ROGERIO PEZATO
Projetos de Pesquisa
Unidades Organizacionais
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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- Fire simulator exposure alters the innate epithelial response and inflammatory status in the airways of firefighters(2021) CORDEIRO, Telma Gomes; AMARAL, Jonatas Bussador do; PAVAO, Valdir; CARDOSO, Ricardo Galesso; VOEGELS, Richard Louis; PEZATO, Pedro Michaluat; PAIXAO, Vitoria; ALMEIDA, Ewin Barbosa de; BACHI, Andre Luis Lacerda; PEZATO, RogerioBackground: Firefighters are often exposed to high temperatures and by-products of combustion, which can compromise their health. We aimed to evaluate the effect of fire exposure in fire simulators on the airways of firefighters at different time-points. Methodology: Thirty-seven male firefighters exposed to fire simulators were evaluated in three phases: pre-exposure, at the end of the first week, and 4 weeks after. Pulmonary function by spirometry, nasal mucociliary clearance; peripheral oxygen saturation, inflammatory markers in the nasal lavage and CC16 in the sputum, nasal obstruction, and quality of life (using the questionnaires NOSE and SNOT-22) were assessed. Results: Higher levels of IL-8, IL-10, and exhaled carbon monoxide were found more in phase 2 than in phase 1. Higher CC16 levels and lower peripheral oxygen saturation were observed in phase 3 as compared to phase 1. Lower levels of IL-2 and peripheral oxygen saturation were found in phase 3 than in phase 2. Higher nasal mucociliary clearance, as well as the worst quality of life and nasal obstruction, were observed in phases 2 and 3 as compared to phase 1. Conclusions: The firefighters' exposures to high temperatures and by-products of combustion in the fire simulators elicit an inflammatory process in the airways with impairment in the innate epithelial response of the upper airway lining. Furthermore, changes in O2 transport affected the professionals' quality of life negatively.
- BMP-7, MMP-9, and TGF-beta tissue remodeling proteins and their correlations with interleukins 6 and 10 in chronic rhinosinusitis(2021) LUCAS, Bernardo Relvas; VOEGELS, Richard Luis; AMARAL, Jonatas Bussador do; BACHI, Andre Luis Lacerda; PEZATO, RogerioIntroduction Chronic rhinosinusitis without nasal polyposis (CRSsNP) and Chronic rhinosinusitis with nasal polyposis (CRSwNP) present distinct tissue remodeling processes. The proteins involved in the process of tissue remodeling have their production and activity related to the inflammatory environment they are. This study aimed to evaluate the protein expression of BMP-7, MMP-9, TGF-beta in chronic sinusitis with and without nasal polyposis and their relations with IL-6 and IL-10. Methods Cross-sectional observational study with 86 participants was divided into three groups: patients with CRSwNP (n = 34), patients with CRSsNP (n = 26), and a control group (CG) without inflammatory disease of the nasal mucosa (n = 26). The primary outcomes were the concentrations of BMP-7, MMP-9, TGF-beta, IL-6, and IL-10. Secondary outcomes were the correlations of these markers. Results The TGF-beta dosage was elevated in the CRSsNP group and reduced in the CSwNP group. The dosage of IL-6 was higher in the CSwNP group, and the IL-10 dosage lower in the groups with sinusitis, and IL-10 was positively correlated with BMP-7 in all groups. There was a negative correlation between IL-6 and IL-10 in all groups observed. The correlation between MMP-9 and interleukins was lost in the CRSsNP group. There was a positive correlation between TGF-beta and IL-6 in the CG, and negative in the CRSsNP group. Conclusion An inflammation shown in rhinosinusitis with an increase in IL-6 and decrease in IL-10 when compared with the control group; only TGF-beta was altered in the tissue remodeling process when compared with BMP-7 and MMP-9 in rhinosinusitis. There is a loss of correlation between tissue remodeling proteins and interleukins studied in CRSsNP.
