Artigos e Materiais de Revistas Científicas - LIM/17

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  • article 20 Citação(ões) na Scopus
    Anti-Neutrophil Extracellular Trap Antibodies in Antiphospholipid Antibody-Positive Patients: Results From the Antiphospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking Clinical Database and Repository
    (2023) ZUO, Yu; NAVAZ, Sherwin; TSODIKOV, Alex; KMETOVA, Katarina; KLUGE, Lyndsay; AMBATI, Amala; HOY, Claire K.; YALAVARTHI, Srilakshmi; ANDRADE, Danieli de; TEKTONIDOU, Maria G.; SCIASCIA, Savino; PENGO, Vittorio; RUIZ-IRASTORZA, Guillermo; BELMONT, H. Michael; GEROSA, Maria; FORTIN, Paul R.; JESUS, Guilherme Ramires de; BRANCH, D. Ware; ANDREOLI, Laura; RODRIGUEZ-ALMARAZ, Esther; PETRI, Michelle; CERVERA, Ricard; WILLIS, Rohan; KARP, David R.; LI, Quan-Zhen; COHEN, Hannah; BERTOLACCINI, Maria Laura; ERKAN, Doruk; KNIGHT, Jason S.
    ObjectiveThis study aimed to elucidate the presence, antigen specificities, and potential clinical associations of anti-neutrophil extracellular trap (anti-NET) antibodies in a multinational cohort of antiphospholipid (aPL) antibody-positive patients who did not have lupus. MethodsAnti-NET IgG/IgM levels were measured in serum samples from 389 aPL-positive patients; 308 patients met the classification criteria for antiphospholipid syndrome. Multivariate logistic regression with best variable model selection was used to determine clinical associations. For a subset of the patients (n = 214), we profiled autoantibodies using an autoantigen microarray platform. ResultsWe found elevated levels of anti-NET IgG and/or IgM in 45% of the aPL-positive patients. High anti-NET antibody levels are associated with more circulating myeloperoxidase (MPO)-DNA complexes, which are a biomarker of NETs. When considering clinical manifestations, positive anti-NET IgG was associated with lesions affecting the white matter of the brain, even after adjusting for demographic variables and aPL profiles. Anti-NET IgM tracked with complement consumption after controlling for aPL profiles; furthermore, patient serum samples containing high levels of anti-NET IgM efficiently deposited complement C3d on NETs. As determined by autoantigen microarray, positive testing for anti-NET IgG was significantly associated with several autoantibodies, including those recognizing citrullinated histones, heparan sulfate proteoglycan, laminin, MPO-DNA complexes, and nucleosomes. Anti-NET IgM positivity was associated with autoantibodies targeting single-stranded DNA, double-stranded DNA, and proliferating cell nuclear antigen. ConclusionThese data reveal high levels of anti-NET antibodies in 45% of aPL-positive patients, where they potentially activate the complement cascade. While anti-NET IgM may especially recognize DNA in NETs, anti-NET IgG species appear to be more likely to target NET-associated protein antigens.
  • article 0 Citação(ões) na Scopus
    Clinical and laboratory features associated with macrophage activation syndrome in Still's disease: data from the international AIDA Network Still's Disease Registry (vol 18, pg 2231, 2023)
    (2024) TRIGGIANESE, Paola; VITALE, Antonio; LOPALCO, Giuseppe; GIARDINI, Henrique Ayres Mayrink; CICCIA, Francesco; AL-MAGHLOUTH, Ibrahim; RUSCITTI, Piero; SFIKAKIS, Petros Paul; IANNONE, Florenzo; ANTONELLI, Isabele Parente de Brito; PATRONE, Martina; ASFINA, Kazi Nur; COLA, Ilenia Di; LASKARI, Katerina; GAGGIANO, Carla; TUFAN, Abdurrahman; SFRISO, Paolo; DAGNA, Lorenzo; GIACOMELLI, Roberto; HINOJOSA-AZAOLA, Andrea; RAGAB, Gaafar; FOTIS, Lampros; DIRESKENELI, Haner; SPEDICATO, Veronica; DAGOSTIN, Marilia Ambiel; IACONO, Daniela; ALI, Hebatallah Hamed; CIPRIANI, Paola; SOTA, Jurgen; KARDAS, Riza Can; BINDOLI, Sara; CAMPOCHIARO, Corrado; NAVARINI, Luca; GENTILESCHI, Stefano; MARTIN-NARES, Eduardo; TORRES-RUIZ, Jiram; SAAD, Moustafa Ali; KOURTESI, Katerina; ALIBAZ-ONER, Fatma; SEVIK, Gizem; IAGNOCCO, Annamaria; MAKOWSKA, Joanna; GOVONI, Marcello; MONTI, Sara; MAGGIO, Maria Cristina; TORRE, Francesco La; GIUDICE, Emanuela Del; HERNANDEZ-RODRIGUEZ, Jose; BARTOLONI, Elena; EMMI, Giacomo; CHIMENTI, Maria Sole; MAIER, Armin; SIMONINI, Gabriele; CONTI, Giovanni; OLIVIERI, Alma Nunzia; TARSIA, Maria; PAULIS, Amato De; GULLO, Alberto Lo; WIESIK-SZEWCZYK, Ewa; VIAPIANA, Ombretta; OGUNJIMI, Benson; THARWAT, Samar; ERTEN, Sukran; NUZZOLESE, Rossana; KARAMANAKOS, Anastasios; FRASSI, Micol; CONFORTI, Alessandro; CAGGIANO, Valeria; MARINO, Achille; SEBASTIANI, Gian Domenico; GIDARO, Antonio; TOMBETTI, Enrico; CARUBBI, Francesco; RUBEGNI, Giovanni; CARTOCCI, Alessandra; BALISTRERI, Alberto; FABIANI, Claudia; FREDIANI, Bruno; CANTARINI, Luca
