ARIANA CAMPOS YANG

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Lattes
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina

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  • article 7 Citação(ões) na Scopus
    Clinical Features and Disease Management in Adult Patients With Atopic Dermatitis Receiving Care at Reference Hospitals in Brazil: the ADAPT Study
    (2021) ARRUDA, L. K.; YANG, A. C.; AOKI, V; CRIADO, R. F. J.; PIRES, M. C.; LUPI, O.; FABRICIO, L. H. Z.; RICHMAN, D.; SILVI, S.
    Background: Atopic dermatitis is a chronic inflammatory skin disease with a prevalence of 0.02% to 8.1% in adults. Adult patients with moderate-to-severe atopic dermatitis are affected by frequent relapses and a significant disease burden. Objective: To determine the clinical, immunological, and therapeutic profile of Brazilian adults with atopic dermatitis. Methods: A multicenter, observational, retrospective, descriptive registry-based study was conducted at reference hospitals between December 2016 and October 2017. The data collected were demographics, personal and family history of atopic diseases, clinical manifestations, laboratory tests, disease severity and management. Results: Of the 187 patients included in the analysis, 56.1% were female and 71.7% were White, with a mean age of 24.7 years. Mean follow-up was 9 years. Asthma or other allergic diseases were reported by 80.2% of patients. The main comorbidity was hypertension (10.2%), and common disease manifestations included pruritus and erythema. Lesions generally affected flexural and nonflexural areas, with typical morphology. Around 83% of patients had moderate-to-severe disease, and 8.6% reported at least 1 hospitalization. Most patients received topical and/or systemic pharmacological therapies, including omalizumab (5.9%); 4.3% received phototherapy. Moreover, 66.8% of patients received adjuvant therapy, and 79.1% changed or discontinued treatment for atopic dermatitis due to remission (46.5%), poor effectiveness (33.7%), or lack of adherence (12.9%). Most patients presented characteristics of type 2 inflammation, with immunoglobulin E levels above 100 IU/mL (94.4%) and peripheral blood eosinophils above 5% (55.9%). Conclusion: Brazilian adult patients with severe atopic dermatitis need treatment to efficiently control the disease and improve quality of life.
  • article 24 Citação(ões) na Scopus
    Mathematical modeling of the transmission of SARS-CoV-2-Evaluating the impact of isolation in SAo Paulo State (Brazil) and lockdown in Spain associated with protective measures on the epidemic of CoViD-19
    (2021) YANG, Hyun Mo; LOMBARDI JUNIOR, Luis Pedro; CASTRO, Fabio Fernandes Morato; YANG, Ariana Campos
    Coronavirus disease 2019 (CoViD-19), with the fatality rate in elder (60 years old or more) being much higher than young (60 years old or less) patients, was declared a pandemic by the World Health Organization on March 11, 2020. A mathematical model considering young and elder subpopulations under different fatality rates was formulated based on the natural history of CoViD-19 to study the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The model considered susceptible, exposed, asymptomatic, pre-symptomatic, mild CoViD-19, severe CoViD-19, and recovered compartments, besides compartments of isolated individuals and those who were caught by test. This model was applied to study the epidemiological scenario resulting from the adoption of quarantine (isolation or lockdown) in many countries to control the rapid propagation of CoViD-19. We chose as examples the isolation adopted in SAo Paulo State (Brazil) in the early phase but not at the beginning of the epidemic, and the lockdown implemented in Spain when the number of severe CoViD-19 cases was increasing rapidly. Based on the data collected from SAo Paulo State and Spain, the model parameters were evaluated, and we obtained a higher estimation for the basic reproduction number R-0 (9.24 for SAo Paulo State, and 8 for Spain) compared to the currently accepted estimation of R-0 around 2 using the SEIR (susceptible, exposed, infectious, and recovered compartments) model. In comparison with the lockdown in Spain, the relatively early adoption of the isolation in SAo Paulo State resulted in enlarging the period of the first wave of the epidemic and delaying its peak. The model allowed to explain the flattening of the epidemic curves by quarantine when associated with the protective measures (face mask, washing hands with alcohol and gel, and social distancing) adopted by the population. The description of the epidemic under quarantine and protections can be a background to foreseen the epidemiological scenarios from the release strategies, which can help guide public health policies by decision-makers.