- Prospective evaluation of clarithromycin in recurrent chronic rhinosinusitis with nasal polyps(2021) BEZERRA, Thiago Freire Pinto; PEZATO, Rogerio; BARROS, Pamella Marletti de; COUTINHO, Larissa Leal; COSTA, Leidianny Firmino; PINNA, Fabio; VOEGELS, RichardIntroduction: The antiinflammatory effects of macrolides, especially clarithromycin, have been described in patients with chronic rhinosinusitis without polyps and also other chronic inflammatory airway diseases. There is no consensus in the literature regarding the effectiveness of clarithromycin in patients with chronic rhinosinusitis with sinonasal polyposis and the national literature does not report any prospective studies on the efficacy of clarithromycin in chronic rhinosinusitis in our population. Objective: To evaluate the effect of clarithromycin in the adjunctive treatment of recurrent chronic rhinosinusitis with sinonasal polyposis refractory to clinical and surgical treatment. Methods: Open prospective study with 52 patients with chronic rhinosinusitis and recurrent sinonasal polyposis. All subjects received nasal lavage with 20 mL 0.9% SS and fluticasone nasal spray, 200 mcg / day, 12/12 h for 12 weeks; and clarithromycin 250 mg 8/8 h for 2 weeks and, thereafter, 12/12 h for 10 weeks. The patients were assessed by SNOT 20, NOSE and Lund-Kennedy scales before, immediately after treatment and 12 weeks after treatment. The patients were also evaluated before treatment with paranasal cavity computed tomography (Lund-Mackay) and serum IgG, IgM, IgA, IgE and eosinophil levels. The outcomes evaluated were: SNOT-20, NOSE and Lund-Kennedy. Results: Most patients were women, aged 47 (15) years (median / interquartile range), and 61.5% (32/52) had asthma. All patients completed the follow-up after 12 weeks and 42.3% (22/52) after 24 weeks. Treatment resulted in a quantitative decrease in the SNOT-20 [2.3 (1.6) vs. 1.4 (1.6); Delta = -0.9 (1.1); p < 0.01]; NOSE [65 (64) vs. 20 (63); Delta = -28 (38), p < 0.01] and Lund-Kennedy [11 (05) vs. 07 (05); Delta = -2 (05); p < 0.01] scores. SNOT-20 showed a qualitative improvement (>0.8) in 54% (28/52, p < 0.04) of patients, a group that showed lower IgE level [108 (147) vs. 289 (355), p < 0.01]. The group of patients who completed follow-up 12 weeks after the end of treatment (n = 22) showed no worsening of outcomes. Conclusion: Long-term adjuvant use of low-dose clarithromycin for chronic rhinosinusitis patients with recurrent sinonasal polyposis refractory to clinical and surgical treatment has resulted in improved quality of life and nasal endoscopy findings, especially in patients with normal IgE levels. This improvement persisted in the patient group evaluated 12 weeks after the end of the treatment. (C) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Impact of SARS-CoV-2 on saliva: TNF-alpha, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM(2022) SANTOS, Julia Gaspar de Oliveira; MIGUEIS, Debora Petrungaro; AMARAL, Jonatas Bussador do; BACHI, Andre Luis Lacerda; BOGGI, Alexandre Coelho; THAMBOO, Andrew; VOEGELS, Richard Louis; PEZATO, RogerioObjectives: Understanding the role of certain salivary components, such as TNF-alpha, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM, in airway defense during the ongoing SARS-CoV-2 pandemic is essential. The salivary immune barrier of patients with COVID-19 may play a role in their prognosis. The present study aims to evaluate the impact of SARS-CoV-2 on saliva composition. Methods: A longitudinal study was carried out with male and female firefighters aged 24-48 years. The study sample (n = 34) was divided into 3 groups: asymptomatic volunteers with a negative polymerase chain reaction (PCR) test for SARS-CoV-2 (group 1, Control, n = 21); patients with symptoms of COVID-19 of less than 7 days' duration and a diagnosis of SARS-CoV-2 infection by PCR (group 2, COVID-19, n = 13); and recovered patients from group 2 who were free of COVID-19 symptoms for at least 2 months (group 3, post-COVID-19 recovery, n = 13). All groups underwent real-time PCR to detect the presence of SARS-CoV-2, as well as analysis of the salivary concentrations of TNF-alpha, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM by the ELISA method. Results: Lactoferrin concentrations were significantly decreased in the infected group (COVID-19) when compared to those not infected by SARS-CoV-2 (control) (p = 0.032). IgA concentrations were decreased in the COVID-19 and post-COVID-19 groups compared to the control group (p = 0.005 and p = 0.016, respectively). Comparison of the COVID-19 and post-COVID-19 groups also revealed an increase in IgM concentrations during acute SARS-CoV-2 infection (p = 0.010). Conclusion: SARS-CoV-2 alters the composition of the salivary immune barrier.