  • article 1 Citação(ões) na Scopus
    Clinical and laboratory features associated with macrophage activation syndrome in Still's disease: data from the international AIDA Network Still's Disease Registry
    (2023) TRIGGIANESE, Paola; VITALE, Antonio; LOPALCO, Giuseppe; GIARDINI, Henrique Ayres Mayrink; CICCIA, Francesco; AL-MAGHLOUTH, Ibrahim; RUSCITTI, Piero; SFIKAKIS, Petros Paul; IANNONE, Florenzo; ANTONELLI, Isabele Parente de Brito; PATRONE, Martina; ASFINA, Kazi Nur; COLA, Ilenia Di; LASKARI, Katerina; GAGGIANO, Carla; TUFAN, Abdurrahman; SFRISO, Paolo; DAGNA, Lorenzo; GIACOMELLI, Roberto; HINOJOSA-AZAOLA, Andrea; RAGAB, Gaafar; FOTIS, Lampros; DIRESKENELI, Haner; SPEDICATO, Veronica; DAGOSTIN, Marilia Ambiel; IACONO, Daniela; ALI, Hebatallah Hamed; CIPRIANI, Paola; SOTA, Jurgen; KARDAS, Riza Can; BINDOLI, Sara; CAMPOCHIARO, Corrado; NAVARINI, Luca; GENTILESCHI, Stefano; MARTIN-NARES, Eduardo; TORRES-RUIZ, Jiram; SAAD, Moustafa Ali; KOURTESI, Katerina; ALIBAZ-ONER, Fatma; SEVIK, Gizem; IAGNOCCO, Annamaria; MAKOWSKA, Joanna; GOVONI, Marcello; MONTI, Sara; MAGGIO, Maria Cristina; TORRE, Francesco La; GIUDICE, Emanuela Del; HERNANDEZ-RODRIGUEZ, Jose; BARTOLONI, Elena; EMMI, Giacomo; CHIMENTI, Maria Sole; MAIER, Armin; SIMONINI, Gabriele; CONTI, Giovanni; OLIVIERI, Alma Nunzia; TARSIA, Maria; PAULIS, Amato De; GULLO, Alberto Lo; WIESIK-SZEWCZYK, Ewa; VIAPIANA, Ombretta; OGUNJIMI, Benson; THARWAT, Samar; ERTEN, Sukran; NUZZOLESE, Rossana; KARAMANAKOS, Anastasios; FRASSI, Micol; CONFORTI, Alessandro; CAGGIANO, Valeria; MARINO, Achille; SEBASTIANI, Gian Domenico; GIDARO, Antonio; TOMBETTI, Enrico; CARUBBI, Francesco; RUBEGNI, Giovanni; CARTOCCI, Alessandra; BALISTRERI, Alberto; FABIANI, Claudia; FREDIANI, Bruno; CANTARINI, Luca
    To characterize clinical and laboratory signs of patients with Still's disease experiencing macrophage activation syndrome (MAS) and identify factors associated with MAS development. Patients with Still's disease classified according to internationally accepted criteria were enrolled in the AutoInflammatory Disease Alliance (AIDA) Still's Disease Registry. Clinical and laboratory features observed during the inflammatory attack complicated by MAS were included in univariate and multivariate logistic regression analysis to identify factors associated to MAS development. A total of 414 patients with Still's disease were included; 39 (9.4%) of them developed MAS during clinical history. At univariate analyses, the following variables were significantly associated with MAS: classification of arthritis based on the number of joints involved (p = 0.003), liver involvement (p = 0.04), hepatomegaly (p = 0.02), hepatic failure (p = 0.01), axillary lymphadenopathy (p = 0.04), pneumonia (p = 0.03), acute respiratory distress syndrome (p < 0.001), platelet abnormalities (p < 0.001), high serum ferritin levels (p = 0.009), abnormal liver function tests (p = 0.009), hypoalbuminemia (p = 0.002), increased LDH (p = 0.001), and LDH serum levels (p < 0.001). At multivariate analysis, hepatomegaly (OR 8.7, 95% CI 1.9-52.6, p = 0.007) and monoarthritis (OR 15.8, 95% CI 2.9-97.1, p = 0.001), were directly associated with MAS, while the decade of life at Still's disease onset (OR 0.6, 95% CI 0.4-0.9, p = 0.045), a normal platelet count (OR 0.1, 95% CI 0.01-0.8, p = 0.034) or thrombocytosis (OR 0.01, 95% CI 0.0-0.2, p = 0.008) resulted to be protective. Clinical and laboratory factors associated with MAS development have been identified in a large cohort of patients based on real-life data.
