SAMUEL KATSUYUKI SHINJO
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
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- The aerobic capacity in patients with antisynthetase syndrome and dermatomyositis(2019) SANTOS, Alexandre Moura dos; MISSE, Rafael Giovani; BORGES, Isabela Bruna Pires; SHINJO, Samuel KatsuyukiBackground This study was aimed at evaluating the aerobic capacity of patients with antisynthetase syndrome (ASS) and dermatomyositis (DM) and analyzing possible relationships between aerobic capacity and disease status, cardiovascular diseases and their risk factors. Methods The study was a cross-sectional, single-center study that assessed the aerobic capacity of 22 women (13 with DM and 9 with ASS) who were matched by age and body mass index to 17 healthy women (control group). The aerobic capacity (oxygen uptake [VO2 peak], anaerobic threshold, respiratory compensation point and time-to-exhaustion) was evaluated using the cardiopulmonary treadmill test. Disease status was assessed using International Myositis Assessment & Clinical Studies Group (IMACS) set scores. Results The patients had low IMACS parameters that showed low or absent disease activity. The distribution of cardiovascular diseases and their risk factors was similar between the patients and the control group (P > 0.05) at the time of the analysis. The patients with DM and the control group had similar aerobic capacity. However, the patients with ASS exhibited significantly reduced aerobic capacity (relative VO2 peak, anaerobic threshold, respiratory compensation point and time to exhaustion) when compared to the control group. In addition, patients with ASS had a lower anaerobic threshold compared to the DM group. There were no significant relationships between the aerobic capacity and disease status, cardiovascular diseases and their risk factors. Conclusion In contrast to DM patients and healthy individuals, patients with stable ASS have significantly impaired aerobic capacity, which is unlikely to be totally explained by traditional cardiovascular diseases, their risk factors and disease status. Further studies are needed to corroborate our data and to clarify the cause of this reduced aerobic capacity in ASS.
conferenceObject Patient global assessment and inflammatory markers in patients with idiopathic inflammatory myopathies - a longitudinal study(2023) LODIN, K.; ESPINOSA-ORTEGAL, F.; DASTMALCHIL, M.; VENCOVSKY, J.; ANDERSSON, H.; CHINOY, H.; LILLEKER, J.; KROGH, N. Steen; SHINJO, S. Katsuyuki; MAURER, B.; GRIGER, Z.; TAVOR, Y.; CERIBELLI, A.; TORRES-RUIZ, J.; MERCADO, M. Vazquez-Del; LEONARD, D.; ERLER, A. A.; ALEXANDERSON, H.; LUNDBERG, I.- Exercise training attenuates skeletal muscle fat infiltration and improves insulin pathway of patients with immune-mediated necrotizing myopathies and dermatomyositis(2023) OLIVEIRA, Diego Sales de; BORGES, Isabela Bruna Pires; MARIE, Suely Kazue Nagahashi; LERARIO, Antonio Marcondes; OBA-SHINJO, Sueli Mieko; SHINJO, Samuel KatsuyukiObjectives: This study aims to evaluate the effects of exercise training on intramuscular lipid content and genes related to insulin pathway in patients with systemic autoimmune myopathies (SAMs). Patients and methods: Between January 2016 and May 2019, a total of seven patients with dermatomyositis (DM; 3 males, 4 females; mean age: 49.8 & PLUSMN;2.3 years; range, 43 to 54 years), six with immune mediated necrotizing myopathy (IMNM; 3 males, 3 females; mean age: 58.5 & PLUSMN;10.6 years; range, 46 to 74 years), and 10 control individuals (CTRL group; 4 males, 6 females; mean age: 48.7 & PLUSMN;3.9 years; range, 41 to 56 years) were included. The muscle biopsy before and after the intervention was performed to evaluate the intramuscular lipid content. Patients underwent a combined exercise training program for 12 weeks. Skeletal muscle gene expression was analyzed and the DM versus CTRL group, DM pre-and post-, and IMNM pre-and post-intervention were compared. Results: The DM group had a higher intramuscular lipid content in type II muscle fibers compared to the CTRL group. After the intervention, there was a reduction of lipid content in type I and II fibers in DM and IMNM group. The CTRL group showed a significantly higher expression of genes related to insulin and lipid oxidation pathways (AMPK$2, AS160, INSR, PGC1-a, PI3K, and RAB14) compared to the DM group. After exercise training, there was an increase gene expression related to insulin pathway and lipid oxidation in DM group (AMPK$2, AS160, INSR, PGC1-a, PI3K, and RAB14) and in IMNM group (AKT2, AMPK$2, RAB10, RAB14, and PGC1-a). Conclusion: Exercise training attenuated the amount of fat in type I and II muscle fibers in patients with DM and IMNM and increased gene expression related to insulin pathways and lipid oxidation in DM and IMNM. These results suggest that exercise training can improve the quality and metabolic functions of skeletal muscle in these diseases.
