EDUARDO FERREIRA BORBA NETO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
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
10 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 10
- Increased corticotropin-releasing hormone (CRH) expression in cutaneous lupus lesions(2015) SCHMITZ, M. K.; BOTTE, D. A.; SOTTO, M. N.; BORBA, E. F.; BONFA, E.; MELLO, S. B. V. deObjective Corticotropin-releasing hormone (CRH) and pro-opiomelanocortin (POMC) axis activation leads to the production of hormones, such as adrenocorticotrophic hormone (ACTH) and the -melanocyte stimulating hormone (-MSH). Data regarding the role of these hormones in systemic lupus erythematosus (SLE) are scarce. In the present study we aim to evaluate the participation of this axis in the cutaneous involvement of SLE. Methods Seventeen SLE patients were clinically evaluated, and biopsies from affected and unaffected skin of these patients were compared with 17 healthy control individuals. Immunohistochemical analyses for CRH, ACTH, -MSH, and MC-1R were performed, and the serum levels of -MSH, IL-1, IL-1ra, IL-6, IL-10, IL-12p70, IL-17, TNF-, and IFN- were measured. Results The affected skin of the SLE patients exhibited higher CRH expression in the deep dermis compared to the skin of the controls (p=0.024), whereas the tissue expression of ACTH, cortisol, -MSH and its receptor MC-1R were comparable in SLE patients and controls. Higher serum levels of IFN- (p=0.041), TNF- (p=0.001) and IL-6 (p=0.049) were observed in SLE patients compared with controls, while -MSH levels were similar in both groups. Conclusion The novel finding of elevated CRH expression solely in the affected skin deep dermis supports the notion of a cutaneous local dysfunction of the CRH-POMC axis in the pathogenesis of cutaneous SLE lesions.
- The effects of exercise on lipid profile in systemic lupus erythematosus and healthy individuals: a randomized trial(2015) BENATTI, Fabiana Braga; MIOSSI, Renata; PASSARELI, Marisa; NAKANDAKARE, Edna R.; PERANDINI, Luiz; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; BORBA, Eduardo; BONFA, Eloisa; GUALANO, Bruno; PINTO, Ana Lucia de SaThe aim of the present study was to evaluate the effects of an exercise training program on lipid profile and composition of high-density lipoprotein (HDL) subfractions in systemic lupus erythematosus (SLE) patients and healthy controls. A 12-week, randomized trial was conducted. Thirty-three physically inactive SLE patients were randomly assigned into two groups: trained (SLE-TR, n = 17) and non-trained (SLE-NT, n = 16). A gender-, BMI-, and age-matched healthy control groups (C-TR, n = 11) also underwent the exercise program. Subjects were assessed at baseline (Pre) and 12 weeks after the 3-month exercise training program (Post) for lipid profile (HDL, low-density lipoprotein, very low-density lipoprotein, and total cholesterol and triglycerides levels) and composition of the HDL subfractions HDL2 and HDL3. SLE patients showed significantly lower contents of Apo A-I, phospholipid, and triglyceride in the HDL3 subfraction (p < 0.05, between-group comparisons) than healthy controls at baseline. The exercise training program did not affect any of the parameters in the SLE-TR group (p > 0.05, within-group comparisons), although there was a trend toward decreased circulating Apo B levels (p = 0.06, ES = -0.3, within-group comparison). In contrast, the same exercise training program was effective in increasing contents of cholesterol, triglyceride, and phospholipid in the HDL2 subfraction in the C-TR group (p = 0.036, ES = 2.06; p = 0.038, ES = 1.77; and p = 0.0021, ES = 2.37, respectively, within-group comparisons), whereas no changes were observed in the composition of the HDL3 subfraction. This study showed that SLE patients have a less effective response to a 12-week exercise training program than healthy individuals, with regard to lipid profile and chemical composition of HDL subfractions. These results reinforce the need for further studies to define the optimal training protocol to improve lipid profile and particularly the HDL composition in these patients (registered at clinicaltrials.gov as NCT01515163).