  • article 71 Citação(ões) na Scopus
    2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria
    (2023) BARBHAIYA, Medha; ZUILY, Stephane; NADEN, Ray; HENDRY, Alison; MANNEVILLE, Florian; AMIGO, Mary-Carmen; AMOURA, Zahir; ANDRADE, Danieli; ANDREOLI, Laura; ARTIM-ESEN, Bahar; ATSUMI, Tatsuya; AVCIN, Tadej; BELMONT, Michael H.; BERTOLACCINI, Maria Laura; BRANCH, D. Ware; CARVALHEIRAS, Graziela; CASINI, Alessandro; CERVERA, Ricard; COHEN, Hannah; COSTEDOAT-CHALUMEAU, Nathalie; CROWTHER, Mark; JESUS, Guilherme de; DELLUC, Aurelien; DESAI, Sheetal; SANCHO, Maria De; DEVREESE, Katrien M.; DIZ-KUCUKKAYA, Reyhan; DUARTE-GARCIA, Ali; FRANCES, Camille; GARCIA, David; GRIS, Jean-Christophe; JORDAN, Natasha; LEAF, Rebecca K.; KELLO, Nina; KNIGHT, Jason S.; LASKIN, Carl; I, Alfred Lee; LEGAULT, Kimberly; LEVINE, Steve R.; LEVY, Roger A.; LIMPER, Maarten; LOCKSHIN, Michael D.; MAYER-PICKEL, Karoline; MUSIAL, Jack; MERONI, Pier Luigi; ORSOLINI, Giovanni; ORTEL, Thomas L.; PENGO, Vittorio; PETRI, Michelle; PONS-ESTEL, Guillermo; GOMEZ-PUERTA, Jose A.; RAIMBOUG, Quentin; ROUBEY, Robert; SANNA, Giovanni; SESHAN, Surya V.; SCIASCIA, Savino; TEKTONIDOU, Maria G.; TINCANI, Angela; WAHL, Denis; WILLIS, Rohan; YELNIK, Cecile; ZUILY, Catherine; GUILLEMIN, Francis; COSTENBADER, Karen; ERKAN, Doruk
    Objective. To develop new antiphospholipid syndrome (APS) classification criteria with high specificity for use in observational studies and trials, jointly supported by the American College of Rheumatology (ACR) and EULAR. Methods. This international multidisciplinary initiative included 4 phases: 1) Phase I, criteria generation by surveys and literature review; 2) Phase II, criteria reduction bymodified Delphi and nominal group technique exercises; 3) Phase III, criteria definition, further reduction with the guidance of real-world patient scenarios, and weighting via consensus-basedmulticriteria decision analysis, and threshold identification; and 4) Phase IV, validation using independent adjudicators' consensus as the gold standard. Results. The 2023 ACR/EULAR APS classification criteria include an entry criterion of at least one positive antiphospholipid antibody(aPL) test within 3 years of identification of an aPL-associated clinical criterion, followedbyadditiveweightedcriteria (score range 1-7 points each) clustered into 6 clinical domains (macrovascular venous thromboembolism, macrovascular arterial thrombosis, microvascular, obstetric, cardiac valve, and hematologic) and 2 laboratory domains (lupus anticoagulant functional coagulation assays, and solid-phase enzyme-linked immunosorbent assays for IgG/IgM anticardiolipin and/or IgG/IgM anti-beta(2)-glycoprotein I antibodies). Patients accumulating at least 3 points each from the clinical and laboratory domains are classified as having APS. In the validation cohort, the new APS criteria versus the 2006 revised Sapporo classification criteria had a specificity of 99% versus 86%, and a sensitivity of 84% versus 99%. Conclusion. These new ACR/EULAR APS classification criteria were developed using rigorous methodology with multidisciplinary international input. Hierarchically clustered, weighted, and risk-stratified criteria reflect the current thinking about APS, providing high specificity and a strong foundation for future APS research.
  • article 4 Citação(ões) na Scopus
    Damage measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in antiphospholipid antibody-positive patients included in the APS ACTION registry
    (2024) BALBI, Gustavo G. M.; AHMADZADEH, Yasaman; TEKTONIDOU, Maria G.; PENGO, Vittorio; SCIASCIA, Savino; UGARTE, Amaia; BELMONT, H. Michael; LOPEZ-PEDRERA, Chary; FORTIN, Paul R.; WAHL, Denis; GEROSA, Maria; JESUS, Guilherme R. de; JI, Lanlan; ATSUMI, Tatsuya; EFTHYMIOU, Maria; BRANCH, D. Ware; NALLI, Cecilia; ALMARAZ, Esther Rodriguez; PETRI, Michelle; CERVERA, Ricard; KNIGHT, Jason S.; ARTIM-ESEN, Bahar; WILLIS, Rohan; BERTOLACCINI, Maria Laura; COHEN, Hannah; ROUBEY, Robert; ERKAN, Doruk; ANDRADE, Danieli Castro Oliveira de
    Objectives Our primary objective was to quantify damage burden measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in aPL-positive patients with or without a history of thrombosis in an international cohort (the APS ACTION cohort). Secondly, we aimed to identify clinical and laboratory characteristics associated with damage in aPL-positive patients. Methods In this cross-sectional study, we analysed the baseline damage in aPL-positive patients with or without APS classification. We excluded patients with other autoimmune diseases. We analysed the demographic, clinical and laboratory characteristics based on two subgroups: (i) thrombotic APS patients with high vs low damage; and (ii) non-thrombotic aPL-positive patients with vs without damage. Results Of the 826 aPL-positive patients included in the registry as of April 2020, 586 with no other systemic autoimmune diseases were included in the analysis (412 thrombotic and 174 non-thrombotic). In the thrombotic group, hyperlipidaemia (odds ratio [OR] 1.82; 95% CI 1.05, 3.15; adjusted P = 0.032), obesity (OR 2.14; 95% CI 1.23, 3.71; adjusted P = 0.007), a & beta;(2)GPI high titres (OR 2.33; 95% CI 1.36, 4.02; adjusted P = 0.002) and corticosteroid use (ever) (OR 3.73; 95% CI 1.80, 7.75; adjusted P < 0.001) were independently associated with high damage at baseline. In the non-thrombotic group, hypertension (OR 4.55; 95% CI 1.82, 11.35; adjusted P = 0.001) and hyperlipidaemia (OR 4.32; 95% CI 1.37, 13.65; adjusted P = 0.013) were independent predictors of damage at baseline; conversely, single aPL positivity was inversely correlated with damage (OR 0.24; 95% CI 0.075, 0.77; adjusted P = 0.016). Conclusions DIAPS indicates substantial damage in aPL-positive patients in the APS ACTION cohort. Selected traditional cardiovascular risk factors, steroids use and specific aPL profiles may help to identify patients more prone to present with a higher damage burden.
