SUZANA PINHEIRO PIMENTA
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article 37 Citação(ões) na Scopus Doxycycline use in patients with lymphangioleiomyomatosis: safety and efficacy in metalloproteinase blockade(2011) PIMENTA, Suzana Pinheiro; BALDI, Bruno Guedes; ACENCIO, Milena Marques Pagliarelli; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroObjective: Lymphangioleiomyomatosis (LAM) is characterized by lung cysts, whose development is associated with matrix metalloproteinase (MMP) hyperactivity, principally that of MMP-2 and MMP-9. Our objective was to compare LAM patients and controls in terms of the levels of these MMPs, as well as to determine the safety and efficacy of treatment with doxycycline, a potent MMP inhibitor. Methods: Prospective clinical study involving female LAM patients who received doxycycline (100 mg/day) for six months. Urine and blood samples were collected for the quantification of MMP-2 and MMP-9 before and after the treatment period. Samples from 10 healthy women were also collected. Results: Of the 41 LAM patients who started the treatment, 34 completed the protocol. Serum and urinary MMP-9 levels were significantly lower in the controls than in the LAM patients (p < 0.0001). Comparing pre- and post-treatment values, we found that the median level of MMP-9 in serum decreased from 919 ng/mL to 871 ng/mL (p = 0.05), whereas that of MMP-9 in urine decreased from 11,558 pg/mL to 7,315 pg/mL (p = 0.10). After treatment, the median level of MMP-2 in serum was significantly lower (p = 0.04) and urinary MMP-2 levels were undetectable. Nausea, diarrhea, and epigastric pain were the most prevalent adverse affects and were often self-limiting. There was only one case in which the patient discontinued the treatment because of side effects. Conclusions: We have demonstrated, for the first time, a decrease in serum and urine levels of MMPs in LAM patients treated with doxycycline, which proved to be a safe medication, with mild and well-tolerated side effects.- Pulmonary arterial involvement leading to alveolar hemorrhage in lymphangioleiomyomatosis(2011) BALDI, Bruno Guedes; PIMENTA, Suzana Pinheiro; KAWASSAKI, Alexandre de Melo; BERNARDI, Fabiola Del Carlo; DOLHNIKOFF, Marisa; CARVALHO, Carlos Roberto Ribeiro
article 17 Citação(ões) na Scopus Evolution of pulmonary function after treatment with goserelin in patients with lymphangioleiomyomatosis(2011) BALDI, Bruno Guedes; MEDEIROS JUNIOR, Pedro; PIMENTA, Suzana Pinheiro; LOPES, Roberto Iglesias; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto RibeiroIn the atypical smooth muscle cells that are characteristic of lymphangioleiomyomatosis (LAM), there are estrogen and progesterone receptors. Therefore, anti-hormonal therapy, despite having produced controversial results, can be considered a treatment option. The objective of this retrospective study was to evaluate hormonal and spirometric data for nine women with LAM after one year of treatment with goserelin. The mean increase in FEV(1) and FVC was 80 mL and 130 mL, respectively. There was effective blockage of the hormonal axis. It is still not possible to exclude a potential beneficial effect of the use of gonadotropin-releasing hormone analogues in LAM patients, which underscores the need for randomized trials.