CARLA GONCALVES SCHAHIN SAAD
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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
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- CHARACTERISTICS ASSOCIATED WITH POOR COVID-19 OUTCOMES IN PEOPLE WITH PSORIASIS AND SPONDYLOARTHRITIS: DATA FROM THE COVID-19 PSOPROTECT AND GLOBAL RHEUMATOLOGY ALLIANCE PHYSICIAN-REPORTED REGISTRIES(2022) MACHADO, P. M.; SCHAEFER, M.; MAHIL, S.; DAND, N.; GIANFRANCESCO, M.; LAWSON-TOVEY, S.; YIU, Z.; YATES, M.; HYRICH, K.; GOSSEC, L.; CARMONA, L.; MATEUS, E.; WIEK, D.; BHANA, S.; GORE-MASSY, M.; GRAINGER, R.; HAUSMANN, J.; SUFKA, P.; SIROTICH, E.; WALLACE, Z.; OLOFSSON, T.; LOMATER, C.; ROMEO, N.; WENDLING, D.; PHAM, T.; RICHARD, C. Miceli; FAUTREL, B.; SILVA, L.; SANTOS, H.; MARTINS, F. R.; HASSELI, R.; PFEIL, A.; REGIERER, A.; ISNARDI, C.; SORIANO, E.; QUINTANA, R.; OMURA, F.; RIBEIRO, F. Machado; PINHEIRO, M.; BAUTISTA-MOLANO, W.; ALPIZAR-RODRIGUEZ, D.; SAAD, C.; DUBREUIL, M.; HAROON, N.; GENSLER, L. S.; DAU, J.; JACOBSOHN, L.; LIEW, J.; STRANGFELD, A.; BARKER, J.; GRIFFITHS, C. E. M.; ROBINSON, P.; YAZDANY, J.; SMITH, C.
- Assessing bone impairment in ankylosing spondylitis (AS) using the trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT)(2019) CAPARBO, Valeria F.; FURLAM, Pedro; SAAD, Carla G. S.; ALVARENGA, Jackeline C.; AUBRY-ROZIER, Berengere; HANS, Didier; BRUM-FERNANDES, Artur J. de; PEREIRA, Rosa M. R.Objectives: To compare bone quality using the trabecular bone score (TBS) and bone microarchitecture in the distal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ankylosing spondylitis (AS) patients and healthy controls (HC). Methods: Areal bone mineral density (aBMD) and TBS (TBS iNsight software) were evaluated using DXA (Hologic, QDR 4500); while volumetric bone mineral density (vBMD) and bone microarchitecture were analyzed in the distal tibia using HR-pQCT (Scanco) in 73 male patients with AS and 52 age-matched HC. Results: AS patients were a mean 41.6 +/- 7.9 years old and had a mean disease duration of 16.4 +/- 8.6 y, with a mean mSASSS 25.6 +/- 16.4. No difference was observed in lumbar spine aBMD in AS patients and HC (p = 0.112), but total hip BMD (p = 0.011) and TBS (p < 0.001) were lower in AS patients. In the distal tibia, reduced trabecular volumetric density [Tb.vBMD (p < 0.006)] and structural alterations - trabecular thickness (Tb.Th), p = 0.044 and trabecular separation (Tb.Sp), p = 0.039 - were observed in AS patients relative to controls. Further analysis comparing TBS < 1.310 and TBS >= 1.310 in AS patients revealed a higher mean body mass index [BMI] (p = 0.010), lower tibia cortical vBMD [Ct.vBMD] (p = 0.007), lower tibia cortical thickness [Ct.Th] : (p = 0.048) in the former group. On logistic regression analysis, BMI (OR = 1.27; 95%IC = 1.08-1.50, p = 0.005), (VF 4.65; 1.13-19.1, p = 0.033) and tibial Ct.vBMD (0.98; 0.97-1.00, p = 0.007) were associated with a lower TBS ( < 1.310). Conclusions: The present study demonstrates that TBS and HR-pQCT imaging are important technologies evaluating bone impairment in AS patients. Moreover, in these patients vertebral fractures were associated with lower TBS.