  • article 2 Citação(ões) na Scopus
    Assessing disease activity and damage in antiphospholipid syndrome
    (2023) ANDRADE, Danieli; TEKTONIDOU, Maria G.
    Antiphospholipid syndrome (APS) has been characterized by a variety of vascular and pregnancy manifestations related to an interplay between thrombotic and inflammatory mechanisms, a progressive accrual of irreversible organ damage and increased morbidity and mortality rates, supporting a high need of optimal treatment approach. The lack of standardized outcome measures is a significant barrier in the design of clinical studies in APS. Disease activity (in principle reversible) and its distinction from disease damage (in principle irreversible) needs to be evaluated by validated scores for use in clinical trials but also in daily clinical practice in APS. A disease damage score in APS, the DIAPS score, has been developed and validated in external cohorts. The development of a disease activity score that will provide an accurate and reproducible rating of each disease domain, can help clinicians and researchers to comprehensively assess the activity of disease and the response to treatment, in an attempt to prevent future damage.
  • article 1 Citação(ões) na Scopus
    Association between ultra-processed food and flavonoid intakes in a nationally representative sample of the US population
    (2024) LEITAO, Alice Erwig; ROSCHEL, Hamilton; OLIVEIRA-JUNIOR, Gersiel; GENARIO, Rafael; FRANCO, Tathiane; MONTEIRO, Carlos Augusto; MARTINEZ-STEELE, Euridice
    Consumption of ultra-processed food (UPF) has been associated with several chronic diseases and poor diet quality. It is reasonable to speculate that the consumption of UPF negatively associates with flavonoid dietary intake; however, this assumption has not been previously examined. The present study aims to assess association between the dietary contribution of UPF and flavonoid intake in the US population aged 0 years and above. We performed a cross-sectional analysis of dietary data collected by 24-h recalls from 7640 participants participating in the National Health and Nutrition Examination Survey 2017-2018. Foods were classified according to the Nova classification system. The updated US Department of Agriculture (USDA) Database for the Flavonoid Content of Selected Foods (Release 3.3) database was used to estimate total and six classes of flavonoid intakes. Flavonoid intakes were compared across quintiles of dietary contribution of UPF (% of total energy intake) using linear regression models. The total and five out of six class flavonoid intakes decreased between 50 and 70 % across extreme quintiles of the dietary contribution of UPF (P- for linear trend < 0 center dot 001); only isoflavones increased by over 260 %. Our findings suggest that consumption of UPF is associated with lower total and five of six class flavonoid intakes and with higher isoflavone intakes, supporting previous evidence of the negative impact of UPF consumption on the overall quality of the diet and health outcomes.
  • article 0 Citação(ões) na Scopus
    Lyme disease and Whipple's disease: a comprehensive review for the rheumatologist
    (2024) GIARDINI, Henrique Ayres Mayrink; NEVES, Fabricio Souza; PEREIRA, Ivanio Alves; CORDEIRO, Rafael Alves
    Despite their rarity, Lyme disease and Whipple's disease are of significant importance in rheumatology, as both can manifest as chronic arthritis, presenting challenges in the differential diagnosis of inflammatory arthropathies. In Lyme disease, arthritis typically emerges as a late manifestation, usually occurring six months after the onset of erythema migrans. The predominant presentation involves mono- or oligoarthritis of large joints, with a chronic or remitting-recurrent course. Even with appropriate antimicrobial treatment, arthritis may persist due to inadequate immunological control triggered by the disease. In contrast, Whipple's disease may present with a migratory and intermittent seronegative poly- or oligoarthritis of large joints, preceding classic gastrointestinal symptoms by several years. Both disorders, particularly Whipple's disease, can be misdiagnosed as more common autoimmune rheumatic conditions such as rheumatoid arthritis and spondyloarthritis. Epidemiology is crucial in suspecting and diagnosing Lyme disease, as the condition is transmitted by ticks prevalent in specific areas of the United States, Europe, and Asia. On the contrary, the causative agent of Whipple's disease is widespread in the environment, yet invasive disease is rare and likely dependent on host genetic factors. In addition to erythema migrans in Lyme disease and gastrointestinal manifestations in Whipple's disease, neurological and cardiac involvement can further complicate the course of both. This article offers a comprehensive review of the epidemiological, pathophysiological, clinical, and therapeutic aspects of both diseases.
  • article 0 Citação(ões) na Scopus
    What should rheumatologists know about Gaucher disease and Fabry disease? Connecting the dots for an overview
    (2024) CORDEIRO, Rafael Alves; ROSA NETO, Nilton Salles; GIARDINI, Henrique Ayres Mayrink
    Gaucher and Fabry diseases are lysosomal storage disorders in which deficient enzyme activity leads to pathological accumulation of sphingolipids. These diseases have a broad phenotypic presentation. Musculoskeletal symptoms and pain complaints are frequently reported by patients. Thus, rheumatologists can be contacted by these patients, contributing to the correct diagnosis, earlier indication of appropriate treatment and improvement of their prognosis. This review describes important concepts about Gaucher and Fabry diseases that rheumatologists should understand to improve patients' quality of life and change the natural history of these diseases.
  • article 0 Citação(ões) na Scopus
    How Cool is That? The Effects of Menthol Mouth Rinsing on Exercise Capacity and Performance: A Systematic Review and Meta-analysis
    (2024) GAVEL, Erica H.; BARRETO, Gabriel; HAWKE, Kierstyn V.; STELLINGWERFF, Trent; JAMES, Lewis J.; SAUNDERS, Bryan; LOGAN-SPRENGER, Heather M.
