ANTONIO CARLOS SEGURO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina - Líder
5 resultados
Resultados de Busca
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bookPart Distúrbios do metabolismo de água e sódio(2016) MAGALDI, Antonio José Barros; SEGURO, Antonio Carlos- Beneficial effects of previous exercise training on renal changes in streptozotocin-induced diabetic female rats(2016) AMARAL, Liliany S. de Brito; SILVA, Fernanda A.; CORREIA, Vicente B.; ANDRADE, Clara E. F.; DUTRA, Barbara A.; OLIVEIRA, Marcio V.; MAGALHAES, Amelia C. M. de; VOLPINI, Rildo A.; SEGURO, Antonio C.; COIMBRA, Terezila M.; SOARES, Telma de J.This study evaluated the effects of aerobic exercise performed both previously and after the induction of diabetes mellitus on changes of renal function and structure in streptozotocin-induced diabetic rats. Female wistar rats were divided into five groups: sedentary control (C+Se); trained control (C+Ex); sedentary diabetic (D+Se); trained diabetic (D+Ex) and previously trained diabetic (D+PEx). The previous exercise consisted of treadmill running for four weeks before the induction of diabetes mellitus. After induction of diabetes mellitus with streptozotocin, the D+PEx, D+Ex and C+Ex groups were submitted to eight weeks of aerobic exercise. At the end of the training protocol, we evaluate the serum glucose, insulin and 17 beta-estradiol levels, renal function and structure, proteinuria, and fibronectin, collagen IV and transforming growth factor beta 1 (TGF-beta 1) renal expressions. Induction of diabetes mellitus reduced the insulin and did not alter 17 beta-estradiol levels, and exercise did not affect any of these parameters. Previous exercise training attenuated the loss of body weight, the blood glucose, the increase of glomerular filtration rate and prevented the proteinuria in the D+PEx group compared to D+Se group. Previous exercise also reduced glomerular hypertrophy, tubular and glomerular injury, as well as the expressions of fibronectin and collagen IV. These expressions were associated with reduced expression of TGF-beta 1. In conclusion, our study shows that regular aerobic exercise especially performed previously to induction of diabetes mellitus improved metabolic control and has renoprotective action on the diabetic kidney.
bookPart Leptospirose(2016) ANDRADE, Lúcia; SEGURO, Antonio Carlos- Hemodiafiltration Decreases Serum Levels of Inflammatory Mediators in Severe Leptospirosis: A Prospective Study(2016) CLETO, Sergio Aparecido; RODRIGUES, Camila Eleuterio; MALAQUE, Ceila Maria; SZTAJNBOK, Jaques; SEGURO, Antonio Carlos; ANDRADE, LuciaBackground Leptospirosis is a health problem worldwide. Its most severe form is a classic model of sepsis, provoking acute respiratory distress syndrome (ARDS) and acute kidney injury (AKI), with associated mortality that remains unacceptably high. We previously demonstrated that early initiation of sustained low-efficiency dialysis (SLED) followed by daily SLED significantly decreases mortality. However, the mode of clearance can also affect dialysis patient outcomes. Therefore, the objective of this study was to compare the effects of SLED with traditional (diffusive) clearance, via hemodialysis, and SLED with convective clearance, via hemodiafiltration (SLEDf), in patients with severe leptospirosis. Methods In this prospective study, conducted in the intensive care unit (ICU) from 2009 through 2012, we compared two groups-SLED (n = 19) and SLEDf (n = 20)-evaluating demographic, clinical, and biochemical parameters, as well as serum levels of interleukins, up to the third day after admission. All patients received dialysis early and daily thereafter. Results During the study period, 138 patients were admitted to our ICU with a diagnosis of leptospirosis; 39 (36 males/3 females) met the criteria for ARDS and AKI. All patients were on mechanical ventilation and were comparable in terms of respiratory parameters. Mortality did not differ between the SLEDf and SLED groups. However, post-admission decreases in the serum levels of interleukin (IL)-17, IL-7, and monocyte chemoattractant protein-1 were significantly greater in the SLEDf group. Direct bilirubin and the arterial oxygen tension/fraction of inspired oxygen ratio were significantly higher in the SLED group. We identified the following risk factors (sensitivities/specificities) for mortality in severe leptospirosis: age >= 55 years (67%/91%); serum urea >= 204 mg/dl (100%/70%); creatinine >= 5.2 mg/dl (100%/58%); Acute Physiology and Chronic Health Evaluation II score >= 39.5 (67%/88%); Sequential Organ Failure Assessment score >= 20.5 (67%/85%); and inspiratory pressure >= 31 mmHg (84%/85%). Conclusions The mode of dialysis clearance might not affect outcomes in severe leptospirosis.
- Allopurinol attenuates rhabdomyolysis-associated acute kidney injury: Renal and muscular protection(2016) GOIS, Pedro H. F.; CANALE, Daniele; VOLPINI, Rildo A.; FERREIRA, Daniela; VERAS, Mariana M.; ANDRADE-OLIVEIRA, Vinicius; CAMARA, Niels O. S.; SHIMIZU, Maria H. M.; SEGURO, Antonio C.Background: Acute kidney injury (AKI) is the most severe complication of rhabdomyolysis. Allopurinol (Allo), a xanthine oxidase inhibitor, has been in the spotlight in the last decade due to new therapeutic applications related to its potent antioxidant effect. The aim of this study was to evaluate the efficacy of Allo in the prevention and treatment of rhabdomyolysis-associated AKI. Methods: Male Wistar rats were divided into five groups: saline control group; prophylactic Allo (300 mg/L of drinking water, 7 days); glycerol (50%, 5 ml/kg, IM); prophylactic Allo + glycerol; and therapeutic Allo (50 mg/ Kg, IV, 30 min after glycerol injection) + glycerol. Results: Glycerol-injected rats showed markedly reduced glomerular filtration rate associated with renal vasoconstriction, renal tubular damage, increased oxidative stress, apoptosis and inflammation. Allo ameliorated all these alterations. We found 8-isoprostane-PGF(2a) (F2-IsoP) as a main factor involved in the oxidative stress-mediated renal vasoconstriction following rhabdomyolysis. Allo reduced F2-IsoP renal expression and restored renal blood flow. Allo also reduced oxidative stress in the damaged muscle, attenuated muscle lesion/inflammation and accelerated muscular recovery. Moreover, we showed new insights into the pathogenesis of rhabdomyolysis-associated AKI, whereas Allo treatment reduced renal inflammation by decreasing renal tissue uric acid levels and consequently inhibiting the inflammasome cascade. Conclusions: Allo treatment attenuates renal dysfunction in a model of rhabdomyolysis-associated AKI by reducing oxidative stress (systemic, renal and muscular), apoptosis and inflammation. This may represent a new therapeutic approach for rhabdomyolysis-associated AKI - a new use for an old and widely available medication.