conferenceObject Monocytes from Male Patients with Ankylosing Spondylitis Display Decreased Osteoclastogenesis and Decreased RANKL/OPG Ratio(2017) CAPARBO, Valeria F.; SAAD, Carla G. S.; MORAES, Julio C. B.; BRUM-FERNANDES, Artur J. de; PEREIRA, Rosa M. R.- Monocytes from male patients with ankylosing spondylitis display decreased osteoclastogenesis and decreased RANKL/OPG ratio(2018) CAPARBO, V. F.; SAAD, C. G. S.; MORAES, J. C.; BRUM-FERNANDES, A. J. de; PEREIRA, R. M. R.aSummaryThe present study investigates the osteoclastogenic capacity of peripheral blood mononuclear cells (PBMCs) in male patients with ankylosing spondylitis (AS). We demonstrated that monocytes from these patients display a lower capacity to generate osteoclasts compared to cells from healthy controls, and osteoclastogenesis was negatively correlated with disease duration.IntroductionAnkylosing spondylitis (AS) is a disease characterized by new bone growth that leads to syndesmophyte formation but AS patients frequently present with low bone mineral density/fractures. Osteoclastogenesis in AS patients is poorly studied and controversial. The aim of this study is to determine if the osteoclastogenic capacity of PBMCs is different in AS patients compared to controls and the relationship between osteoclastogenesis and clinical/laboratory parameters.MethodsPBMCs from 85 male AS patients and 59 controls were tested for CD16+ cells and induced to differentiate into osteoclasts over 3weeks in vitro. Serum levels of RANKL, osteoprotegerin (OPG), C-terminal telopeptide of type I collagen (CTX), and amino-terminal pro-peptide of type I collagen (P1NP) were also evaluated.ResultsPBMCs from AS patients had fewer CD16+ cells and produced fewer osteoclasts compared to controls. Apoptosis occurred less frequently in osteoclasts obtained from AS patients than in osteoclasts from the controls. A lower RANKL/OPG and CTX/P1NP were observed in AS patients compared to controls. AS patients taking NSAIDs presented no difference regarding the number of OCs produced and the percentage of CD16+ cells compared to controls. However, patients taking TNF inhibitors (TNFi) presented lower OC numbers than controls. A negative correlation was demonstrated between the number of osteoclasts generated from PBMCs of AS patients and disease duration.ConclusionMonocytes from male AS patients display a lower capacity to generate osteoclasts in vitro compared to cells from controls. Osteoclastogenesis was negatively correlated with disease duration. This finding supports the idea that osteoclasts play a role in the physiopathology of bone disease in AS patients.
- Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries(2023) MACHADO, Pedro M.; SCHAEFER, Martin; MAHIL, Satveer K.; LIEW, Jean; GOSSEC, Laure; DAND, Nick; PFEIL, Alexander; STRANGFELD, Anja; REGIERER, Anne Constanze; FAUTREL, Bruno; ALONSO, Carla Gimena; SAAD, Carla G. S.; GRIFFITHS, Christopher E. M.; LOMATER, Claudia; MICELI-RICHARD, Corinne; WENDLING, Daniel; RODRIGUEZ, Deshire Alpizar; WIEK, Dieter; MATEUS, Elsa F.; SIROTICH, Emily; SORIANO, Enrique R.; RIBEIRO, Francinne Machado; OMURA, Felipe; MARTINS, Frederico Rajao; SANTOS, Helena; DAU, Jonathan; BARKER, Jonathan N.; HAUSMANN, Jonathan; HYRICH, Kimme L.; GENSLER, Lianne; SILVA, Ligia; JACOBSOHN, Lindsay; CARMONA, Loreto; PINHEIRO, Marcelo M.; ZELAYA, Marcos David; SEVERINA, Maria de los Angeles; YATES, Mark; DUBREUIL, Maureen; GORE-MASSY, Monique; ROMEO, Nicoletta; HAROON, Nigil; SUFKA, Paul; GRAINGER, Rebecca; HASSELI, Rebecca; LAWSON-TOVEY, Saskia; BHANA, Suleman; PHAM, Thao; OLOFSSON, Tor; BAUTISTA-MOLANO, Wilson; WALLACE, Zachary S.; YIU, Zenas Z. N.; YAZDANY, Jinoos; ROBINSON, Philip C.; SMITH, Catherine H.ObjectivesTo investigate factors associated with severe COVID-19 in people with psoriasis (PsO), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA). MethodsDemographic data, clinical characteristics and COVID-19 outcome severity of adults with PsO, PsA and axSpA were obtained from two international physician-reported registries. A three-point ordinal COVID-19 severity scale was defined: no hospitalisation, hospitalisation (and no death) and death. ORs were estimated using multivariable ordinal logistic regression. ResultsOf 5045 cases, 18.3% had PsO, 45.5% PsA and 36.3% axSpA. Most (83.6%) were not hospitalised, 14.6% were hospitalised and 1.8% died. Older age was non-linearly associated with COVID-19 severity. Male sex (OR 1.54, 95% CI 1.30 to 1.83), cardiovascular, respiratory, renal, metabolic and cancer comorbidities (ORs 1.25-2.89), moderate/high disease activity and/or glucocorticoid use (ORs 1.39-2.23, vs remission/low disease activity and no glucocorticoids) were associated with increased odds of severe COVID-19. Later pandemic time periods (ORs 0.42-0.52, vs until 15 June 2020), PsO (OR 0.49, 95% CI 0.37 to 0.65, vs PsA) and baseline exposure to TNFi, IL17i and IL-23i/IL-12+23i (OR 0.57, 95% CI 0.44 to 0.73; OR 0.62, 95% CI 0.45 to 0.87; OR 0.67, 95% CI 0.45 to 0.98; respectively; vs no disease-modifying antirheumatic drug) were associated with reduced odds of severe COVID-19. ConclusionOlder age, male sex, comorbidity burden, higher disease activity and glucocorticoid intake were associated with more severe COVID-19. Later pandemic time periods, PsO and exposure to TNFi, IL17i and IL-23i/IL-12+23i were associated with less severe COVID-19. These findings will enable risk stratification and inform management decisions for patients with PsO, PsA and axSpA during COVID-19 waves or similar future respiratory pandemics.