    Background Menthol (MEN) mouth rinsing (MR) has gained considerable interest in the athletic population for exercise performance; however, the overall magnitude of effect is unknown. Objective The aim of this systematic review and meta-analysis was to determine the efficacy of menthol MEN MR and the impact it has on exercise capacity and performance. Methods Three databases were searched with articles screened according to the inclusion/exclusion criteria. Three-level meta-analyses were used to investigate the overall efficacy of MEN MR and the impact it has on exercise capacity and performance. Meta-regressions were then performed with 1) mean VO2(peak), 2) MEN swilling duration; 3) the MEN concentration of MR solution, 4) the number of executed swills throughout a single experiment, 5) the use of flavoured sweetened, non-caloric, or non-flavoured neutral solutions as controls, 6) mean environmental temperature at the time of exercise tests, and 7) exercise type as fixed factors to evaluate their influence on the effects of MEN MR. Results Ten MEN MR studies included sufficient information pertaining to MEN MR and exercise performance and capacity. MR with MEN resulted in no significant change in capacity and performance (SMD = 0.12; 95% CI - 0.08, 0.31; p = 0.23, n = 1, tau(2)1 < 0.0001, tau(2)2 = < 0.0001, I-2 = 0%). No significant influence was detected in meta-regressions for VO2(peak), (estimate: 0.03; df = 8; 95% CI - 0.03, 0.09; p = 0.27), swilling duration (5 vs. 10 s: 0.00; df = 16; 95% CI - 0.41, 0.41; p = 1.0), MEN concentration (low [0.01%] vs. high [0.1%]: - 0.08; df = 15; 95% CI - 0.49, 0.32; p = 0.67), number of swills (estimate: 0.02; df = 13; 95% CI - 0.05, 0.09; p = 0.56), the use of flavoured sweetener or non-caloric as control (non-flavoured vs. flavoured: 0.12; df = 16; 95% CI - 0.30, 0.55; p = 0.55) or mean room temperature during exercise tests (estimate: 0.01; df = 16; 95% CI - 0.02, 0.04; p = 0.62). Conclusion MEN MR did not significantly improve overall exercise capacity and performance, though those involved in endurance exercise may see benefits.
  • article 1 Citação(ões) na Scopus
    Use of Buffers in Specific Contexts: Highly Trained Female Athletes, Extreme Environments and Combined Buffering Agents-A Narrative Review
    (2023) CARR, Amelia J.; MCKAY, Alannah K. A.; BURKE, Louise M.; SMITH, Ella S.; URWIN, Charles S.; CONVIT, Lilia; JARDINE, William T.; KELLY, Monica K.; SAUNDERS, Bryan
    This narrative review evaluated the evidence for buffering agents (sodium bicarbonate, sodium citrate and beta-alanine), with specific consideration of three discrete scenarios: female athletes, extreme environments and combined buffering agents. Studies were screened according to exclusion and inclusion criteria and were analysed on three levels: (1) moderating variables (supplement dose and timing, and exercise test duration and intensity), (2) design factors (e.g., use of crossover or matched group study design, familiarisation trials) and (3) athlete-specific factors (recruitment of highly trained participants, buffering capacity and reported performance improvements). Only 19% of the included studies for the three buffering agents reported a performance benefit, and only 10% recruited highly trained athletes. This low transferability of research findings to athletes' real-world practices may be due to factors including the small number of sodium citrate studies in females (n = 2), no studies controlling for the menstrual cycle (MC) or menstrual status using methods described in recently established frameworks, and the limited number of beta-alanine studies using performance tests replicating real-world performance efforts (n = 3). We recommend further research into buffering agents in highly trained female athletes that control or account for the MC, studies that replicate the demands of athletes' heat and altitude camps, and investigations of highly trained athletes' use of combined buffering agents. In a practical context, we recommend developing evidence-based buffering protocols for individual athletes which feature co-supplementation with other evidence-based products, reduce the likelihood of side-effects, and optimise key moderating factors: supplement dose and timing, and exercise duration and intensity.
  • article 1 Citação(ões) na Scopus
    Does sodium bicarbonate based extra-cellular buffering support reduce high intensity exercise-induced fatigue and enhance short-term recovery assessed by selected blood biochemical indices?
    (2024) DURKALEC-MICHALSKI, Krzysztof; KAMINSKA, Joanna; SAUNDERS, Bryan; POKRYWKA, Andrzej; LONIEWSKI, Igor; STEFFL, Michal; PODGORSKI, Tomasz
    Exercise-induced metabolic processes induce muscle acidification which contributes to a reduction in the ability to perform repeated efforts. Alkalizing agents such as sodium bicarbonate (NaHCO3) prevent large blood pH changes, however, there is no evidence on whether regulation of acid-base balance may also support whole body homeostasis monitored through heamatological and biochemical blood markers in a dose-dependent manner. Thirty Cross-Fit-trained participants were studied in a randomized, multi cross-over, placebo (PLA)controlled double-blind manner in which they performed a control session (CTRL, without supplementation), three NaHCO3 visits (three different doses) and PLA (sodium chloride in an equimolar amount of sodium as NaHCO3). Each visit consisted of two 30-s Wingate tests separated by CrossFit-specific benchmarks (Wall Balls and Burpees - both performed for 3 min). Blood samples were collected at rest, immediately post-exercise and after 45 min recovery. Significant differences between visits appeared for blood pH, percentage of lymphocytes and granulocytes, red blood cells count and haemoglobin concentration at post-exercise and 45-min recovery, and for white blood cells count, percentage of monocytes, concentration of magnesium and creatinine at 45-min recovery. Most of the observed differences for heamatological and biochemical markers were significant compared to CTRL, but not different after PLA. NaHCO3 supplementation compared to PLA did not significantly affect exercise or recovery shifts in studied blood indicators. However, the changes in these markers after NaHCO3 and PLA in relation to CTRL indicate a possible role of sodium.