- Visceral adipose tissue in granulomatosis with polyangiitis: association with disease activity parameters(2021) FURLAM, Pedro L.; PEREZ, Mariana O.; FRANCO, Andre S.; CAPARBO, Valeria F.; SHINJO, Samuel K.; PEREIRA, Rosa M. R.Objective To assess the body composition (BC) of patients with granulomatosis with polyangiitis (GPA) compared to healthy controls, emphasizing visceral adipose tissue (VAT) and associated BC parameters with disease activity, the damage index, and inflammatory parameters in patients with GPA. Methods This study was conducted in 43 patients with GPA and 43 healthy controls matched by sex, age, and body mass index (BMI). BC was analyzed using dual-energy X-ray absorptiometry (DXA). The fat mass parameters evaluated were total fat mass (FM), adiposity (%), the fat mass index (FMI: fat mass/ht(2)), and VAT (g, cm(2), cm(3)). Disease activity was assessed by the Birmingham Vasculitis Activity Score (BVAS). Damage was assessed by the Vasculitis Damage Index (VDI). C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) were measured. Results Comparing patients with GPA with healthy controls, patients had a significantly greater VAT (VAT in g: 685.81 +/- 306.10 vs. 581.21 +/- 235.57, p = 0.04; VAT in cm(2): 142.23 +/- 63.48 vs. 119.84 +/- 49.54, p = 0.03; VAT in cm(3): 741.33 +/- 330.97 vs. 628.44 +/- 254.66, p = 0.04). Patients with higher VAT (>= 768 g) had an increased value of ESR (22.77 +/- 26.79 vs. 11.57 +/- 11.30 mm/1st hour, p = 0.04) and an increased value of BVAS (3.18 +/- 4.15 vs. 0.90 +/- 1.70, p = 0.01) when compared to patients with less VAT (< 768 g). Conclusion Patients with GPA have altered BC compared to healthy controls. Moreover, higher VAT was associated with disease activity and higher inflammatory markers, suggesting a relationship between GPA activity and adiposity parameters.
- Frequency and clinical relevance of anti-Mi-2 autoantibody in adult Brazilian patients with dermatomyositis(2019) CARVALHO, Maria Isabel Cardoso dos Passos; SHINJO, Samuel KatsuyukiBackground: To analyze the frequency and clinical relevance of anti-Mi-2 autoantibody in a representative sample of patients with dermatomyositis. Methods: This longitudinal inception cohort study, from 2001 to 2017, included 87 definite adult dermatomyositis. Anti-Mi-2 analysis was performed using a commercial kit. Results: Seventeen patients (19.5%) had anti-Mi-2 and 70 (80.5%) did not have this autoantibody. The following parameters were equally distributed between the patients with versus without anti-Mi-2: mean age at the disease diagnosis onset, median follow-up lime, constitutional symptoms (baseline), cutaneous cumulative lesions, dysphagia, joint and pulmonary involvement There was also no difference between the groups in relation to follow-up time, disease relapsing, treatment disease status, deaths and occurrence of neoplasia. In contrast patients with anti-Mi2 antibodies had higher frequency of elevated serum levels of muscle enzymes at disease onset (median: creatine phosphokinase 6240 [3800-9148] U/L and aldolase 60.0 [35.0-138.0] U/L), lower frequency of pulmonary involvement at disease onset (5.9%), less current glucocorticoid dose (median: 0 [0-10] mg/day), and higher frequency of disease remission during follow-up (58.8%) in comparison with patients without anti-Mi-2 autoantibody (484 [115-4880] and 12.1 [63-70.0] U/L, 40.0%, 0 [0-10] mg/day, 27.1%, respectively). Conclusion: The anti-Mi-2 autoantibody was found in one fifth of patients with dermatomyositis. This autoantibody was associated with a lower occurrence of pulmonary involvement, a higher frequency of disease in remission, and elevated levels of muscle enzymes. There was also no correlation regarding the frequency of disease relapsing or neoplasia development.
