ALBERTO QUEIROZ FARIAS
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Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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- GUT MICROBIOTA, PREBIOTICS, PROBIOTICS, AND SYNBIOTICS IN GASTROINTESTINAL AND LIVER DISEASES: PROCEEDINGS OF A JOINT MEETING OF THE BRAZILIAN SOCIETY OF HEPATOLOGY (SBH), BRAZILIAN NUCLEUS FOR THE STUDY OF HELICOBACTER PYLORI AND MICROBIOTA (NBEHPM), AND BRAZILIAN FEDERATION OF GASTROENTEROLOGY (FBG)(2020) BARBUTI, Ricardo Correa; SCHIAVON, Leonardo Lucca; OLIVEIRA, Cláudia P; ALVARES-DA-SILVA, Mário Reis; SASSAKI, Lígia Yukie; PASSOS, Maria do Carmo F; FARIAS, Alberto Queiroz; BARROS, Luisa Leite; BARRETO, Bruno Paes; ALBUQUERQUE, Gisela Bandeira de Melo Lins de; ALVES, Amanda Mandarino; NAVARRO-RODRIGUEZ, Tomás; BITTENCOURT, Paulo LisboaABSTRACT Over the last years, there is growing evidence that microorganisms are involved in the maintenance of our health and are related to various diseases, both intestinal and extraintestinal. Changes in the gut microbiota appears to be a key element in the pathogenesis of hepatic and gastrointestinal disorders, including non-alcoholic fatty liver disease, alcoholic liver disease, liver cirrhosis, inflammatory bowel disease, irritable bowel syndrome, and Clostridium difficile - associated diarrhea. In 2019, the Brazilian Society of Hepatology (SBH) in cooperation with the Brazilian Nucleus for the Study of Helicobacter Pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG) sponsored a joint meeting on gut microbiota and the use of prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases. This paper summarizes the proceedings of the aforementioned meeting. It is intended to provide practical information about this topic, addressing the latest discoveries and indicating areas for future studies.
- Evolution of Biomarkers of Atherogenic Risk in Liver Transplantation Recipients(2018) LINHARES, L. M. C.; OLIVEIRA, C. P.; ALVARES-DA-SILVA, M. R.; STEFANO, J. T.; BARBEIRO, H. V.; BARBEIRO, D. F.; TERRABUIO, D. R. B.; ABDALA, E.; SORIANO, F. G.; CARRILHO, F. J.; FARIAS, A. Q.; SIDDIQUI, M. S.; D'ALBUQUERQUE, L. A. C.Background. Cardiovascular disease is a major contributing factor to long-term mortality after liver transplantation (LT). Methods. This study evaluated the evolution of atherogenic risk in liver transplant recipients (LTRs). Thirty-six subjects were prospectively enrolled at 12 months and followed for 48 months after liver transplantation. Serum biomarkers of endothelial dysfunction (sICAM-1 and sVCAM-1), chronic inflammation (serum amyloid A), and oxidative stress (myeloperoxidase) were measured at 12 and 48 months after LT. Additionally, at 12 months all patients underwent a cardiac computed tomography (CT) scan and a coronary artery calcium score (CACS). Results. The prevalence of risk factors of metabolic syndrome (MS) increased over the course of the study. The patients' sVCAM-1 and sICAM-1 increased from 1.82 +/- 0.44 ng/mL to 9.10 +/- 5.82 ng/mL (P < .001) and 0.23 +/- 0.09 ng/mL to 2.7 +/- 3.3 ng/mL, respectively from month 12 to 48. Serum myeloperoxidase increased from 0.09 +/- 0.07 ng/mL to 3.46 +/- 3.92 ng/mL (P < .001) over the course of the study. Serum amyloid A also increased from 21.4 +/- 40.7 ng/mL at entry to 91.5 +/- 143.6 ng/mL at end of study (P < .001). Conclusion. No association between these biomarkers and MS was noted. The cardiac CT revealed mild and moderate disease in 19% and 25% of the cohort, respectively. No association between serum biomarkers and CACS was noted. Serum biomarkers of atherogenic risk increase rapidly in LTRs and precede coronary plaques.