  • article 1 Citação(ões) na Scopus
    Proceedings of the GRAPPA 2022 Executive Retreat
    (2023) NG, Beverly Cheok Kuan; JADON, Deepak; ADEBAJO, Adewale; AYAN, Gizem; DUFFIN, Kristina Callis; CHANDRAN, Vinod; COATES, Laura C.; D'AGOSTINO, Maria Antonietta; VLAM, Kurt de; DEODHAR, Atul; EDER, Lihi; GARG, Amit; GLADMAN, Dafna D.; GOEL, Niti; GOTTLIEB, Alice B.; HUSNI, M. Elaine; KATZ, Arnon; KAVANAUGH, Arthur; LUBRANO, Ennio; MEASE, Philip J.; MEROLA, Joseph F.; NASH, Peter; OGDIE, Alexis; PENNINGTON, Stephen R.; PEREZ-CHADA, Lourdes M.; PROFT, Fabian; ROSEN, Cheryl F.; SAVAGE, Laura; GOLDENSTEIN-SCHAINBERG, Claudia; SIEBERT, Stefan; SORIANO, Enrique R.; STEINKOENIG, Ingrid; TILLETT, William; ARMSTRONG, April W.; FITZGERALD, Oliver
    The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) leadership congregated for a strategic planning meeting before the 2022 GRAPPA annual meeting in New York, USA. Meeting aims were to review GRAPPA's performance in relation to its 2016 goals and identify successes and areas for further improvement, identify key GRAPPA priorities and activities for the next 5 years, and explore committee structures to best support these aims.
  • article 0 Citação(ões) na Scopus
    Can Muscular Parameters Predict Symptoms of Anxiety and Depression?
    (2024) TANAKA, Gabriella Mayumi; NEVES, Lucas Melo; GONCALVES, Cristiane Maria; RASQUINHO, Guilherme Araujo; REIMBERG, Thais; OLIVEIRA, Rosemeire de; LIMA, Anderson Fortunato de; GIL, Saulo
    Major depressive disorder and anxiety disorders are among the major public health issues. Therefore, identifying predictors of symptoms of depression and anxiety holds fundamental importance to avoid the aggravation of these conditions. Muscle strength and function (e.g., handgrip strength and timed-stands test) are widely recognized predictors of health outcomes; however, their association with symptoms of depression and anxiety is still not completely understood. This study investigated the associations between handgrip strength and timed-stands test scores with symptoms of depression and anxiety. In addition, we examined whether individuals exhibiting greater strength levels demonstrate reduced symptoms of anxiety and depression compared to those with lower levels of strength. This is a community-based, cross-sectional study. Participants were recruited through social media and underwent a semi-structured interview to record sociodemographic characteristics, comorbidities, use of tobacco and medication, and symptoms of anxiety (Beck's Anxiety Inventory [BAI]) and depression (Beck's Depressive Inventory [BDI]). Subsequently, anthropometric characteristics, handgrip strength, and functionality (i.e., timed-stands test) were assessed. In all, 216 individuals were evaluated. The adjusted regression model showed an inverse association between handgrip strength and anxiety (beta = -0.22; 95% CI [-0.38, -0.07]; R2 = 0.07, p = .005) and depression symptoms (beta = -0.25; 95% CI [-0.42, -0.07]; R2 = 0.05, p = .006). Similarly, timed-stands test scores were associated with anxiety (beta = -0.33; 95% CI [-0.54, -0.13]; R2 = 0.09, p = .002) and depression (beta = -0.32; 95% CI [-0.56, -0.09]; R2 = 0.06, p = .008). Furthermore, the low-strength group showed higher values on the BAI (9.5 vs. 5.9 arbitrary units; p = .0008) and BDI than the high-strength group (10.8 vs. 7.9 arbitrary units; p = .0214). When individuals were stratified by the timed-stands test, the low timed-stands group demonstrated higher values on the BAI (9.9 vs. 5.5 arbitrary units; p = .0030) and BDI than the high timed-stands group (11.2 vs. 7.5 arbitrary units; p < .0001). The results highlight muscular parameters as significant predictors associated with anxiety and depression symptoms.
  • article 0 Citação(ões) na Scopus
    Impact of methyl-donor micronutrient supplementation on DNA methylation patterns: A systematic review and meta-analysis of in vitro, animal and human studies
    (2023) MOTA, Jhulia Caroline da; RIBEIRO, Amanda A.; CARVALHO, Lucas M.; ESTEVES, Gabriel P.; SIECZKOWSKA, Sofia M.; GOESSLER, Karla F.; GUALANO, Bruno; NICOLETTI, Carolina F.
    Background: DNA methylation patterns are directly associated with diverse metabolic disorders. The status of methyl-donor micronutrients has been associated with DNA methylation levels, and altered ingestion of folate, choline, betaine, B vitamins and methionine may impact genes both globally and at the level of promoter regions. Despite this, the role of methyl-donor micronutrient supplementation on DNA methylation profiles is currently unclear. Objectives: The aims of this systematic review and meta-analysis were to identify and synthesize the evidence about methyl-donor nutrients supplementation on DNA methylation profile. Methods: A systematic literature search was performed in MEDLINE, EMBASE, SCOPUS and Web of Sciences databases with a combination of terms related to DNA methylation assessment, supplementation and methyl-donor nutrients. Studies (in vitro, animal models or human clinical trials) were included if DNA methylation levels after any kind of methyl-donor micronutrient supplementation or treatment was investigated. Studies were assessed for bias using Revised Cochrane risk-of-bias tool for randomized trials, Risk Of Bias in Non-randomized Studies of Interventions or Systematic Review Centre for Laboratory Animal Experimentation tools. Data was extracted from studies measuring DNA methylation level in any sample or tissue, following any kind of methyl-donor micronutrient supplementation or treatment. Separate random-effects meta-analyses were performed for animal model studies and human clinical trials, which examined the effects of folic acid supplementation on DNA methylation. Results: Fifty-seven studies were included in the systematic review: 18 human clinical trials, 35 in animal model and 4 in vitro studies. Concerning overall risk of bias, most of the studies were classified as ""high risk"" or ""some concerns"". Meta-analysis with meta-regression from studies in animal models showed that folic acid dose significantly affected DNA methylation and that high and very high dose showed increases in DNA methylation when compared to low doses. However, meta-analysis from human clinical trials showed that folic acid supplementation did not promote significant changes in DNA methylation when compared to placebo. Conclusion: Folic acid supplementation may change global DNA methylation levels in animals supplemented with high, as compared to low, doses. Heterogeneity in studies and supplementation protocols make it difficult to establish clinical recommendations. However, these effects, even if small, might be of clinical importance in the management of patients with diseases related to DNA hypomethylation.