- Carpal tunnel syndrome and prediabetes: Is there a true association?(2015) VASCONCELOS, Jose Tupinamba Sousa; PAIVA, Angela Maria Freitas; CAVALCANTI, Mauro Furtado; CARVALHO, Jozelio Freire de; BONFA, Eloisa; BORBA, Eduardo FerreiraBackground: Carpal tunnel syndrome (CTS) is probably associated with diabetes mellitus, but its link to prediabetes (PD) is unknown. Objective: To determine prevalence of PD and others risk factors in CTS. Methods: A cross-sectional study including 115 idiopathic CTS patients and 115 age-, gender-and body mass index (BMI)-matched controls was performed. Clinical, laboratory and neurophysiological evaluations were conducted in all subjects to confirm CTS diagnosis. CTS severity was graded on a standardized neurophysiological scale. PD was defined using strict criteria. Results: The prevalence of PD was similar in CTS and control groups (27% vs. 21.7%, respectively P=0.44). Nocturnal symptoms (91.3%) and moderate CTS (58.3%) were most frequently observed in CTS patients. In logistic regression analysis, PD was significantly correlated with age (odds ratio [OR] 1.05,95% confidence interval [CI] 1.01-1.09; P=0.006) and BMI (OR 1.08. 95% CI 1.01-1.16; P=0.026), but not with CTS (OR 0.82,95% CI 0.43-1.53; P=0.537). CTS patients with PD had a significantly higher mean age compared to those without PD (53.8 +/- 10.2 vs. 49.5 +/- 8.6 years, respectively P=0.027). The frequency of age >60 years was significantly higher in CTS with PD than in CTS without PD (29.0% vs. 8.3%, respectively P=0.04) as was BMI >30 kg/m(2) (64.5% vs. 33.3%, respectively P=0.03). No significant differences were observed between the two O'S groups with respect to gender, BMI, symptoms, and neurophysiological severity of CTS. Conclusions: Our findings indicated that CTS is not associated with PD, but that PD is closely linked to age and overweight.
- Consenso da Sociedade Brasileira de Reumatologia para o diagnóstico, manejo e tratamento da nefrite lúpica(2015) KLUMB, Evandro Mendes; SILVA, Clovis Artur Almeida; LANNA, Cristina Costa Duarte; SATO, Emilia Inoue; BORBA, Eduardo Ferreira; BRENOL, Joao Carlos Tavares; ALBUQUERQUE, Elisa Martins das Neves de; MONTICIELO, Odirlei Andre; COSTALLAT, Lilian Tereza Lavras; LATORRE, Luiz Carlos; SAUMA, Maria de Fatima Lobato da Cunha; BONFA, Eloisa Silva Dutra de Oliveira; RIBEIRO, Francinne MachadoObjective: To develop recommendations for the diagnosis, management and treatment of lupus nephritis in Brazil. Method: Extensive literature review with a selection of papers based on the strength of scientific evidence and opinion of the Commission on Systemic Lupus Erythematosus members, Brazilian Society of Rheumatology. Results and conclusions: 1) Renal biopsy should be performed whenever possible and if this procedure is indicated; and, when the procedure is not possible, the treatment should be guided with the inference of histologic class. 2) Ideally, measures and precautions should be implemented before starting treatment, with emphasis on attention to the risk of infection. 3) Risks and benefits of treatment should be shared with the patient and his/her family. 4) The use of hydroxychloroquine (preferably) or chloroquine diphosphate is recommended for all patients (unless contraindicated) during induction and maintenance phases. 5) The evaluation of the effectiveness of treatment should be made with objective criteria of response (complete remission/partial remission/refractoriness). 6) ACE inhibitors and/or ARBs are recommended as antiproteinuric agents for all patients (unless contraindicated). 7) The identification of clinical and/or laboratory signs suggestive of proliferative or membranous glomerulonephritis should indicate an immediate implementation of specific therapy, including steroids and an immunosuppressive agent, even though histological confirmation is not possible. 8) Immunosuppressives must be used during at least 36 months, but these medications can be kept for longer periods. Its discontinuation should only be done when the patient achieve and maintain a sustained and complete remission. 9) Lupus nephritis should be considered as refractory when a full or partial remission is not achieved after 12 months of an appropriate treatment, when a new renal biopsy should be considered to assist in identifying the cause of refractoriness and in the therapeutic decision.
