CAMILLE PINTO FIGUEIREDO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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- HR-pQCTin vivoimaging of periarticular bone changes in chronic inflammatory diseases: Data from acquisition to impact on treatment indications(2021) FIGUEIREDO, Camille P.; PEREZ, Mariana O.; SALES, Lucas Peixoto; SCHETT, Georg; PEREIRA, Rosa M. R.Imaging is essential for the assessment of bone and inflammatory joint diseases. There are several imaging techniques available that differ regarding resolution, radiation exposure, time expending, precision, cost, availability or ability to predict disease progression. High-resolution peripheral quantitative computed tomography (HR-pQCT) that was introduced in 2004 allows thein vivoevaluation of peripheral bone microarchitecture and demonstrated high precision in assessing bone changes in inflammatory musculoskeletal diseases. This review summarizes the use of HR-pQCT for the evaluation of the hand skeleton in inflammatory joint diseases. We conducted a review of the literature regarding the protocols that involve hand joints assessment and evaluation of bone changes as erosions and osteophytes in chronic inflammatory diseases. Apart from measuring bone density and structure of the radius and the tibia, HR-pQCT has contributed to assessment of bone erosions and osteophytes, considered the hallmark of diseases as rheumatoid arthritis and psoriatic arthritis, respectively. In this way, there are some conventions recently established by rheumatic study groups that we just summarized here in order to standardize HR-pQCT measurements.
- Bone erosions associated with systemic bone loss on HR-pQCT in women with longstanding polyarticular juvenile idiopathic arthritis(2023) RIBEIRO, Surian Clarisse C. R.; SALES, Lucas P.; FERNANDES, Alan L.; PEREZ, Mariana O.; TAKAYAMA, Liliam; CAPARBO, Valeria F.; ASSAD, Ana Paula L.; AIWAKA, Nadia E.; GOLDENSTEIN-SCHAINBERG, Claudia; BORBA, Eduardo F.; DOMICIANO, Diogo S.; FIGUEIREDO, Camille P.; PEREIRA, Rosa M. R.Objectives: To analyze longstanding polyarticular juvenile idiopathic arthritis (pJIA) for possible associations between localized bone damage (erosions), and systemic bone loss. Besides, to compare the systemic bone mass of pJIA with healthy controls. Methods: Thirty-four pJIA women and 99 healthy controls (HC) were included. Radius and tibia of all subjects were scanned by HR-pQCT. Volumetric bone mineral density (vBMD), bone microarchitecture, and -finite element parameters were analyzed. Patients underwent HR-pQCT of 2nd and 3rd metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the dominant hand, for bone erosions quantification. Results: The mean age of patients was 31.5 +/- 7.4yrs with a mean disease duration of 21.7 +/- 9.2yrs. Bone erosions were detectable in 79% of patients. The number of bone erosions was positively correlated with cortical porosity (Ct.Po) at tibia (r = 0.575, p = 0.001), and radius (r = 0.423, p = 0.018); and negatively correlated with cortical vBMD at tibia (r=-0.420, p = 0.015). In a logistic regression analysis, adjusted for anti-CCP, the presence of bone erosions was independently associated with Ct.Po at radius (p = 0.018) and cortical vBMD at tibia (p = 0.020). Moreover, cortical and trabecular vBMD, trabecular number, and mu-finite element parameters were decreased in patients compared to HC (p < 0.05). Conclusion: Bone erosions in longstanding pJIA women were associated with decreased cortical bone parameters, and these patients showed systemic bone impairment at peripheral sites compared with healthy controls.