  • article 1 Citação(ões) na Scopus
    Caffeine, CYP1A2 Genotype, and Exercise Performance: A Systematic Review and Meta-analysis
    (2024) BARRETO, Gabriel; ESTEVES, Gabriel p.; MARTICORENA, Felipe; OLIVEIRA, Tamires n.; GRGIC, Jozo; SAUNDERS, Bryan
    Purpose: This study aimed to summarize and meta-analyze existing evidence regarding the influence of CYP1A2 genotypes on the acute effects of caffeine for exercise performance and to investigate the interaction between genotype, dosage, and timing of caffeine supplementation. Methods: Six databases were searched for studies determining the effect of caffeine (except mouth rinsing) on exercise performance between CYP1A2 genotypes. Three-level meta-analyses were performed using standardized mean differences (SMD; Hedge's g ) to determine the effect of caffeine on exercise outcomes within and between CYP1A2 genotypes (AA, AC, and CC). Meta-regressions were performed for dose, timing, and presence of reported conflict of interests (RCOI). A meta-analysis was also performed with placebo values to assess for imbalances between genotypes. Results: Thirteen studies, totaling 119 outcomes and 440 participants, were included (233 AA, 175 AC, ad 34 CC). Caffeine improved performance for AA (SMD = 0.30, 95% confidence interval [CI] = 0.21-0.39, P < 0.0001) and AC (SMD = 0.16, 95% CI = 0.06-0.25, P = 0.022) but worsened performance for CC (SMD = -0.22, 95% CI = -0.44 to -0.01, P < 0.0001). Dose affected only CC, with greater doses generating more positive SMD (CC-dose estimate: +0.19/1 mgkg -1 body mass, 95% CI = 0.04-0.33, P = 0.01). Timing influenced only CC, with better performance with later onset of exercise after supplementation (CC-timing estimate: +0.01/min, 95% CI = 0.00-0.02, P = 0.02). RCOI only affected SMD of CC (CC-RCOI estimate: -0.57, 95% CI = -1.02 to -0.12, P = 0.01). After excluding studies with RCOI, no influence of genotype was seen (all P >= 0.19). Small, nonsignificant differences were seen in placebo between genotypes (SMD AA vs CC: -0.13; AA vs AC: -0.12; AC vs CC: -0.05; all P >= 0.26). Conclusions: Caffeine improved performance for AA and AC but worsened performance for CC. Dose and timing moderated the efficacy of caffeine for CC only. Caution is advised because baseline differences and studies with RCOI could have influenced these results.
  • article 4 Citação(ões) na Scopus
    Energy constraint and compensation: Insights from endurance athletes
    (2023) DOLAN, Eimear; KOEHLER, Karsten; ARETA, Jose; LONGMAN, Daniel P.; PONTZER, Herman
    The Constrained Model of Total Energy Expenditure predicts that increased physical activity may not influence total energy expenditure, but instead, induces compensatory energetic savings in other processes. Much remains unknown, however, about concepts of energy expenditure, constraint and compensation in different populations, and it is unclear whether this model applies to endurance athletes, who expend very large amounts of energy during training and competition. Furthermore, it is well-established that some endurance athletes consciously or unconsciously fail to meet their energy requirements via adequate food intake, thus exacerbating the extent of energetic stress that they experience. Within this review we A) Describe unique characteristics of endurance athletes that render them a useful model to investigate energy constraints and compensations, B) Consider the factors that may combine to constrain activity and total energy expenditure, and C) Describe compensations that occur when activity energy expenditure is high and unmet by adequate energy intake. Our main conclusions are as follows: A) Higher activity levels, as observed in endurance athletes, may indeed increase total energy expenditure, albeit to a lesser degree than may be predicted by an additive model, given that some compensation is likely to occur; B) That while a range of factors may combine to constrain sustained high activity levels, the ability to ingest, digest, absorb and deliver sufficient calories from food to the working muscle is likely the primary determinant in most situations and C) That energetic compensation that occurs in the face of high activity expenditure may be primarily driven by low energy availability i.e., the amount of energy available for all biological processes after the demands of exercise have been met, and not by activity expenditure per se.
