 6 (P = 0.001) when compared with group 2. We did not observe significant difference in amylase (P = 0.867), lipase (P = 0.993), and histology (P = 0.201). Conclusions: In our experimental model, we reproduced the cold phase of pancreas IR, and the pancreas hypothermia reduced the inflammatory mediators after reperfusion.
conferenceObject Low Molecular Weight Heparin Fragment Decreases Intracellular Calcium in Human Hepatocarcinoma Cells Under Calcium Overload(2016) VASQUES, Enio R.; CUNHA, Jose Eduardo M.; COELHO, Ana Maria M.; SAMPIETRE, Sandra N.; ABDO, Emilio E.; NADER, Helena B.; TERSARIOL, Ivarne S.; LIMA, Marcelo A.; D'ALBUQUERQUE, Luiz Augusto C.; CHAIB, Eleazar; RODRIGUES, Tiago- Sevoflurane Preconditioning plus Postconditioning Decreases Inflammatory Response with Hemodynamic Recovery in Experimental Liver Ischemia Reperfusion(2019) FIGUEIRA, Estela Regina Ramos; ROCHA-FILHO, Joel Avancini; LANCHOTTE, Cinthia; COELHO, Ana Maria Mendonca; NAKATANI, Mauro; TATEBE, Eduardo Ryoiti; LIMA, Jonathan Augusto Venceslau; MENDES, Camilla Oliveira; ARAUJO, Bruno Camargo Rocha Paim de; ABDO, Emilio Elias; D'ALBUQUERQUE, Luiz Carneiro; GALVAO, Flavio Henrique FerreiraObjective. The inhalation anesthetic sevoflurane has presented numerous biological activities, including anti-inflammatory properties and protective effects against tissue ischemic injury. This study investigated the metabolic, hemodynamic, and inflammatory effects of sevoflurane pre- and postconditioning for short periods in the rescue of liver ischemia-reperfusion (IR) injury using a rat model. Materials and Methods. Twenty Wistar rats were divided into four groups: sham group, control ischemia group (partial warm liver ischemia for 45min followed by 4h of reperfusion), SPC group (administration of sevoflurane 2.5% for 15min with 5min of washout before liver IR), and SPPoC group (administration of sevoflurane 2.5% for 15min before ischemia and 20min during reperfusion). Results. All animals showed a decrease in the mean arterial pressure (MAP) and portal vein blood flow during ischemia. After 4h of reperfusion, only the SPPoC group had MAP recovery. In both the SPC and SPPoC groups, there was a decrease in the ALT level and an increase in the bicarbonate and potassium serum levels. Only the SPPoC group showed an increase in the arterial blood ionized calcium level and a decrease in the IL-6 level after liver reperfusion. Therefore, this study demonstrated that sevoflurane preconditioning reduces hepatocellular injury and acid-base imbalance in liver ischemia. Furthermore, sevoflurane postconditioning promoted systemic hemodynamic recovery with a decrease in inflammatory response.
- Prognostic significance of epidermal growth factor receptor overexpression in pancreas cancer and nodal metastasis(2015) PERINI, Marcos Vinicius; MONTAGNINI, Andre Luis; COUDRY, Renata; PATZINA, Rosely; PENTEADO, Sonia; ABDO, Emilio Elias; DINIZ, Alessandro; JUKEMURA, Jose; CUNHA, Jose Eduardo Monteiro daBackgroundIdentification of molecular markers in pancreatic adenocarcinoma (PA) has the potential to guide targeted therapy. The objective of this study is to determine the prognostic significance of epidermal growth factor receptor (EGFR) expression (membrane and cytoplasmic) in resected PA and its correlation with lymph node metastasis and survival. MethodsEGFR overexpression was determined by immunohistochemistry, and the pattern of expression was compared between the primary tumour, adjacent normal pancreas and involved lymph nodes. ResultsA total of 88 patients had curative resection. No difference was found in mEGFR overexpression between tumoural and metastatic nodal tissues (P = 0.28). Median overall survival time was 22.9 months. Overall cumulative 1-, 3- and 5-year survival was 48%, 20% and 18%, respectively. In positive mEGFR tumour expression, survival was 46% at 1 year, 8% at 3 years and 0% at 5 years (P < 0.05). Univariate analysis showed that male gender, portal vein (PV) resection, perineural, lymphovascular and peri-pancreatic invasion, positive margins and positive mEGFR expression in tumour tissue had worse survival. Multivariate analysis showed that male gender, PV resection, vascular and perineural invasion remained independent predictors of poor survival. ConclusionPositive mEGFR overexpression is associated with decreased survival; however, it is not an independent prognostic factor.