conferenceObject Bone Erosions and Osteophytes in Premenopausal Women with Long-standing Rheumatoid Arthritis: Association with Systemic Bone Involvement Using HR-pQCT(2021) PEREZ, Mariana; FIGUEIREDO, Camille; SALES, Lucas; MEDEIROS-RIBEIRO, Ana; TAKAYAMA, Liliam; DOMICIANO, Diogo; BONFIGLIOLI, Karina; CAPARBO, Valeria; PEREIRA, Rosa- Lower hand grip in rheumatoid arthritis patients is associated with low finite element analysis using high resolution peripheral quantitative computed tomography scan of the 2nd metacarpophalangeal joint(2022) FIGUEIREDO, Camille Pinto; PEREZ, Mariana Ortega; SALES, Lucas Peixoto; DOMICIANO, Diogo Souza; SAMPAIO-BARROS, Marilia M.; CAPARBO, Valeria de Falco; PEREIRA, Rosa Maria RodriguesAim To evaluate hand function by hand grip test in rheumatoid arthritis (RA) patients, and its association with bone erosions and the estimated bone strength (finite element - FE analysis) through the analysis of the 2nd metacarpal head of the dominant hand using high resolution peripheral quantitative computed tomography (HR-pQCT). Method Eighty-two female RA patients between 18-50 years old were selected. Demographic data, Health Questionnaire Assessment Disability Index (HAQ), Disease Activity Score of 28 joints (DAS)-28, simplified disease activity index (SDAI) and the hand grip test were set. The HR-pQCT scans of 2nd metacarpophalangeal joints of the dominant hand of all patients were performed according to SPECTRA group protocols. The images were used to assess bone erosions and FE analysis. The hand grip test was categorized in 2 groups and separately compared (< 18 vs >= 18 kgf). A logistic regression was performed using hand grip test A significant difference was found between the 2 groups regarding HAQ, inflammatory markers (erythrocyte sedimentation rate, C-reactive protein), DAS-28, SDAI, total volume of erosion and bone strength parameter (FE analysis - Failure Load [F.Load]). The logistic regression analysis showed that the risk factors associated with hand grip test <18 kgf were higher SDAI (odds ratio [OR] 0.912; 95% CI 0.837-0.993) and lower values of bone strength parameter (F.Load) (OR 1.007; 95% CI 1.002-1.012). Conclusion Lower values of hand grip test were associated with higher disease activity score-SDAI and lower bone strength of 2nd metacarpal bone head of the dominant hand evaluated here through a FE analysis using HR-pQCT scan.
- Transcriptomic characterization of classical monocytes highlights the involvement of immuno-inflammation in bone erosion in Rheumatoid Arthritis(2023) SALES, Lucas Peixoto; HOUNKPE, Bidossessi Wilfried; PEREZ, Mariana Ortega; CAPARBO, Valeria Falco; DOMICIANO, Diogo Souza; BORBA, Eduardo Ferreira; SCHETT, Georg; FIGUEIREDO, Camille Pinto; PEREIRA, Rosa Maria RodriguesIntroduction: Evidence-based data suggest that under inflammatory conditions, classical monocytes are the main source of osteoclasts and might be involved in bone erosion pathophysiology. Here, we analyze the transcriptomic profile of classical monocytes in erosive and non-erosive rheumatoid arthritis patients in order to better understand their contribution to bone erosion.Methods: Thirty-nine premenopausal RA patients were consecutively enrolled and divided into two groups based on the presence of bone erosions on hand joints. Classical monocytes were isolated from peripheral blood through negative selection, and RNA-seq was performed using a poly-A enrichment kit and Illumina (R) platform. Classical monocytes transcriptome from healthy age-matched women were also included to identify differentially expressed genes (DEGs). Therefore, gene sets analysis was performed to identify the enriched biological pathways.Results: RNA-seq analysis resulted in the identification of 1,140 DEGs of which 89 were up-regulated and 1,051 down-regulated in RA patients with bone erosion compared to those without bone erosions. Among up-regulated genes, there was a highlighted expression of IL18RAP and KLF14 related to the production of pro-inflammatory cytokines, innate and adaptive immune response. Genes related to collagen metabolism (LARP6) and bone formation process (PAPPA) were down-regulated in RA patients with erosions. Enriched pathways in patients with erosions were associated with greater activation of immune activation, and inflammation. Interestingly, pathways associated with osteoblast differentiation and regulation of Wnt signaling were less activated in RA patients with erosions.Conclusion: These findings suggest that alterations in expression of monocyte genes related to the inflammatory process and impairment of bone formation might have an important role in the pathophysiology of bone erosions in RA patients.
- RNA-SEQUENCING OF CLASSICAL MONOCYTES FROM RHEUMATOID ARTHRITIS PATIENTS WITH AND WITHOUT BONE EROSION(2023) SALES, L. Peixoto; HOUNKPE, B.; PEREZ, M.; CAPARBO, V.; DOMICIANO, D. S.; BORBA, E.; FIGUEIREDO, C.; PEREIRA, R. M.