- Work situation, work ability and expectation of returning to work in patients with systemic autoimmune myopathies(2023) CORDEIRO, Rafael A.; FISCHER, Frida M.; SHINJO, Samuel K.Objectives To document the work situation, the work ability and the expectation of returning to work among adult patients with systemic autoimmune myopathies (SAMs), and to identify the factors associated with each of these outcomes. Methods Cross-sectional study. The work situation (performing paid work vs out of work) was ascertained via a structured questionnaire. For those who were working, we applied the Work Ability Index (WAI; scale 7-49); and for those who were out of work, we applied the Return-to-Work Self-Efficacy questionnaire (RTW-SE; scale 11-66). Results Of the 75 patients with SAMs included, 33 (44%) were doing paid work and 42 (56%) were out of work. The work situation was independently associated with physical function, assessed by the Health Assessment Questionnaire-Disability Index (HAQ-DI). A 1-point increase in the HAQ-DI (scale 0-3) decreased the chance of doing paid work by 66% (95% CI: 0.16, 0.74; P = 0.007). Patients performing paid work had a mean WAI of 33.5 (6.9). The following variables were associated with a decrease in the WAI score in the regression model: female sex (-5.04), diabetes (-5.94), fibromyalgia (-6.40), fatigue (-4.51) and severe anxiety (-4.59). Among those out of work, the mean RTW-SE was 42.8 (12.4). Cutaneous manifestations and >12 years of education were associated with an average increase of 10.57 and 10.9 points, respectively, in the RTW-SE. A 1-point increase in the HAQ-DI decreased the RTW-SE by 4.69 points. Conclusion Our findings highlight the poor work participation in a well-characterized sample of working-age patients with SAMs. Strategies to improve work-related outcomes in these patients are urgently needed.
- Diagnosis and treatment of interstitial lung disease related to systemic autoimmune myopathies: a narrative review(2023) SOUZA, F. H. C. de; ARAUJO, D. B. de; HOFF, L. S.; BALDI, B. G.; FARIA, M. S. M. S.; ROCHA JUNIOR, L. F. da; SILVA, L. R. S. Da; PINTO, Behrens; BEZERRA, M. C.; MIOSSI, R.; CORDEIRO, R. A.; SHINJO, S. K.Systemic autoimmune myopathies (SAMs) are rare diseases that lead to muscle inflammation and may be associated with a variety of systemic manifestations. Although there is great heterogeneity in the spectrum of extra-muscular involvement in SAMs, interstitial lung disease (ILD) is the most frequent lung manifestation. SAM-related ILD (SAM-ILD) presents significant variations according to geographic location and temporal trends and is associated with increased morbidity and mortality. Several myositis autoantibodies have been discovered over the last decades, including antibodies targeting aminoacyl-tRNA synthetase enzymes, which are associated with a variable risk of developing ILD and a myriad of other clinical features. In this review, the most relevant topics regarding clinical manifestations, risk factors, diagnostic tests, autoantibodies, treatment, and prognosis of SAM-ILD are highlighted. We searched PubMed for relevant articles published in English, Portuguese, or Spanish from January 2002 to September 2022. The most common SAM-ILD patterns are nonspecific interstitial pneumonia and organizing pneumonia. The combination of clinical, functional, laboratory, and tomographic features is usually sufficient for diagnostic confirmation, without the need for additional invasive methods. Glucocorticoids remain the first-line treatment for SAM-ILD, although other traditional immunosuppressants, such as azathioprine, mycophenolate, and cyclophosphamide have demonstrated some efficacy and, therefore, have an important role as steroid-sparing agents.
conferenceObject Immunogenicity and Safety of an Inactivated Virus Vaccine Against SARS-CoV-2 in Patients with Autoimmune Rheumatic Diseases(2021) MEDEIROS-RIBEIRO, Ana; AIKAWA, Nadia; SAAD, Carla Goncalves Schahin; YUKI, Emily Figueiredo Vieira Neves; PEDROSA, Tatiana do Nascimento; FUSCO, Solange; ROJO, Priscila; PEREIRA, Rosa; SHINJO, Samuel; ANDRADE, Danieli; SAMPAIO-BARROS, Percival; RIBEIRO, Carolina; DEVEZA, Giordano; MARTINS, Victor Adriano de Oliveira; SILVA, Clovis Artur; LOPES, Marta; DUARTE, Alberto; ANTONANGELO, Leila; SABINO, Ester; KALLAS, Esper; PASOTO, Sandra Gofinet; BONFA, EloisabookPart Doenças inflamatórias musculares(2014) SOUZA, Fernando Henrique Carlos de; SHINJO, Samuel Katsuyuki- Camptocormia secondary to polymyositis(2013) MATTAR, Melina Andrade; GORDO, Joara Martins da Silva; HALPERN, Ari Stiel Radu; SHINJO, Samuel KatsuyukiCamptocormia is a postural affliction characterised by abnormal flexion of the thoracolumbar spine, which appears upon standing, increases with walking, and disappears in the supine position. Only five cases of camptocormia secondary to idiopathic inflammatory myopathies have been described in the literature. In this case report, we describe the case of a male patient 67 years of age who suffered from polymyositis for 18 years, which was associated with manifestations compatible with camptocormia. The clinical manifestations were stable and did not progress. Polymyositis is an idiopathic inflammatory myopathy clinically characterised by symmetric weakness that predominantly affects the proximal muscles. Nevertheless, polymyositis is a systemic autoimmune disease; therefore, the skeletal muscles may be diffusely affected, including the paravertebral muscles, which may manifest as camptocormia.