  • article 10 Citação(ões) na Scopus
    Mathematical model describing CoViD-19 in Sao Paulo, Brazil - evaluating isolation as control mechanism and forecasting epidemiological scenarios of release
    (2020) YANG, H. M.; LOMBARDI JUNIOR, L. P.; CASTRO, F. F. M.; YANG, A. C.
    In Sao Paulo, Brazil, the first case of coronavirus disease 2019 (CoViD-19) was confirmed on 26 February, the first death due to CoViD-19 was registered on 16 March, and on 24 March, Sao Paulo implemented the isolation of persons in non-essential activities. A mathematical model was formulated based on non-linear ordinary differential equations considering young (60 years old or less) and elder (60 years old or more) subpopulations, aiming to describe the introduction and dissemination of the new coronavirus in Sao Paulo. This deterministic model used the data collected from Sao Paulo to estimate the model parameters, obtainingR(0)= 6.8 for the basic reproduction number. The model also allowed to estimate that 50% of the population of Sao Paulo was in isolation, which permitted to describe the current epidemiological status. The goal of isolation implemented in Sao Paulo to control the rapid increase of the new coronavirus epidemic was partially succeeded, concluding that if isolation of at least 80% of the population had been implemented, the collapse in the health care system could be avoided. Nevertheless, the isolated persons must be released one day. Based on this model, we studied the potential epidemiological scenarios of release by varying the proportions of the release of young and elder persons. We also evaluated three different strategies of release: All isolated persons are released simultaneously, two and three releases divided in equal proportions. The better scenarios occurred when young persons are released, but maintaining elder persons isolated for a while. When compared with the epidemic without isolation, all strategies of release did not attain the goal of reducing substantially the number of hospitalisations due to severe CoViD-19. Hence, we concluded that the best decision must be postponing the beginning of the release.
  • article 2 Citação(ões) na Scopus
    A Sea Urchin Roe Tropomyosin-Like Protein Is Recognized in Vitro by Shrimp-Allergic Individuals
    (2012) PASCAL, M.; GRISHINA, G.; YANG, A.; AYUSO, R.
  • article 0 Citação(ões) na Scopus
    Underlying IPEX syndrome in a patient with idiopathic juvenile arthritis and vitiligo
    (2022) MENDONCA, Leonardo Oliveira; CHUSTER, Adriana Pitchon dos Reis; DORNA, Mayra Barros; BARROS, Samar Freschi; ALVES, Janaina Baptista; GONCALVES, Victor Lucas; YANG, Ariana Campos; KALIL, Jorge; TOLEDO-BARROS, Myrthes Anna Maragna; KOKRON, Cristina Maria
    Background: IPEX syndrome is an X-linked inborn error of immunity clinically characterized by the triad of: enteropathy, polyendocrinopathy and eczema. However many other clinical presentations lacking the triad above described have been reported what underpin the need of careful clinical suspicion, immunological evaluation and genetic sequencing. Case presentation: Here we report a case of a Brazilian boy with severe eczema as the first and only presentation requiring cyclosporin therapy. Progressive and cumulative symptoms of arthritis and enteropathy lead to the suspicion of an inborn error of immunity. Peripheral FOXP3 expression was normal (CD127-/CD4+/CD25+/FOXP3+-396 cells-63%) and a pathogenic mutation in FOXP3 gene (c.1150G > A; p.Ala384Thr), confirmed the diagnosis of IPEX syndrome. Conclusions: IPEX syndrome should be suspected in patients presenting with severe eczema associated or not with other autoimmune/hyper inflammatory diseases in life. Our study also reinforces that FOXP3 expression by flowcytometry seems not to be a good screening method, and genetic sequencing is mandatory even in those with high suspicion and normal peripheral FOXP3 expression.