- Association of Bone Erosions and Osteophytes With Systemic Bone Involvement on High-Resolution Peripheral Quantitative Computed Tomography in Premenopausal Women With Longstanding Rheumatoid Arthritis(2022) PEREZ, Mariana O.; FIGUEIREDO, Camille P.; SALES, Lucas P.; MEDEIROS-RIBEIRO, Ana Cristina; TAKAYAMA, Liliam; DOMICIANO, Diogo S.; BONFIGLIOLI, Karina; CAPARBO, Valeria F.; PEREIRA, Rosa M. R.Objective To evaluate premenopausal women with longstanding rheumatoid arthritis (RA) for potential associations between parameters of localized bone involvement and parameters of systemic bone involvement in the affected joints. Methods Eighty consecutively evaluated premenopausal women with RA were included in the study, along with 160 healthy female control subjects who were matched to the patients by age and body mass index. Volumetric bone mineral density (vBMD), bone microarchitecture, and finite elements of biomechanical bone strength (bone stiffness and estimated failure load) at the distal radius and distal tibia were analyzed by high-resolution peripheral quantitative computed tomography (HR-pQCT) in patients with RA compared to healthy controls. In addition, in patients with RA, localized bone involvement in the metacarpophalangeal and proximal interphalangeal joints was analyzed by HR-pQCT, to identify bone erosions and osteophytes. Results Among the 80 premenopausal women with longstanding RA, the mean +/- SD age was 39.4 +/- 6.7 years and mean +/- SD disease duration was 9.8 +/- 5.3 years. Trabecular and cortical bone parameters and bone strength at the distal radius and distal tibia were all impaired in patients with RA compared to healthy controls (each P < 0.05). In total, 75% of RA patients had evidence of bone erosions, and 41.3% of RA patients had detectable osteophytes on HR-pQCT. RA patients with bone erosions, as compared to RA patients without bone erosions, had lower cortical vBMD (at the distal radius, mean +/- SD 980 +/- 72 mg HA/cm(3) versus 1,021 +/- 47 mg HA/cm(3) [P = 0.03]; at the distal tibia, 979 +/- 47 mg HA/cm(3) versus 1,003 +/- 34 mg HA/cm(3) [P = 0.04]) and higher cortical bone porosity (at the distal radius, mean +/- SD 2.8 +/- 2.5% versus 1.8 +/- 1.6% [P = 0.04]; at the distal tibia, 3.7 +/- 1.6% versus 2.7 +/- 1.6% [P = 0.01]). In patients with RA, osteophyte volume at the distal radius was positively correlated with trabecular vBMD (r = 0.392, P = 0.02), trabecular number (r = 0.381, P = 0.03), and trabecular stiffness (r = 0.411, P = 0.02), and negatively correlated with trabecular separation (r = -0.364, P = 0.04), as determined by Pearson's or Spearman's correlation test. Conclusion The findings show that premenopausal women with longstanding RA have systemic bone fragility at peripheral joint sites. Moreover, the presence of bone erosions is mainly associated with cortical bone fragility at the distal radius and tibia, and presence of osteophytes is associated with repair of trabecular bone at the distal radius.