- Pro-atherosclerotic markers and cardiovascular risk factors one year after liver transplantation(2014) ALVARES-DA-SILVA, Mario Reis; OLIVEIRA, Claudia Pinto Marques Souza de; STEFANO, Jose Tadeu; BARBEIRO, Hermes V.; BARBEIRO, Denise; SORIANO, Francisco G.; FARIAS, Alberto Queiroz; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz Augusto CarneiroAIM: To investigate pro-atherosclerotic markers (endothelial dysfunction and inflammation) in patients one year after liver transplantation. METHODS: Forty-four consecutive liver transplant (LT) outpatients who were admitted between August 2009 and July 2010, were followed-up by for 1 year, exhibited no evidences of infection or rejection, all of them underwent tacrolimus-based immunosuppressive regimens were consecutively enrolled. Inflammatory cytokines (TNF alpha, IFN gamma, IL-8, and IL-10), endothelial biomarkers (sVCAM-1, sICAM-1, MPO, adiponectin, PAI-1, SAP, SAA, E-selectin, and MMP-9), high sensitive C-reactive protein, and Framingham risk score (FRS) were assessed. The anthropometric data, aminotransferases, metabolic syndrome features, glucose and lipid profiles, and insulin resistance data were also collected. The LT recipients were compared to 22 biopsy-proven non-alcoholic steatohepatitis (NASH) patients and 20 healthy controls (non-obese, non-diabetics, and non-dyslipidemic). RESULTS: The LT recipients had significantly younger ages and lower body mass indices, aminotransferases, fasting glucose and insulin levels, glucose homeostasis model and metabolic syndrome features than the NASH patients. Classic cardiovascular risk markers, such as Hs-CRP and FRS [2.0 (1.0-8.75)], were lower in the LT patients compared to those observed in the NASH patients (P = 0.009). In contrast, the LT recipients and NASH patients had similar inflammatory and endothelial serum markers compared to the controls (pg/mL): lower IL-10 levels (32.3 and 32.3 vs 62.5, respectively, P = 0.019) and higher IFN gamma (626.1 and 411.9 vs 67.9, respectively, P < 0.001), E-selectin (48.5 and 90.03 vs 35.7, respectively, P < 0.001), sVCAM-1 (1820.6 and 1692.4 vs 1167.2, respectively, P < 0.001), and sICAM-1 (230.3 and 259.7 vs 152.9, respectively, P = 0.015) levels. CONCLUSION: Non-obese LT recipients have similar pro-atherosclerotic serum profiles after a short 1-year follow-up period compared to NASH patients, suggesting a high risk of atherosclerosis in this population.
- Hepatitis E virus infection increases the risk of diabetes and severity of liver disease in patients with chronic hepatitis C virus infection(2021) ZITELLI, Patricia Momoyo Yoshimura; GOMES-GOUVEA, Michele; MAZO, Daniel F.; SINGER, Julio da Motta; OLIVEIRA, Claudia P. M. S.; FARIAS, Alberto Queiroz; PINHO, Joao Renato; TANIGAWA, Ryan Yukimatsu; ALVES, Venancio Avancini Ferreira; CARRILHO, Flair Jose; PESSOA, Mario GuimaraesOBJECTIVES: Co-infection with hepatitis A or B viruses may aggravate liver injury in patients infected with hepatitis C virus (HCV). However, few studies have assessed co-infection with hepatitis E virus (HEV) and HCV. Therefore, this study aimed to assess the prevalence and impact of HEV infection among Brazilian patients with chronic HCV infection. METHODS: This observational study included adult patients with chronic HCV infection who were naive to antiviral therapy from January 2013 to March 2016. A total of 181 patients were enrolled, and HEV serology and PCR were performed for all patients. RESULTS: Seropositivity for anti-HEV IgG was detected in 22 (12.0%) patients and anti-HEV immunoglobulin M in 3 (1.6%). HEV RNA showed inconclusive results in nine (4.9%) patients and was undetectable in the remaining patients. HEV serology positive patients had more severe liver disease, characterized by liver fibrosis >= 3 versus <= 2 (p<0.001), Aspartate Aminotransferase-to-Platelet Ratio Index of >= 1.45 (p=0.003), and Fibrosis-4 score of >= 3.25 (p=0.001). Additionally, the odds of HEV-positive patients developing diabetes mellitus were 3.65 (95% CI 1.40-9.52) times the corresponding odds of HEV-negative patients. A case-control-based histological analysis (n=11 HEV-HCV-positive patients and n=22 HCV-positive patients) showed no significant differences between the groups. CONCLUSIONS: This prevalence is higher than that reported in previous studies of the general population in Brazil. Thus, HEV infection may influence the severity of liver disease and may represent an additional risk of developing diabetes mellitus in patients with HCV infection.
