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
14 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 14
article 18 Citação(ões) na Scopus High prevalence of metabolic syndrome in antisynthetase syndrome(2018) ARAUJO, P. A. O.; SILVA, M. G.; BORBA, E. F.; SHINJO, S. K.Objective A high frequency of metabolic syndrome (MetS) has been recently described in different idiopathic inflammatory myopathies, but not in antisynthetase syndrome (ASS). Therefore, the aim of the present study was to determine the prevalence of MetS in ASS and also its possible association with cardiovascular the risk factors and ASS-related disease characteristics. Methods A cross-sectional single centre study of 42 consecutive ASS patients was conducted from 2012 to 2015 and compared to 84 healthy individuals matched for gender, age, ethnicity and body mass index-matched (control group). MetS was defined according to the 2009 Join Interim Statement. Clinical and laboratory data were assessed according to a standardised protocol. Results ASS patients had a median age of 41.1 years with a predominance of female gender and white race. ASS patients had a higher frequency of MetS (42.9% vs. 13.1%; p<0.001) as well as of insulin resistance than controls. Moreover, ASS patients had higher resistin, lower leptin and similar adiponectin levels in serum than controls. Further analysis of ASS patients with (n=18) and without (n=24) MetS revealed that older age at disease onset (48.7 vs. 35.4 years; p<0.001) was identified in those with the syndrome but were similar regarding disease duration, disease status, treatment, insulin resistance and serum adipocytokine levels. Conclusion The prevalence of MetS was high in ASS patients that also had serum resistin and low leptin levels. As also identified in other idiopathic inflammatory myopathies, MetS in ASS is more prevalent in older patients.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.article 7 Citação(ões) na Scopus Does previous corticosteroid treatment affect the inflammatory infiltrate found in polymyositis muscle biopsies?(2015) PINHATA, M. M.; NASCIMENTO, J. J.; MARIE, S. K. N.; SHINJO, S. K.Objective The aim of the study was to evaluate the effect of the prior use of corticosteroids (CS) on the presence of inflammatory infiltrates (In!) in muscle biopsies of polymyositis (PM). Methods We retrospectively evaluated 60 muscle biopsy samples that had been obtained at the time of the diagnosis of PM. The patients were divided into three groups according to the degree of the InI present in the muscle biopsies: (a) minimal InI present only in an interstitial area of the muscle biopsy (endomysium, perimysium) or in a perivascular area; (B) moderate InI in one or two areas of the interstitium or of the perivascular area; and (C) moderate InI throughout the interstitium or intense inflammation in at least one area of the interstitium or of the perivascular area. Results The three groups were comparable regarding the demographic, clinical and laboratory features (p>0.05). Approximately half of the patients in each group were using CS at the time of the muscle biopsy. The median (interquartile) duration of CS use [4 (0-38), 4 (0-60) and 5 (0-60) days: groups A, B and C, respectively] and the median cumulative CS dose used [70 (0-1200), 300 (0-1470) and 300 (0-1800)mg] were similar between the groups (p>0.05). Conclusion Previous CS use did not influence the presence or the degree of InI found in muscle biopsies in PM with clinical and laboratory disease activity. Our study showed that muscle biopsies should be performed this population, even in individuals who have already been taking CSs.article 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.article 17 Citação(ões) na Scopus Reduction of ovarian reserve in adult patients with dermatomyositis(2015) SOUZA, F. H. C. de; SHINJO, S. K.; YAMAKAMI, L. Y. S.; VIANA, V. S. T.; BARACAT, E. C.; BONFA, E.; SILVA, C. A.Objective To assess ovarian reserve markers and anti-corpus luteum (anti-CoL) antibodies in dermatomyositis (DM) patients. Methods Forty female DM patients were invited to participate. Exclusion criteria included hormonal contraceptive use within the last six months, neoplasia associations, overlapped systemic autoimmune diseases, current pregnancy, gynaecological surgery and