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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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.
- 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 IDENTIFYING DETERMINANTS OF FAVOURABLE AND POOR PHYSICAL FUNCTION IN SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS FROM AN INTERNATIONAL COLLABORATIVE STUDY(2023) LEE, S. Y.; HOLLOWAY, A.; NIKIPHOROU, E.; PARODIS, I.; RAVICHANDRAN, N.; DAY, J.; JOSHI, M.; SAHA, S.; JAGTAP, K.; KATCHAMART, W.; GOO, P. A.; VAIDYA, B.; VELIKOVA, T.; SEN, P.; SHINJO, S. Katsuyuki; AGARWAL, V.; TAN, A. L.; ZIADE, N.; MILCHERT, M.; GRACIA-RAMOS, A. E.; CABALLERO, C. Vinicio; CHINOY, H.; AGARWAL, V.; AGGARWAL, R.; GUPTA, L.; WINCUP, C.article Transcranial direct current stimulation is safe and effective in autoimmune myopathies: a randomised, double-blind, sham-controlled trial(2023) SOUSA, L. F. A. de; MISSE, R. G.; SANTOS, L. M. dos; TANAKA, C.; GREVE, J. M. A.; BAPTISTA, A. F.; SHINJO, S. K.Objective We aimed to assess the safety and efficacy of transcranial direct current stimulation (tDCS) in patients with systemic autoimmune myopathies (SAMs).Methods This prospective, randomised, sham-controlled, double-blind, study included 20 patients with SAMs allocated to receive sham or active tDCS (2mA, 20 minutes, 3 days). Electrodes were positioned with the anode over the C1 or C2, whereas the cathode was placed over the Fp2 or Fp1, respectively. The groups were evaluated in four periods with specific questionnaires and functional tests: pre-stimulation and after 30 minutes, three weeks, and eight weeks post-tDCS.Results Two patients from the sham group withdrew after the three sessions. The demographic data, type of myositis, disease duration, and disease status were comparable between the active and sham tDCS groups. After interventions, in the active tDCS group, the physical aspects of SF-36 in week eight, mean and better timed up-and-go test at each evaluation, peak torque of stimulated inferior limb extension improved significantly (p<0.05). The emotional aspect of SF-36 decreased only in the active tDCS group (p<0.001). The patients' adherence to the protocol was 100% and no serious adverse event was reported, including disease relapses.Conclusion This study evidences the safety of tDCS, as well as its potential efficacy in improving muscle strength and function in SAMs patients. More studies with a larger sample and longer tDCS sessions are necessary to corroborate the results of the present study.- High prevalence of fatigue in patients with Takayasu arteritis: a case-control study in a Brazilian centre(2022) SANTOS, Alexandre Moura dos; MISSE, Rafael Giovani; BORGES, Isabela Bruna Pires; SILVA, Sarah Luiza Gomes da; KIM, Ana Woo Sook; PEREIRA, Rosa Maria R.; SHINJO, Samuel KatsuyukiObjectives. Several studies have shown not only a high prevalence of fatigue but also a reduction in health-related quality of life (HRQoL) in patients with rheumatic diseases. Owing to insufficient research in this area, we aimed to assess the prevalence of fatigue and its contribution to impairment of HRQoL in patients with Takayasu arteritis (TAK). Methods. This single-centre case-control study included 53 TAK patients who were matched by age, BMI and sex with 100 healthy individuals. Aside from the patients' general data, the following information was collected: disease activity, level of activities of daily living (HAQ), physical activity levels and chronic fatigue. Results. The TAK patients and healthy individuals were comparable in terms of current age, BMI and sex distribution. The median disease duration of TAK was 13.0 (7.0-20.0) years, and 11 (20.8%) patients had active disease. Compared with healthy individuals, patients with TAK had a higher prevalence of fatigue and lower HAQ score, physical activity level and intensity, and physical and psychosocial domains of the modified fatigue impact scale (P < 0.01). Moreover, TAK patients had increased fatigue rates compared with the healthy individuals (fatigue severity scale: odds ratio = 2.6; 95% CI = 1.2, 5.4; modified fatigue impact scale: odds ratio = 2.6; 95% CI = 1.2, 5.5). Fatigue was positively correlated with worsening HAQ, CRP levels, daily prednisone dose and disease activity, and negatively correlated with disease duration. Conclusion. TAK patients have a higher prevalence of fatigue, which affects different aspects of the disease, including physical function. Thus, fatigue-focused treatments should also be considered in clinical practice.
- Rosa Maria Rodrigues Pereira (1958-2022) IN MEMORIAM(2023) JORGETTI, Vanda; PD, Sampaio-Barros; SK, Shinjo; BONFA, Eloisa
article 0 Citação(ões) na Scopus Rosa Maria Rodrigues Pereira(2022) JORGETTI, Vanda; SAMPAIO-BARROS, Percival Degrava; SHINJO, Samuel Katsuyuki; BONFA, Eloisaarticle 18 Citação(ões) na Scopus Feasibility, safety and efficacy of exercise training in immune-mediated necrotising myopathies: a quasi-experimental prospective study(2019) SOUZA, J. M. de; OLIVEIRA, D. S. de; PERIN, L. A.; MISSE, R. G.; SANTOS, A. M. dos; GUALANO, B.; PINTO, A. L. de Sa; ROSCHEL, H.; LIMA, F. R.; SHINJO, S. K.Objective To evaluate the feasibility, safety and efficacy of exercise training in patients with immune-mediated necrotising myopathies (IMNM). Methods Eight consecutive sedentary patients with IMNM (5 anti-signal recognition particle and 3 anti-hydroxy-methyl-glutaryl coenzyme A reductase) were engaged in this study. Disease status was based on International Myositis Assessment and Clinical Studies Group (IMACS) core set measures. Physical performance was evaluated by cardiopulmonary exercise test, repetition maximum (RM) protocol, handgrip dynamometry, sit-to-stand (STS) and timed up-and-go (TUG) tests. All these parameters were measured at baseline and after a 12-week, twice-a-week, supervised exercise training comprising aerobic and strength exercises. Results Patients (aged 61 years on average) were very disabled at the beginning of the disease (mean duration of 17.7 months), but after being aggressively treated with a treat-to-target approach, they presented only mild symptoms that were well-controlled with oral immunosuppression and low disease status scores by the time of the exercise intervention. No disease relapsing, worsening of the IMACS set scores or adverse events were observed throughout the training period. Patients also increased aerobic capacity (e.g. time to achieve anaerobic threshold and time to achieve exhaustion), muscle strength (e.g. 1RM bench press) and function (e.g. STS test). Conclusion Supervised exercise training did not impair disease status and seemed to be feasible, safe and effective in patients with IMNM. Moreover, exercise training increased aerobic capacity, muscle strength and function, suggesting that this could be a novel potential coadjuvant therapy in IMNM.