conferenceObject BRAZILIAN PATIENTS WITH CIRRHOSIS HAVE LOWER HOSPITALIZATIONS AND HIGHER MICROBIAL DIVERSITY RELATED TO HEALTHIER DIET COMPARED TO AMERICAN PATIENTS(2021) ALVARES-DA-SILVA, Mario R.; OLIVEIRA, Claudia P.; FAGAN, Andrew; LONGO, Larisse; THOEN, Rutiane U.; YOSHIMURA, Patricia M.; FERREIRA, Zitelli Renee M. Tanaka; MCGEORGE, Sara; FARIAS, Alberto Q.; SIKAROODI, Masoumeh; GILLEVET, Patrick M.; BAJAJ, Jasmohan S.conferenceObject Cardiovascular risk and coronary artery calcium score after liver transplantation: study at fouth year(2017) LINHARES, L. M.; OLIVEIRA, C. P.; ALVARES-DA-SILVA, M. R.; STEFANO, J. T.; GEBRIM, E. M.; BARBEIRO, H. V.; BARBEIRO, D. F.; TERRABUIO, D. R.; ABDALA, E.; SORIANO, F. G.; CARRILHO, F. J.; FARIAS, A. Q.; AUGUSTO, L.; ALBUQUERQUE, C. D'- Interaction of Microbiome, Diet, and Hospitalizations Between Brazilian and American Patients With Cirrhosis(2022) ALVARES-DA-SILVA, Mario R.; OLIVEIRA, Claudia P.; FAGAN, Andrew; LONGO, Larisse; THOEN, Rutiane U.; ZITELLI, Patricia M. Yoshimura; FERREIRA, Renee M. Tanaka; MCGEORGE, Sara; SHAMSADDINI, Amirhossein; FARIAS, Alberto Q.; SIKAROODI, Masoumeh; GILLEVET, Patrick M.; BAJAJ, Jasmohan S.BACKGROUND & AIMS: Gut microbiota are affected by diet, country, and affect outcomes in cirrhosis. Western diets are associated with dysbiosis. Comparisons with other diets is needed. We aimed to compare cirrhosis patients from the United States with cirrhosis patients from Brazil with respect to diet, microbiota, and impact on hospitalizations. METHODS: Healthy controls and compensated/decompensated outpatients with cirrhosis from the United States and Brazil underwent dietary recall and stool for 16S ribosomal RNA sequencing. Demographics and medications/cirrhosis details were compared within and between countries. Patients with cirrhosis were followed up for 90-day hospitalizations. Regression for Shannon diversity was performed within cirrhosis. Regression for hospitalizations adjusting for clinical and microbial variables was performed. RESULTS: Model for end-stage liver disease (MELD), diabetes, ascites, and albumin were similar, but more Americans were men, had higher hepatic encephalopathy and alcohol/hepatitis C etiology, with lower nonalcoholic fatty liver disease than Brazilians. Brazilians had higher cereal, rice, and yogurt intake vs the United States. As disease progressed, cereals, rice/beans, coffee, and chocolate consumption was reduced. Microbial diversity was higher in Brazilians. Within cirrhosis, high diversity was related to Brazilian origin (P < .0001), age, and cereal intake (P = .05), while high MELD scores (P = .009) and ascites (P = .05) did the reverse. Regardless of stage, beneficial taxa and taxa associated with grant and yogurt intake were higher (Ruminococcaceae, Christensenellacae, and Prevotellaceae), while pathobionts (Porphyromonadaceae, Sutterellaceae, and Enterobacteriaceae) were lower in Brazilians. More Americans were hospitalized vs Brazilians (P = .002). On regression, MELD (P = .001) and ascites (P = .001) were associated with higher hospitalizations, while chocolate (P = .03) and Brazilian origin (P = .001) were associated with lower hospitalizations with/without microbiota inclusion. CONCLUSIONS: Brazilian cirrhotic patients follow a diet richer in cereals and yogurt, which is associated with higher microbial diversity and beneficial microbiota and could contribute toward lower hospitalizations compared with a Western-diet-consuming American cohort.
conferenceObject CORONARY ARTERY CALCIUM SCORE AND FRAMINGHAM SCORE IN EVALUATION OF CARDIOVASCULAR RISK AFTER LIVER TRANSPLANTATION(2016) CARONE, L.; OLIVEIRA, C. P.; ALVARES-DA-SILVA, M. R.; STEFANO, J. T.; TERRABUIO, D. R. B.; ABDALA, E.; CARRILHO, F. J.; FARIAS, A. Q.; D'ALBUQUERQUE, L. A. C.conferenceObject CONVENTIONAL AND NOVEL CARDIOVASCULAR RISK FACTORS IN LIVER TRANSPLANT RECIPIENTS (LTR)(2012) ALVARES-DA-SILVA, M. R.; OLIVEIRA, C.; STEFANO, J. T.; OKAMATSU, E.; BARBEIRO, H.; BARBEIRO, D. F.; SORIANO, F.; FARIAS, A. Q.; CARRILHO, F. J.; D'ALBUQUERQUE, L. A. C.conferenceObject THE IMPORTANCE OF LYSOSOMAL ACID LIPASE DEFICIENCY INVESTIGATION IN THE ETIOLOGICAL INVESTIGATION OF CHRONIC CRYPTOGENIC LIVER DISEASES(2019) PESSOA, Mario G.; CANDOLO, Aline Coelho Rocha; ZITELLI, Patricia; SINGER, Julio Da Motta; MAZO, Daniel; CUNHA-SILVA, Marlone; GRECA, Raquel D.; OLIVEIRA, Claudia P. M. S.; LIMA, Roque G.; COUTO, Claudia A.; ARAUJO, Roberta Chaves; FARIAS, Alberto Q.; CARRILHO, Flair J.