FERNANDA RODRIGUES LIMA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
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
9 resultados
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- Exercise training can attenuate the inflammatory milieu in women with systemic lupus erythematosus(2014) PERANDINI, Luiz A.; SALES-DE-OLIVEIRA, Diego; MELLO, Suzana B. V.; CAMARA, Niels O.; BENATTI, Fabiana B.; LIMA, Fernanda R.; BORBA, Eduardo; BONFA, Eloisa; SA-PINTO, Ana L.; ROSCHEL, Hamilton; GUALANO, BrunoSystemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation. This study sought to assess the effects of an exercise training program on cytokines and soluble TNF receptors (sTNFRs) in response to acute exercise in SLE women. Eight SLE women and 10 sex-, age-, and body mass index-comparable healthy controls (HC) participated in this study. Before and after a 12-wk aerobic exercise training program, cytokines and sTNFRs were assessed at rest and in response to single bouts of acute moderate/intense exercise. HC performed the acute exercise bouts only at baseline. After the exercise training program, there was a decrease in resting TNFR2 levels (P = 0.025) and a tend to reduction interleukin (IL)-10 levels (P = 0.093) in SLE. The resting levels of IL-6, IL-10, and TNF-alpha after the exercise training in SLE reached HC levels (P > 0.05). In response to a single bout of acute moderate exercise, the area under the curve (AUC) of IL-10 was significantly reduced after the exercise training program in SLE (P = 0.043), and the AUC of IL-10, IL-6, TNF-alpha, and sTNFR1 of SLE approached control values (P = 0.05). In response to a single bout of acute intense exercise, the AUC of IL-10 was significantly reduced in SLE (P = 0.015). Furthermore, the AUC of sTNFR2 tended to decrease after exercise training program in SLE (P = 0.084), but it did not reach control values (P = 0.001). An aerobic exercise training program attenuated the inflammatory milieu in SLE women, revealing a novel homeostatic immunomodulatory role of exercise in an autoimmunity condition.
- Exercise as an Adjuvant Treatment in Persistent Active Polymyositis(2014) MATTAR, Melina Andrade; GUALANO, Bruno; ROSCHEL, Hamilton; PERANDINI, Luiz Augusto; DASSOUKI, Thalita; LIMA, Fernanda Rodrigues; SHINJO, Samuel Katsuyuki; PINTO, Ana Lucia de SaObjectives: A growing number of studies have suggested that exercise may promote therapeutic effects in patients with idiopathic inflammatory myopathy. This prospective case series study aimed to report on the effects of exercise in patients with persistent active myositis. Methods: Three patients with persistent active polymyositis were submitted to a 12-week supervised exercise program comprising both aerobic and strength exercises. Results: After the intervention, the patients presented improvements in selected parameters of muscle function and aerobic conditioning. In addition, an overall improvement was detected in the quality of life, as measured by both the 36-item Short-Form Health Survey and the Health Assessment Questionnaire questionnaires. Importantly, exercise did not increase serum levels of creatine kinase and aldolase. Conclusions: The findings herein suggest that a combined aerobic and strength training program may be tolerable and potentially effective in improving muscle function, aerobic conditioning, and quality of life in patients with persistent active polymyositis.