- Plasma kinetics of an LDL-Like non-protein nanoemulsion and transfer of lipids to high-density Lipoprotein (HDL) in patients with rheumatoid arthritis(2015) POZZI, Fernanda S.; MARANHAO, Raul C.; GUEDES, Lissiane K.; BORBA, Eduardo F.; LAURINDO, Ieda M. M.; BONFA, Eloisa; VINAGRE, Carmen G.BACKGROUND: Rheumatoid arthritis (RA) is a systemic inflammatory disease associated with cardiovascular risk, but with normal plasma lipids. OBJECTIVE: The aim was to investigate low-density lipoprotein (LDL) and high-density lipoprotein (HDL) metabolism in RA patients using radioactive nanoemulsions resembling an LDL lipid structure (LDE) as metabolic probes. METHODS: Thirty patients with RA, 16 in remission and 14 in high activity, and 30 healthy controls were studied. LDE labeled with C-14-cholesteryl ester (C-14-CE) and H-3-unesterified cholesterol (H-3-UC) was intravenously injected followed by 24 hour plasma sampling. Fractional clearance rates (FCR, h(-1)) were calculated by compartmental analysis. Lipid transfers to HDL were assayed by incubating plasma samples with a donor nanoemulsion labeled with radioactive lipids; % lipids transferred to HDL were quantified after chemical precipitation. RESULTS: LDL cholesterol, triglycerides, unesterified cholesterol, and oxidized LDL were equal in RA and controls, and HDL cholesterol was even higher in RA. Compared with controls, apolipoprotein B was lower, apolipoprotein A1 was equal, and apolipoprotein E was higher in RA. Decay curves of LDE labels were faster in RA patients than in controls (C-14-CE: 0.072 +/- 0.066 and 0.038 +/- 0.027, P = .0115; H-3-UC: 0.066 +/- 0.042 and 0.035 +/- 0.039; P < .0044). FCRs were equal in 2 RA subgroups. Transfer of UC, triglycerides, and phospholipids to HDL was equal between RA and controls, but CE transfer was lower in RA. HDL size was smaller in RA patients than in controls (8.5 +/- 0.5 nm; 9.2 +/- 0.8 nm, P < .0001). CONCLUSION: RA patients were more efficient in removing atherogenic LDL from plasma, as indicated by higher CE and UC FCR, with in lower apolipoprotein B. This was unexpected because of the higher cardiovascular risk in RA.
- Impact of Therapy on Metabolic Syndrome in Young Adult Premenopausal Female Lupus Patients: Beneficial Effect of Antimalarials(2015) MUNIZ, Luciana F.; PEREIRA, Rosa M. R.; SILVA, Thiago F.; BONFA, Eloisa; BORBA, Eduardo F.ObjectiveThere are no data about the main factors associated with metabolic syndrome in young premenopausal systemic lupus erythematosus (SLE) patients. The aim of the study was to evaluate the frequency of metabolic syndrome and disease- or therapy-related factors in premenopausal young SLE patients. MethodsA total of 103 premenopausal SLE patients ages <40 years were selected and compared to 35 healthy premenopausal age-matched women. Metabolic syndrome was defined according to the 2009 Joint Interim Statement. ResultsA higher frequency of metabolic syndrome (22.3% versus 5.7%; P=0.03) was observed in the SLE group. Metabolic syndrome-SLE patients had higher SLE Disease Activity Index scores (meanSD 5.9 +/- 7.6 versus 1.9 +/- 2.7; P=0.006), more frequently had previous renal disease (73.9% versus 51.2%; P=0.05) and current renal disease (34.8% versus 10.0%; P=0.008), and had higher current prednisone dose (median [range] 20 [0-60] versus 5 [0-60] mg/dl; P=0.018) and cumulative prednisone dose (mean +/- SD 41.48 +/- 27.81 versus 24.7 +/- 18.66 gm; P=0.023) than those without metabolic syndrome. Chloroquine was less frequently used in metabolic syndrome-SLE patients (65.2% versus 90.0%; P=0.008). In multivariate analysis, only current chloroquine use (prevalence ratio [PR] 0.29, 95% confidence interval [95% CI] 0.13-0.64) and cumulative prednisone were associated with metabolic syndrome (PR 1.02, 95% CI 1.01-1.04). Further estimated prevalence analysis identified the fact that antimalarial use promoted continuous decrease in the progressive metabolic syndrome prevalence associated with glucocorticoid cumulative dose. ConclusionThe prevalence of metabolic syndrome is high in premenopausal young adult SLE patients. Chloroquine has a protective effect on the prevalence of metabolic syndrome in these patients, and this benefit counteracts the deleterious effect of glucocorticoids in a dose-dependent manner.