  • article 4 Citação(ões) na Scopus
    Relative cost-effectiveness of using an extensively hydrolyzed casein formula in managing infants with cow's milk allergy in Brazil
    (2016) GUEST, Julian F.; YANG, Ariana C.; OBA, Jane; RODRIGUES, Maraci; CAETANO, Rosane; POLSTER, Lilian
    Objective: To estimate the cost-effectiveness of three alternative dietetic strategies for cow's milk allergy in Brazil: 1) using an extensively hydrolyzed casein formula (eHCF; -Nutramigen) as a first-line formula, but switching to an amino acid formula (AAF) if infants remain symptomatic; 2) using an AAF as a first-line formula and then switching to an eHCF after 4 weeks once infants are symptom-free, but switching back to an AAF if infants become symptomatic; and 3) using an AAF as a first-line formula and keeping all infants on that formula. The analysis was conducted from the perspective of the Brazilian public health care system, Sistema Unico de Saude. Methods: Decision modeling was used to estimate the probability of immunoglobulin E (IgE)-mediated and non-IgE-mediated allergic infants developing tolerance to cow's milk by 12 months from starting a formula. The models also estimated the Sistema Unico de Saude cost (at 2013/2014 prices) of managing infants over 12 months after starting a formula, as well as the relative cost-effectiveness of each of the dietetic strategies. Results: The probability of developing tolerance to cow's milk by 12 months from starting a formula was higher among infants with either IgE-mediated or non-IgE-mediated allergy who were initially fed with an eHCF, compared with those who were initially fed with an AAF. The total health care cost of initially feeding an eHCF to cow's milk allergic infants was less than that of initially feeding both IgE-mediated and non-IgE-mediated infants with an AAF. Conclusion: Within the study's limitations, using an eHCF instead of an AAF for the first-line management of newly-diagnosed infants with cow's milk allergy affords a cost-effective use of publicly funded resources, since it improves the outcome for less cost.
  • article 0 Citação(ões) na Scopus
    A concept for integrated care pathways for atopic dermatitis-A GA2LEN ADCARE initiative
    (2023) ZUBERBIER, Torsten; LATIFF, Amir Abdul; AGGELIDIS, Xenofon; AUGUSTIN, Matthias; BALAN, Radu-Gheorghe; BANGERT, Christine; BECK, Lisa; BIEBER, Thomas; BERNSTEIN, Jonathan A.; COLILLA, Marta Bertolin; BERARDI, Alejandro; SERRA-BALDRICH, Esther; SIEMENS, Kristina; SMITH, Cathrine; STAUBACH, Petra; STEVANOVIC, Katarina; SU-KUCUK, Ozlem; SUSSMAN, Gordon; TAVECCHIO, Simona; MITREVSKA, Natasa Teovska; THACI, Diamant; TOUBI, Elias; TRAIDL-HOFFMANN, Claudia; TREUDLER, Regina; VADASZ, Zahava; HOFMAN, Ingrid van; VENTURA, Maria Teresa; WANG, Zhao; WERFEL, Thomas; WOLLENBERG, Andreas; YANG, Ariana; YEW, Yik Weng; ZHAO, Zuotao; ZWIENER, Ricardo; WORM, Margitta; BEDBROOK, Anna; BINDSLEV-JENSEN, Carsten; BOUSQUET, Jean; BRUIN-WELLER, Marjolein de; BRUSCKY, Dayanne; BUYUKTIRYAKI, Betul; CANONICA, Giorgio Walter; CASTRO, Carla; CHANTURIDZE, Natia; CHONG-NETO, Herberto Jose; CHU, Chia-Yu; CHULAROJANAMONTRI, Leena; CORK, Michael; CRIADO, Roberta F. J.; BARREDO, Laia Curto; CUSTOVIC, Adnan; DARSOW, Ulf; EMURLAI, Arben; PABLO, Ana