conferenceObject Cortical Bone Erosion in the 2nd Metacarpal Bone Head: Association with Its Bone Mineral Density by HR-pQCT in Rheumatoid Arthritis Patients(2019) FIGUEIREDO, Camille; PEREZ, Mariana; RIBEIRO, Ana Cristina de Medeiros; CAPARBO, Valeria; PEREIRA, Rosa- Bone erosion in the 2nd metacarpophalangeal head: association with its bone mineral density by HR-pQCT in rheumatoid arthritis patients(2021) FIGUEIREDO, Camille P.; PEREZ, Mariana O.; SALES, Lucas Peixoto; MEDEIROS, Ana Cristina; CAPARBO, Valeria F.; PEREIRA, Rosa M. R.BackgroundRheumatoid arthritis (RA) is a chronic autoimmune disease depicted by synovial inflammation leading to local and systemic bone loss. The aim of this study was to evaluate by a HR-pQCT (High Resolution Peripheral Quantitative Computed Tomography) study which parameters are associated with volume of bone erosions including bone mineral density (BMD) around erosions (VOI 1 to 4=volume of interest), BMD of metacarpophalangeal (MCP) head, BMD of radius, presence of osteophytes and joint space width (JSW).MethodsFifty female RA patients (18-50years) were enrolled in this study. Demographic and disease-specific data, laboratory inflammatory parameters and handgrip test were performed. All patients underwent HR-pQCT of 2nd and 3rd MCP joints and distal radius, according to established protocols. The volume of bone erosions was evaluated by MIAF (Medical Image Analysis Framework) software. Osteophytes were analyzed by manual method.ResultsThe mean of age and disease duration were 40.06.0yrs. and 10.8 +/- 4.8yrs., respectively. According to DAS-28 (Disease Activity Score), 54% (27) of the sample were in remission. However, when SDAI (Simplified Disease Activity Index) was used, only 18% (9) were under remission. The mean of HAQ (Health Assessment Questionnaire), ESR (Erythrocyte sedimentation rate) and CRP (C reactive protein) were 0.9 +/- 0.7, 13.9 +/- 12.2mm and 5.6 +/- 7.5mg/mL, respectively. Forty-six bone erosions (0.9 +/- 1.2 erosion/patient) and 14 osteophytes (0.3 +/- 0.7 osteophyte/patient) were found in 2nd MCP head. The median (IQR-Interquartile range) of volume of erosion and volume of osteophytes were 14.9 (5.7;35.9)mm(3) and 3.1 (2.1, 4.3)mm(3), respectively. The mean of JSW was 80.5 +/- 34.2mm(3). The volume of bone erosions was negatively correlated with BMD of 2nd MCP head, VOI-4 and JSW; and it was positively correlated with osteophytes number. Regarding absence or presence of erosion in 2nd MCP head, a significant difference was found between BMD of MCP head, osteophyte number and JSW. Multiple linear regression analysis showed that only BMD of 2nd MCP head was independently associated with volume of bone erosions.ConclusionBMD of MCP head was independently associated with volume of bone erosion, suggesting that this parameter should be used to analyze and monitoring bone destruction, as well as to evaluate treatment response in RA patients.
- Evaluation of bone erosion in rheumatoid arthritis patients by high-resolution peripheral quantitative computed tomography scans: Comparison between two semi-automated programs in a three-dimensional setting(2021) FIGUEIREDO, Camille Pinto; PEREZ, Mariana Ortega; SALES, Lucas Peixoto; CAPARBO, Valeria de Falco; PEREIRA, Rosa Maria RodriguesAim The aim of this study was to compare OsiriX software with the previous published Medical Image Analysis Framework (MIAF) method to assess the volume of erosion in patients with rheumatoid arthritis (RA). Methods Forty RA patients underwent high-resolution peripheral quantitative computed tomography scans of the second and third metacarpophalangeal joints, and thirty-four patients with any bone erosion were enrolled. Two techniques were applied to erosion evaluation: (a) semi-automated MIAF software, and (b) semi-automated segmentation by free open-source Digital Imaging and Communications in Medicine viewer, OsiriX software. MIAF has been published before, but this is the first time that OsiriX has been used in this way in rheumatology. Bland & Altman plots described agreement between methods. Results Forty-eight erosions from 34 patients were analyzed. Mean age was 40.74 +/- 5.32 years and mean disease duration was 10.68 +/- 4.96 years. Both methods demonstrated a strong correlation regarding erosion volume (r = 0.96, P < 0.001). Median (interquartile range) of erosion volume was 12.14 (4.5-36.07) when MIAF was considered, and 11.80 (3.45-29.42) when the OsiriX tool was used (P = 0.139). MIAF and OsiriX showed good agreement when the Bland & Altman plot was performed. Evaluation by MIAF took 22.69 +/- 6.71 minutes, whereas OsiriX took only 2.62 +/- 1.09 minutes (P < 0.001). Conclusion The three-dimensional segmentation of bone erosions can be done by both MIAF and OsiriX software with good agreement. However, because OsiriX is a widespread tool and faster, its method seems to be more feasible for evaluating peripheral bone damage, especially bone erosions.