individual choice not to participate. The final experimental group for this cross-sectional study included 16 DM patients and 23 healthy controls, each of whom was evaluated during the early follicular phase of the menstrual cycle. Values for IgG anti-CoL (via immunoblotting), follicle stimulating hormone (FSH), estradiol, inhibin B, anti-Mullerian hormone (AMH) serum levels (via ELISA) and sonographic antral follicle count (AFC) were determined. Results DM patients and controls were of comparable mean age (p>0.05). The mean age of DM onset was 29.1 +/- 4.7 years, with disease duration of 5.6 +/- 3.2 years. Menstrual cycle characteristics, comorbidity and lifestyle were similar amongst patients in both groups (p>0.05). AMH values of <= lng/mL (p=0.027) and AFC values (p=0.017) were significantly reduced in DM patients relative to the control group, whereas serum estradiol levels (p<0.001) were higher in DM patients compared to controls. In contrast, serum FSH and inhibin B levels, ovarian volumes, and anti-CoL antibody frequency were similar in both groups. Differences in AFC and estradiol were determined to be significant following Bonferroni correction for multiple testing. Conclusion We identified a diminished ovarian reserve in DM patients of reproductive age. Further studies are necessary to assess the idiopathic inflammatory myopathy-related factors involved in the ovarian impairment of this patient population.article 3 Citação(ões) na Scopus The effect of prior corticosteroid use in muscle biopsies from patients with dermatomyositis(2015) SHINJO, S. K.; NASCIMENTO, J. J.; MARIE, S. K. N.Objective The aim of this study was to evaluate the effect of prior corticosteroid (CS) use on the presence of inflammatory infiltrates (In!) in muscle biopsies from dermatomyositis (DM). Methods Sixty-five muscle biopsy samples were obtained at the time of DM diagnosis. The patients were divided into the following three groups according to the degree of the InI present in the muscle biopsies: (I) minimal InI present only in an interstitial area (endomysium, perimysium) or in a perivascular area; (II) moderate InI in one or two areas of the interstitium or of the perivascular area; and (III) moderate InI throughout the interstitium or intense inflammation in at least one area of the interstitium or of the perivascular area. Results All groups (I=17,II=16 and III=32) were comparable regarding the patient age at the time of the muscle biopsy, gender, ethnicity distribution, time interval between the muscle biopsy and the symptom onset, clinical manifestations, degree of muscle weakness, autoantibodies and serum muscle enzyme measurements (p<0.05). The median (interquartile) duration of CS use [7(0-60), 6(0-105) and 14 (0-30) days in groups I, II and III, respectively] and the median cumulative CS dose used [560 (0-2100), 1005 (0-2850) and 875 (0-2850) mg] were similar between the groups (p>0.05). Conclusion Previous CS use did not influence the presence or the degree of inflammatory infiltrates found in muscle biopsies in DM with clinical and laboratory disease activity. Therefore, muscle biopsies should be performed in this population, including patients currently undergoing CS therapy.article 8 Citação(ões) na Scopus Necrotising myopathy associated with anti-signal recognition particle (anti-SRP) antibody(2017) SOUZA, F. H. C. de; MIOSSI, R.; SHINJO, S. K.Objective Prompted by the few studies available in the literature, we analysed patients with necrotising myopathy associated with anti-signal recognition particle (anti-SRP). Methods We conducted a retrospective, single-centre cohort study involving 14 patients with anti-SRP antibody followed between 2001 and 2016. Results Patients had a mean age at disease onset of 40.7 years and were predominantly female and of white ethnicity. At disease onset, all patients had limb muscle weakness with median serum of creatine phosphokinase level of 8080U/L, 64.3% had constitutional symptoms, 50% dysphagia, 42.9% myalgia, 21.4% and 14.3% pulmonary and articular involvement, respectively. There were no cases of cutaneous, neurological or cardiac involvements. Notably, 21.4% of patients had previous exposure to statins. Moreover, with the exception of one patient, all received methylprednisolone pulse therapy and/or human intravenous