de; GIACCO, Stefano Del; GIROLOMONI, Giampiero; JOVANOVA, Tanja Deleva; DELEURAN, Mette; DOULADIRIS, Nikolaos; DUARTE, Bruno; DUBAKIENE, Ruta; ELLER, Esben; ENGEL-YEGER, Batya; ENSINA, Luis Felipe; FILHO, Nelson Rosario; FLOHR, Carsten; FOMINA, Daria; FRANCUZIK, Wojciech; GALIMBERTI, Maria Laura; GIMENEZ-ARNAU, Ana M.; GODSE, Kiran; MORTZ, Charlotte Gotthard; GOTUA, Maia; HIDE, Michihiro; HOETZENECKER, Wolfram; HUNZELMANN, Nicolas; IRVINE, Alan; JACK, Carolyn; KANAVAROU, Ioanna; KATOH, Norito; KINACIYAN, Tamar; KOCATUERK, Emek; KULTHANAN, Kanokvalai; LAPEERE, Hilde; LAU, Susanne; NASTRI, Mariana Machado Forti; MAKRIS, Michael; MANSOUR, Eli; MARSLAND, Alexander; FELIX, Mara Morelo Rocha; CASTRO, Ana Paula Moschione; NETTIS, Eustachio; NICOLAS, J. F.; NOSBAUM, Audrey; ODEMYR, Mikaela; PAPAPOSTOLOU, Niki; PARISI, Claudio A. S.; PAUDEL, Sushil; PETER, Jonny; POKHAREL, Prakash; PUIG, Luis; QUINT, Tamara; RAMON, German Dario; REGATEIRO, Frederico; RICCI, Giampaolo; ROSARIO, Cristine; SACKESEN, Cansin; SCHMID-GRENDELMEIER, Peter
    Introduction: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems.Methods: The GA(2)LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL(2)EN ADCARE centres.Results: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD.Conclusion: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD.
  • article 0 Citação(ões) na Scopus
    Fructose biphosphate aldolase: A new cassava allergen
    (2023) VENTURA, Anne K. R. M.; ALVES, Safiri de P.; CASTRO, Roberta A.; ROSSINI, Bruno C.; DELAZARI, Lucilense S.; OLIVEIRA, Amanda M. de; MORETTI, Ana I. S.; CASTRO, Fabio F. M.; KALIL, Jorge; YANG, Ariana C.; SANTOS, Keity S.
    Background: Food allergy has considerably increased in recent years and this situation has been aggravated mainly by the consumption of more processed and complex foods, since minor or potentially allergenic foods are not required to be labeled. Manihot esculenta (cassava) is a widely consumed food in South America, Africa, and Asia and can be used in the production of flour and starch, as well as several other products. This root can cause allergic reactions with symptoms ranging from mild to severe. Methods: Thus, the aim of this study was the characterization of the immunogenic cassava proteins responsible for sensitizing patients allergic to it. Using a 2D-SDS-PAGE based proteomic approach, six proteins were identified, including Fructose Bisphosphate Aldolase (FBA). Recom-binant FBA was produced in Expi293 cells and evaluated by immunoblotting with the serum of 10 individual study subjects. Results: Our results showed six cassava IgE-reactive proteins. From those, recombinant fructose bisphosphate aldolase (FBA) showed a positivity of 80% among tested sera, proving to be a highly sensitizing protein. Conclusion: The recombinant FBA molecule obtained in this study can be important for in vivo diagnostic assays, by producing more accurate results, and for desensitization protocols, in which the use of the isolated molecule produces more precise results by avoiding secondary sensitization. Trial registration: All patients signed a consent form approved by the internal ethics committee CAPPesq, Comissao de etica para Analise de Projetos de Pesquisa do HC FMUSP (CAAE: 10420619.6.0000.0068).