- ABO blood group in primary antiphospholipid syndrome: influence in the site of thrombosis?(2015) NASCIMENTO, Natalia Mastantuono; BYDLOWSKI, Sergio Paulo; SOARES, Rosangela Paula Silva; ANDRADE, Danieli Castro Oliveira de; BONFA, Eloisa; SEGURO, Luciana Parente Costa; BORBA, Eduardo FerreiraAntiphospholipid syndrome (APS) is characterized by vascular thrombosis and/or obstetric complications associated with presence of antiphospholipid antibodies (aPL) but additional factors would also induce thrombosis. ABO (H) blood groups are known to be closely related to thrombosis, especially non-O blood type with venous events. The aim of this study was to investigate possible role of ABO (H) blood types in the thrombotic events in primary APS (PAPS). Seventy PAPS patients were selected for the study and were divided according to ABO blood group in: O PAPS (n = 26) and non-O PAPS (n = 44). ABO blood group phenotyping was performed by indirect technique. aPL anticardiolipin (aCL) and anti-beta eta2 glycoprotein-1 (a beta 2GPI) and the concentrations and activities of von Willebrand factor (VWF) were measured with ELISA. Lupus anticoagulant (LA) was detected by coagulation assays. A significant higher frequency of venous events was observed in non-O PAPS group (72.7 vs. 46.2 %, p = 0.040). In contrast, the frequency of arterial events was significantly higher in the O PAPS compared to the non-O PAPS group (69.2 vs. 36.4 %, respectively; p = 0.013). Frequencies of aCL, LA, a beta 2GPI and triple aPL positivity were similar in both groups (p > 0.05). VWF antigen (75.54 +/- A 8.68 vs. 79.51 +/- A 7.07 IU/dl, p = 0.041) and activity (70.23 +/- A 11.96 vs. 77.92 +/- A 13.67 %, p = 0.020) were decreased in O PAPS compared to non-O blood group. VWF:CB/VWF:Ag ratio was similar among groups (p > 0.05). This is the first report that confirms the role of ABO blood system in thrombosis of PAPS and suggests that non-O blood group was related with venous events and O blood group with arterial thrombosis.
conferenceObject Effectiveness of Renoprotective Approaches in Lupus Nephritis: More Than Just Immunosuppression(2015) CASTRO, Maite; BORBA, Eduardo Ferreira; LOPES, Michelle; PASOTO, Sandra G.; BONFA, Eloisa; SEGURO, Luciana- Circulating Follicular Helper-Like T Cells in Systemic Lupus Erythematosus(2015) CHOI, Jin-Young; HO, John Hsi-en; PASOTO, Sandra G.; BUNIN, Viviane; KIM, Sang Taek; CARRASCO, Solange; BORBA, Eduardo F.; GONCALVES, Celio R.; COSTA, Priscila R.; KALLAS, Esper G.; BONFA, Eloisa; CRAFT, JosephObjective. To assess circulating follicular helper T (Tfh)-like CD4+ T cells in patients with systemic lupus erythematosus (SLE) and determine their relationship to disease activity. Methods. Blood samples from patients with SLE, as well as blood samples from patients with Behcet's disease (BD) and healthy individuals as controls, were analyzed. In all samples, circulating Tfh-like cells were enumerated by flow cytometry, using, as markers, expression of CXCR5, inducible T cell costimulator (ICOS), and programmed death 1 (PD-1) protein, as well as secretion of interleukin-21 (IL-21). The frequency of circulating Tfh-like cells was compared to that of circulating plasmablasts (CD19+IgD-CD38+). In addition, the possible association of circulating Tfh-like cells with the SLE Disease Activity Index (SLEDAI) was evaluated. Results. The subset of circulating Tfh-like T cells, identified as CXCR5(high)ICOS(high)PD-1(high), was expanded in the blood of SLE patients compared to controls. Circulating Tfh-like cells were found to produce IL-21 and had lower expression of CCR7 as compared to that in circulating CXCR5(high) central memory T cells, thereby enabling their distinction. Expression of PD-1, but not ICOS or CXCR5, was significantly elevated in circulating Tfh-like cells from SLE patients compared to controls. PD-1 expression among CXCR5(high) circulating Tfh-like cells correlated with the SLEDAI, frequency of circulating plasmablasts, and anti-double-stranded DNA antibody positivity, but not with disease duration or past organ injury; rather, this cell profile appeared to be a reflection of current active disease. Conclusion. Circulating Tfh-like cells are associated with disease activity in SLE, suggesting that their presence indicates abnormal homeostasis of T cell-B cell collaboration, with a causal relationship that is central to disease pathogenesis. These findings also suggest that circulating Tfh-like cells provide a surrogate for aberrant germinal center activity in SLE, and that their PD-1 expression offers a tool for measuring disease activity and monitoring the response to therapies.