- Nitric oxide synthase inhibition reduces albumin induced lung damage in acute pancreatitis(2013) ABDO, Emilio Elias; COELHO, Ana Maria Mendonca; PATZINA, Rosely Antunes; SAMPIETRE, Sandra Nassa; CUNHA, Jose Eduardo Monteiro; MACHADO, Marcel Cerqueira Cesar; D'ALBUQUERQUE, Luiz Augusto CarneiroBackground/objectives: Colloid resuscitation in acute pancreatitis (AP) is a matter of controversy due to the possible deleterious effect on lung function. A previous study demonstrates that albumin administration increases lung damage in burns and this effect can be reversed by inducible nitric oxide synthase (iNOS) inhibition. This study evaluates the effects of S-methylisothiourea (SMT), a specific iNOS inhibitor, on lungs and pancreas of rats with AP receiving intravenous albumin. Methods: AP was induced in Wistar rats by intraductal 5% taurocholate injection. To evaluate the effect of albumin on lung damage, animals received IV saline or human albumin immediately after AP (Groups: Saline and Albumin). To evaluate the effect of iNOS inhibition on lung damage, SMT was given immediately after AP (Group Saline+SMT, and Group Albumin-FSMT). At 12 h after AP induction, serum amylase activity, lung vascular permeability and myeloperoxidase (MPO) activity were evaluated. Lung and pancreas histological analysis were performed. Results: Serum amylase activity, pancreatic edema, lung vascular permeability, MPO activity, and inflammatory infiltration were significantly increased after AP. Albumin administration increased lung vascular permeability, inflammatory infiltration, and pancreatic edema compared to saline administration (p < 0.05). Albumin administration with SMT reduced lung vascular permeability, MPO activity, and inflammatory infiltration compared to albumin administration alone (p < 0.05). Conclusion: Lung and pancreatic damage induced by albumin administration for restoration of plasma volume in AP are reduced by iNOS inhibition. Awareness of this fact may be useful in high-risk patients who need to receive albumin for volume replacement.
- PRELIMINARY RESULTS OF TOPICAL HEPATIC HYPOTHERMIA IN A MODEL OF LIVER ISCHEMIA/REPERFUSION INJURY IN RATS(2017) ABDO, Emilio Elias; FIGUEIRA, Estela Regina Ramos; ROCHA-FILHO, Joel Avancini; CHAIB, Eleazar; D’ALBUQUERQUE, Luiz Augusto Carneiro; BACCHELLA, TelesforoABSTRACT BACKGROUND Ischemia/reperfusion causes organ damage but it is mandatory in hepatic transplantation, trauma and other complex liver surgeries, when Pringle maneuver is applied to minimize bleeding during these procedures. It is well known that liver ischemia/reperfusion leads to microcirculatory disturbance and cellular injury. In this setting hypothermia is known to reduce oxygen demand, lowering intracellular metabolism. OBJECTIVE: To evaluate the effects of hypothermia in liver ischemia/reperfusion injury, using a new model of topic isolated liver hypothermia. METHODS We used male Wistar rats weighting about 250 grams, kept in ad libitum feeding regime and randomly divided into two groups of nine animals: 1) Normothermic group, rats were submitted to normothermic ischemia of the median and left hepatic lobes, with subsequent resection of right and caudate lobes during liver reperfusion; and 2) Hypothermic group, rats were submitted to liver ischemia under hypothermia at 10°C. Liver ischemia was performed for 45 minutes. The animals were euthanized 48 hours after liver reperfusion for blood and liver tissue sampling. RESULTS The transaminases analyses showed a significant decrease of AST and ALT in Hypothermic group (P<0.01) compared to Normothermic group (1403±1234 x 454±213 and 730±680 x 271±211 U/L, respectively). Histology showed severe necrosis in 50% and mild necrosis in 50% of cases in Normothermic group, but severe necrosis in 10% and mild or absent necrosis 90% of the cases in hypothermic group. CONCLUSION: A simplified model of liver ischemia/reperfusion that simulates orthotopic liver autotransplantion was demonstrated. Topical hypothermia of isolated hepatic lobules showed liver protection, being a viable and practical method for any kind of in vivo liver preservation study.