- Upper Airway Mucociliary Clearance is Impaired in Dyspneic COVID-19 Patients(2023) PEZATO, Rogerio; DAVID, Andrea Goldwasser; BOGGI, Alexandre Coelho; MELO, Bruna; ROSALINO, Claudia Maria Valete; RODRIGUEZ, Athenea Pascual; THAMBOO, Andrew; VOEGELS, Richard LouisCovid-19 is transmitted mainly by respiratory droplets and as the upper airway mucosa is the first innate immune barrier, it is crucial to understand the effects of SARS-CoV-2 on this system. In the current study, we aimed to evaluate the nasal mucociliary clearance in patients with SARS-CoV-2 infection and their symptom development. Observational cross-sectional study. The nasal mucociliary clearance (NMC) time was evaluated by the saccharin test and the results were compared between patients with SARS-CoV-2 infection (group 1) and controls (group 2, asymptomatic patients with a negative polymerase chain reaction test). We also compared the NMC time for each specific symptom suffered by participants in group 1 with the NMC time of the control group as well as with the patients in group 1 who were asymptomatic. There was a significant increase in NMC time in group 1 with dyspnea when compared to the control group (p = 0.032) and also when compared to patients who were infected were not dyspneic (p = 0.04). There were no differences in the clearance times when considering other symptoms. COVID-19 patients with dyspnea present with altered nasal mucociliary clearance.
- Impact of Chronic Rhinosinusitis with Nasal Polyposis on IL-12 and IL-8(2023) AMARAL, J. B. do; DAVID, A. G.; MELLO, L.; BACHI, A. L. L.; VOEGELS, R. L.; THAMBOO, A.; PEZATO, R.Introduction: The pathophysiology of Chronic Rhinosinusitis is coordinated by distinct inflammatory reactions in different individuals. Inflammatory environments with a predominance of Th2 lymphocytes tend also to be rich in eosinophils. These environments are common during the formation of nasal polyps associated with aspirin intolerance, which is also marked by an increase in inflammatory mediators, especially IL-4, IL-5, and IL-13. Despite the significance of these inflammatory mediators, the relevance of IL-12 subunits' presence within eosinophilic nasal polyps, however, has been less studied. The current study aims to evaluate the presence of IL-12 subunits, IL-12p40 and IL-12p70, in eosinophilic nasal polyps and their correlations with IL-8 presence. Materials and Methods: We compared the concentrations of IL-8, IL12p40, and IL12p70 among samples of eosinophilic nasal polypoid tissue, eosinophilic nasal polypoid tissue associated with aspirin intolerance, and healthy nasal mucosa, using an indirect immunoassay (ELISA) kit. Results: When compared to healthy nasal mucosa, there was a lower concentration of IL-8 in Chronic Rhinosinusitis with Nasal Polyp (CRSwNP) tissue. Aspirin Intolerant polypoid tissue also presented a lower concentration of IL-12 subunits compared to healthy nasal mucosa. There was no significant correlation between IL-8 and IL-12 in the eosinophilic polypoid conditions. Conclusion: In CRSwNP, there is a reduction in IL-8 and IL-12 subunits compared to control, with a lack of correlation between IL-12 and IL-8. The lack of correlation can be justified by a type two inflammatory storm environment.