article 26 Citação(ões) na Scopus Inflammatory cytokine kinetics to single bouts of acute moderate and intense aerobic exercise in women with active and inactive systemic lupus erythematosus(2015) PERANDINI, L. A.; SALES-DE-OLIVEIRA, D.; V, S. B. Mello; CAMARA, N. O.; BENATTI, F. B.; LIMA, F. R.; BORBA, E.; BONFA, E.; ROSCHEL, H.; SA-PINTO, A. L.; GUALANO, B.Objectives: The aim of this study was to evaluate changes in the cytokines INF-gamma, IL-10, IL-6, TNF-alpha and soluble TNF receptors (sTNFR1 and sTNFR2) in response to single bouts of acute moderate and intense exercise in systemic lupus erythematosus women with active (SLEACTIVE) and inactive (SLEINACTIVE) disease. Methods: Twelve SLEINACTIVE women (age: 35.3 +/- 5.7 yrs: 25.6 +/- 3.4 kg/m(2)), eleven SLEINACTIVE women (age: 30.4 +/- 4.5 yrs; 26.1 +/- 4.8 kg/m(2)), and 10 age- and BMI-matched healthy control women (HC) performed 30 minutes of acute moderate (similar to 50% of VO(2)peak) and intense (similar to 70% of VO(2)peak) exercise bout. Cytokines and,soluble TNF receptors were assessed at baseline, immediately after; every 30 minutes up to three howls, and 24 hours after both acute exercise bouts. Results: In response to acute moderate exercise, cytokines and soluble TNF receptors levels remained unchanged in all groups (P>0.05), except for a reduction in IL-6 levels in the SLEACTIVE group at the 60th and 180th minutes of recovery (P<0.05), and a reduction in sTNFR1 levels in the He group at the 90th, 120th, 150th, 180th minutes of recovery (P<0.05). The SLEINACTIVE group showed higher levels of TNF-alpha, sTNFR1, and sTNFR2 at all time points when compared with the HC group (P<0.05). Also, the SLEACTIVE group showed higher levels of IL-6 at the 60th minute of recovery (P<0.05) when compared with the HC group. After intense exercise, sTNFR1 levels were reduced at the 150th (P=0.041) and 180th (P=0.034) minutes of recovery in the group. whereas the other cytokines and sTNFR2 levels remained unchanged (P>0.05). hi the He group, IL-10, TNF-alpha, sTNFR1, and sTNFR2 levels did not change, whilst INF-gamma levels decreased (P=0.05) and IL-6 levels increased immediately after the exercise (P=0.028), returning to baseline levels 24 hours later (P > 0.05). When compared with the HC group, the SLEINACTIVE, group showed higher levels of TNF-alpha and sTNFR2 in all time points, and higher levels of sTNFR1 at the end of exercise and at the 30th minute of recovery (P<0.05). The SLEACTIVE group also showed higher levels of TNF-alpha at all time points when compared with the HC group (P<0.05), (except after 90 min, 120 min and 24 hours of recovery) (P>0.05). Importantly, the levels of all cytokine and soluble TNF receptors returned to baseline 24 hours after the end of acute exercise, irrespective of its intensity in all three groups (P>0.05). Conclusion: This study demonstrated that both the single bouts of acute moderate and intense exercise induced mild and transient changes in cytokine levels in both SLEINACTIVE and SLEACTIVE women, providing novel evidence that acute aerobic execise does not trigger inflammation in patients with this disease.