immunoglobulin (IVIg), as well as prednisone and different immunosuppressive drugs or rituximab. Relapse occurred in 64.3% of the cases. However, most patients had significant recovery of muscle strength, with half no longer using glucocorticoids and the remainder on a weaning regimen with low dose prednisone. Conclusion Unlike the cases described in the literature, there was a high frequency of extra-muscular symptoms in the patients studied. Moreover, one fifth of patients had previous exposure to statin use. There was a high relapse rates, but with good clinical and laboratory recovery, especially with pulse therapy regimen of methylprednisolone and/or IVIg.article 7 Citação(ões) na Scopus Serum interleukin-17A level is associated with disease activity of adult patients with dermatomyositis and polymyositis(2019) SILVA, M. G.; OBA-SHINJO, S. M.; MARIE, S. K. N.; SHINJO, S. K.Objective To assess serum interleukin (IL)-17A levels in patients with dermatomyositis (DM) and polymyositis (PM) and correlate them with the demographic, clinical, laboratory and therapeutic data of these diseases. Methods This was a cross-sectional, single-centre study that included defined DM and PM patients who were age-, gender- and ethnicity-matched to healthy individuals. Serum IL-17A analysis, as well as analysis for other cytokines (IL-6, TNF alpha and IFN gamma), was performed by multiplex immunoassay. The disease status parameters were based on the International Myositis Assessment and Clinical Studies Group (IMACS) set scores. Results Eighty DM, 32 PM patients and 104 healthy individuals were enrolled. Mean age of patients with DM and PM was 46.0 and 47.7, respectively, with a predominance of women and white ethnicity in both groups. Overall, clinical, laboratory, therapeutic, and current disease status were similar among patients with DM and PM. Median serum IL-17A level was higher in patients with PM and DM than the control group (0.73 vs. 0.49 vs. 0.35 pg/mL, respectively; p<0.050) and higher in PM when compared to DM (p<0.001). In DM, serum IL-17A levels were associated with cumulative cutaneous lesions, IMACS parameters, and serum IL-6 and IFN gamma levels. In PM, serum IL-17A levels correlated with patients' current age, IMACS parameters and serum TNF alpha and IFN gamma levels. Conclusion Serum IL-17A levels are not only increased, but also associated with disease activity in patients with DM and PM. Our data strongly suggest that IL-17A may be a biomarker of disease activity for these systemic autoimmune myopathies.article Different clinical phenotypes in anti-melanoma differentiation-associated protein 5-associated positive dermatomyositis(2023) PALLO, P. A. Olivo; SHINJO, S. K.article 24 Citação(ões) na Scopus The high prevalence of metabolic syndrome in polymyositis(2014) SOUZA, F. H. C. de; SHINJO, S. K.Objective Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that are associated with increased cardiovascular diseases (CVD). MetS has been systematically evaluated in all systemic autoimmune rheumatic diseases except for polymyositis (PM). This study aimed to evaluate the frequency of MetS in PM patients and analyse the possible association of MetS with traditional risk factors of CVD and PM-related clinical and laboratory features. Methods The present cross-sectional, single-centre study included 35 consecutive PM patients (Bohan and Peter, 1975) and 70 healthy controls. MetS diagnosis was determined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII). Results The age, gender and ethnicity distributions between the PM and control groups were comparable (p>0.050). The median PM disease duration was 5 years. Compared with healthy subjects, PM patients had higher prevalence of MetS (45.7% vs. 20.0%, p=0.011). In an additional univariate analysis of PM patients with (n=26) and without (n=19) MetS revealed that patients with this complication were older (56.1 +/- 7.8 vs. 44.3 +/- 12.8 years; p=0.002) with more cumulative prednisolone doses, higher scores on the health assessment questionnaire and on the physician visual analogue scale (p<0.050). Disease duration was comparable between both groups (p>0.050). Conclusion MetS and CVD risks are highly prevalent in PM. Monitoring for and early treatments of modifiable risk factors for CVD in PM patients are necessary.