- New Nasopharyngeal Flap for Posterior Skull-Base Reconstruction: The Upper-Tongue Flap(2022) PEZATO, Rogerio; DASSI, Camila; STAMM, Aldo Cassol; VOEGELS, Richard LouisIntroduction Reconstructions of clival resection are still challenging, and additional reconstructive methods may be necessary to achieve full coverage of the skull-base defect in patients with middle- and lower-clivus disease. Objective To describe a new nasopharyngeal flap for the middle and lower clivus. Methods Using nasal endoscopy in a cadaver dissection, we demonstrated a new nasopharygeal flap to cover the lower and middle clival resection. Results We described a new nasopharyngeal flap capable of covering the lower and middle portion of the clivus. Discussion The new nasopharyngeal flap, called the upper-tongue flap, is particularly adequate as an alternative for the reconstruction of middle and lower clivus defects, and it is better used in association with a nasalseptal flap in cases in which the nasalseptal flap alone does not provide enough mucosal coverage. Conclusion The new nasopharyngeal flap can be used in the reconstruction of clival resection.
- Anatomical terminology of the internal nose and paranasal sinuses: cross-cultural adaptation to Portuguese(2018) BEZERRA, Thiago Freire Pinto; STAMM, Aldo; ANSELMO-LIMA, Wilma Teresinha; FORNAZIERI, Marco Aurelio; MELO, Nelson D'Avila; BALSALOBRE, Leonardo; JOTZ, Geraldo Pereira; LEAO, Henrique Zaquia; NUNES, Andre Alencar Araripe; FELIPPU, Alexandre; CEDIN, Antonio Carlos; PINHEIRO-NETO, Carlos D.; OLIVEIRA, Diego Lima; SAKANO, Eulalia; KOSUGI, Eduardo Macoto; ARAUJO, Elizabeth; VALERA, Fabiana Cardoso Pereira; PINNA, Fabio de Rezende; ROMANO, Fabrizio Ricci; PADUA, Francine Grecco de Melo; RAMOS, Henrique Faria; TELLES JR., Joao; SA, Leonardo Conrado Barbosa de; D'ASSUNCAO FILHO, Leopoldo Marques; SENNES, Luiz Ubirajara; GREGORIO, Luis Carlos; SAMPAIO, Marcelo H.; SANTOS, Marco Cesar Jorge dos; FRANCA, Marco; MOCELLIN, Marcos; LESSA, Marcus Miranda; AVELINO, Melissa Ameloti G.; TEPEDINO, Miguel; ANDRADE, Nilvano Alves de; PILTCHER, Otavio B.; ROITHMANN, Renato; PILAN, Renata Mendonca; MEIRELES, Roberto Campos; GUIMARAES, Roberto Eustaquio; SANTOS, Rodrigo de Paula; PEZATO, Rogerio; PIGNATARI, Shirley; ABDO, Tatiana Telles; NAKAJIMA, Victor; ALMEIDA, Washington; VOEGELS, Richard L.Introduction: Functional endonasal endoscopic surgery is a frequent surgical procedure among otorhinolaryngologists. In 2014, the European Society of Rhinology published the ""European Position Paper on the Anatomical Terminology of the Internal Nose and Paranasal Sinuses"", aiming to unify the terms in the English language. We do not yet have a unified terminology in the Portuguese language. Objective: Transcultural adaptation of the anatomical terms of the nose and paranasal cavities of the ""European Anatomical Terminology of the Internal Nose and Paranasal Sinuses"" to Portuguese. Methods: A group of rhinologists from diverse parts of Brazil, all experienced in endoscopic endonasal surgery, was invited to participate in the creation of this position paper on the anatomical terms of the nose and paranasal sinuses in the Portuguese language according to the methodology adapted from that previously described by Rudmik and Smith. Results: The results of this document were generated based on the agreement of the majority of the participants according to the most popular suggestions among the rhinologists. A cross-cultural adaptation of the sinonasal anatomical terminology was consolidated. We suggest the terms ""inferior turbinate"", ""nasal septum"", ""(bone/cartilaginous) part of the nasal septum"", ""(middle/inferior) nasal meatus"", ""frontal sinus drainage pathway"", ""frontal recess"" and ""uncinate process"" be standardized. Conclusion: We have consolidated a Portuguese version of the European Anatomical Terminology of the Internal Nose and Paranasal Sinuses, which will help in the publication of technical announcements, scientific publications and the teaching of the internal anatomical terms of the nose and paranasal sinuses in Brazil. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.