  • article 1 Citação(ões) na Scopus
    Effect of atorvastatin on muscle tissues of dermatomyositis and antisynthetase syndrome patients with dyslipidemia
    (2024) BORGES, Isabela Bruna Pires; OBA-SHINJO, Sueli Mieko; LERARIO, Antonio Marcondes; MARIE, Suely Kazue Nagahashi; SHINJO, Samuel Katsuyuki
    Introduction: In a recent study, we have shown that atorvastatin is clinically safe for dermatomyositis (DM) and antisynthetase syndrome (ASS) patients with dyslipidemia. Herein, we showed in an unprecedented way, the safety of atorvastatin on the muscular tissues of these patients.Methods: Transcriptome analysis was performed on samples of the vastus lateralis muscle obtained at baseline and after 12 weeks of atorvastatin (20 mg/day) intervention in DM or ASS patients with dyslipidemia [6DM and 5ASS received atorvastatin, and 2DM and 3ASS received placebo]. The results were analyzed considering differences in expression fold change before and after treatment. Histological and histochemical analyses were also performed.Results: In both groups, no significant changes were observed in genes related to the mitochondrial, oxidative, insulin, lipid, and fibrogenic pathways. Histological analysis showed a slight variability in the fiber size that was preserved after the intervention. In addition, the mosaic of muscle fibers was preserved in the internal architecture of the fibers and all histological regions. No fiber necrosis or atrophy, focal failures, subsarcolemmal accumulation, lipids, areas of fibrosis, or alterations in mitochondrial activity were observed. All muscle fibers were labeled for MHC I.Conclusion: Atorvastatin did not promote significant changes in the expression of genes related to mitochondrial, oxidative, insulin, lipid, and fibrogenic pathways in the muscle tissues of DM and ASS patients with dyslipidemia. Atorvastatin did not also promote histological and histochemical changes in muscle tissues. Our results reinforce the safety of the administration of atorvastatin to treat dyslipidemia in patients with DM and ASS.
  • article 0 Citação(ões) na Scopus
    Impact of Transcranial Direct Current Stimulation in Pain, Fatigue, and Health Quality of Life of Patients with Idiopathic Inflammatory Myopathies: A Randomized, Double-Blind, Sham-Controlled Crossover Clinical Trial
    (2024) MISSE, Rafael Giovani; SANTOS, Alexandre Moura dos; BORGES, Isabela Bruna Pires; GRECCO, Marcus Vinicius; FARIA, Marlise Sitima Mendes Simoes; SILVA, Lorenza Rosa Silverio da; CORREIA, Bruna Lindoso; KIM, Ana Woo Sook; TANAKA, Clarice; GREVE, Julia Maria D'Andrea; BAPTISTA, Abrahao Fontes; SHINJO, Samuel Katsuyuki
    Objectives. To assess the effectiveness of transcranial direct current stimulation (tDCS) for pain, fatigue, physical function, and health-related quality of life in patients with idiopathic inflammatory myopathy (IIM). Methods. This randomized, double-blind, sham-controlled, crossover clinical trial enrolled IIM patients with fatigue and pain who received tDCS (20 min, 2 mA) or sham stimulation for 10 daily sessions. Electrodes were placed according to the 10/20 EEG system. Both the groups underwent aerobic exercise training during the intervention period. The patients were evaluated for disease perception, pain, and fatigue using uni-multidimensional questionnaires and physical tests in the periods before and after the first and second interventions and after 12 weeks of follow-up. Results. After the tDCS intervention, a reduction in the general score of multidimensional pain of 32.0 (1.5-38.0) vs. 0.0 (0.0-13.4) with effect size (ES) of -0.78 was noted, and after sham intervention, a reduction of 26.0 (0.0-37.0) vs. 5.0 (0.0-19.2) with ES of -0.54 (P=0.047) was also noted. Similar results were evidenced with fatigue (22.5 (15.4-33.2) vs. 5.5 (0.0-14.6) with ES of -0.82) and sham intervention (21.0 (15.8-29.5) vs. 4.0 (4.0-17.5) with ES of -0.80 (P=0.012)). There were no differences in the domains of the fatigue and pain questionnaires. Adherence was observed in 88.8% of the patients without adverse events. Conclusion. The association of tDCS with aerobic training promoted additional effects in relation to the group subjected to placebo stimulation on general pain and fatigue scores, as well as on pain intensity, without changes in the subdomains of the pain and fatigue questionnaire. This trial is registered with NCT04678635.
  • article 0 Citação(ões) na Scopus
    Data-driven, cross-disciplinary collaboration: lessons learned at the largest academic health center in Latin America during the COVID-19 pandemic
    (2024) RITTO, Ana Paula; ARAUJO, Adriana Ladeira de; CARVALHO, Carlos Roberto Ribeiro de; SOUZA, Heraldo Possolo De; FAVARETTO, Patricia Manga e Silva; SABOYA, Vivian Renata Boldrim; GARCIA, Michelle Louvaes; KULIKOWSKI, Leslie Domenici; KALLAS, Esper Georges; PEREIRA, Antonio Jose Rodrigues; COBELLO JUNIOR, Vilson; SILVA, Katia Regina; ABDALLA, Eidi Raquel Franco; SEGURADO, Aluisio Augusto Cotrim; SABINO, Ester Cerdeira; RIBEIRO JUNIOR, Ulysses; FRANCISCO, Rossana Pulcineli Vieira; MIETHKE-MORAIS, Anna; LEVIN, Anna Sara Shafferman; SAWAMURA, Marcio Valente Yamada; FERREIRA, Juliana Carvalho; SILVA, Clovis Artur; MAUAD, Thais; GOUVEIA, Nelson da Cruz; LETAIF, Leila Suemi Harima; BEGO, Marco Antonio; BATTISTELLA, Linamara Rizzo; DUARTE, Alberto Jose da Silva; SEELAENDER, Marilia Cerqueira Leite; MARCHINI, Julio; FORLENZA, Orestes Vicente; ROCHA, Vanderson Geraldo; MENDES-CORREA, Maria Cassia; COSTA, Silvia Figueiredo; CERRI, Giovanni Guido; BONFA, Eloisa Silva Dutra de Oliveira; CHAMMAS, Roger; BARROS FILHO, Tarcisio Eloy Pessoa de; BUSATTO FILHO, Geraldo
    Introduction The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency.Methods At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output.Results Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19.Discussion Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.