- Differential Angiogenic Induction Impacts Nasal Polyp Tissue Growth(2023) GOES, Hallyson Andre Nascimento de; SARAFAN, Masih; AMARAL, Jonatas Bussador do; ALMEIDA, Joyce dos Anjos; VOEGELS, Richard Louis; CRUZ, Leandro Ticlia de la; THAMBOO, Andrew; GOMES, Ligia Ferreira; PEZATO, RogerioIn chronic rhinosinusitis with nasal polyps, inflammatory edema drives tissue remodeling favoring anomalous growth of the nasal mucosa, but a proangiogenic contribution of nasal polyp in support of tissue growth is still controversial. The chorioallantoic membrane of chicken embryo model was employed to address the potentiality of nasal tissue fragments to modulate angiogenesis. Fifty-seven fertilized eggs were implanted with polyp or healthy nasal mucosa tissue or were kept as non-implanted controls. The embryos' size, length, and development stage, and chorioallantoic membrane vasculature morphology were evaluated after 48 h. Quantitative computer vision techniques applied to digital chorioallantoic membrane images automatically calculated the branching index as the ratio between the areas of the convex polygon surrounding the vascular tree and the vessels' area. Ethics approval and consent to participate: the study was approved by the Human Research Ethics Committee of the Federal University of Sao Paulo (CAAE number: 80763117.1.0000.5505) and by the Animal Research Ethics Committee of University of Sao Paulo (no CEUA 602-2019). Mucosal, but not polyp tissue implants, hampered embryo development and induced underdeveloped chorioallantoic membranes with anastomosed, interrupted, and regressive vessels. Vessels' areas and branching indexes were higher among the chorioallantoic membranes with polyp implants and controls than among those with healthy mucosa implants. Nasal polyp presents differential angiogenic induction that impacts tissue growth.
- Three-dimensional cell culture for the study of nasal polyps(2022) FRANCA, Carolina Nunes; BACHI, Andre Luis Lacerda; KOSUGI, Eduardo Macoto; PEZATO, Rogerio; SANTELLI, Glaucia Maria Machado; AMARAL, Jonatas Bussador doObjectives: Three-dimensional (3D) cell cultures have many applications such as stem cell biology research, new drug discovery, cancer, and Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). This disease is characterized by a significant impact on quality of life and productivity. The diversity of factors that act in the progression of CRSwNP point to the creation of a cell culture model that allows the integration of different cell types with extracellular matrix. This work aimed to create a cell culture model in 3 dimensions (spheroids) for the study of Nasal Polyposis. Methods: Nasal polyp tissue from patients diagnosed with CRSwNP was mechanically dissociated using tweezers and a scalpel and the solution containing cells and small aggregates of nasal polyps was transferred to a Petri dish containing 5 mL of culture medium at the concentration of 10(6) cells/mL. Results: The spheroids were cultivated for 20 days, fixed and analyzed using confocal microscopy. In a 3D culture environment, the spheroids were formed both by clustering cells and from small tissue fragments. In the cultures analyzed, the ciliary beat was present from the dissociation of the cells up to 20 days in culture. Conclusion: Our findings also point to these characteristics showing the environment generated in our study, the cells remained differentiated for a longer time and with ciliary beating. Thus, this work shows that nasal polyp-derived cells can be maintained in a 3D environment, enabling better strategies for understanding CRSwNP in situations similar to those found in vivo. (c) 2021 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.