- Safety and possible effects of low-intensity resistance training associated with partial blood flow restriction in polymyositis and dermatomyositis(2014) MATTAR, Melina Andrade; GUALANO, Bruno; PERANDINI, Luiz Augusto; SHINJO, Samuel Katsuyuki; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia; ROSCHEL, HamiltonIntroduction: Our aim was to evaluate the safety and efficacy of a low-intensity resistance training program combined with partial blow flow restriction (BFR training) in a cohort of patients with polymyositis (PM) and dermatomyositis (DM). Methods: In total, 13 patients with PM and DM completed a 12-week twice a week low-intensity (that is, 30% one-repetition-maximum (1RM)) resistance exercise training program combined with partial blood flow restriction (BFR). Assessments of muscle strength, physical function, quadriceps cross sectional (CSA) area, health-related quality of life, and clinical and laboratory parameters were assessed at baseline and after the intervention. Results: The BFR training program was effective in increasing the maximal dynamic strength in both the leg-press (19.6%, P < 0.001) and knee-extension exercises (25.2% P < 0.001), as well as in the timed-stands (15.1%, P < 0.001) and timed-up-and-go test (-4.5%, P = 0.002). Quadriceps CSA was also significantly increased after the intervention (4.57%, P = 0.01). Similarly, all of the components of the Short Form-36 Health Survey, the Health Assessment Questionnaire scores, and the patient-and physician reported Visual Analogue Scale were significantly improved after training (P < 0.05). Importantly, no clinical evidence or any other self-reported adverse event were found. Laboratory parameters (creatine kinase and aldolase) were also unchanged (P > 0.05) after the intervention. Conclusions: We demonstrated that a 12-week supervised low-intensity resistance training program associated with partial blood flow restriction may be safe and effective in improving muscle strength and function as well as muscle mass and health-related quality of life in patients with PM and DM.
- The Liposuction-Induced Effects on Adiponectin and Selected Cytokines Are Not Affected by Exercise Training in Women(2014) SOLIS, Marina Yazigi; ARTIOLI, Guilherme Giannini; MONTAG, Eduardo; PAINELLI, Vitor de Salles; SAITO, Fabio Lopes; LIMA, Fernanda Rodrigues; ROSCHEL, Hamilton; GUALANO, Bruno; LANCHA JUNIOR, Antonio Herbert; BENATTI, Fabiana BragaIt has been suggested that the abrupt liposuction-induced decrease in adipose tissue could affect adipokine secretion pattern. We hypothesized that exercise training could positively impact adipokine metabolism following liposuction. The aim of this study was to investigate the effects of liposuction on inflammation-related adipokines in women who were either exercise-trained or remained sedentary after surgery. Thirty-six healthy normal-weight women underwent an abdominal liposuction and two months after surgery were randomly allocated into two groups: trained (TR, n = 18, four-month exercise program) and nontrained (NT, n = 18). Inflammation-related adipokine serum levels (TNF-alpha, IL-6, IL-10, and adiponectin) and abdominal and thigh subcutaneous adipose tissue (scAT) mRNA levels were assessed before (PRE) and six months after surgery (POST6). TNF-alpha, IL-6, and IL-10 serum levels were unchanged in both groups. In contrast, TNF-alpha, IL-6, and IL-10 mRNA levels in scAT were increased, whereas adiponectin scAT mRNA and serum levels were decreased at POST6 (P < 0.05, main effect for time). No changes were observed in mRNA levels of MCP-1, CD14, and CD68 in any of the groups. In conclusion, liposuction downregulates adiponectin scAT gene expression and serum levels and upregulates scAT gene expression of inflammation-related genes six months after surgery in normal-weight women, irrespective of exercise training.
- ACUTE AEROBIC EXERCISE INDUCES INCREASES ON PLASMA LEVELS OF alpha-MELANOCYTE STIMULATING HORMONE IN PATIENTS WITH ACTIVE SYSTEMIC LUPUS ERYTHEMATOSUS(2014) PERANDINI, L.; GUALANO, B.; PINTO, A. L. D. S.; LIMA, F.; BONFA, E.; BORBA, E. F.; ROSCHEL, H.; MELLO, S. B.
- Acute physical exercise is safe in patients with primary antiphospholipid syndrome with exclusive venous thrombosis and under oral anticoagulation with warfarin(2014) GARCIA, Carolina Borges; SEGURO, Luciana Parente Costa; PERANDINI, Luiz Augusto; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; NEGRAO, Carlos Eduardo; BONFA, Eloisa; BORBA, Eduardo FerreiraThe purpose of present study was to evaluate the effects of maximal acute physical exercise on prothrombin time/international normalized ratio (PT/INR) in patients with primary antiphospholipid syndrome (PAPS) under oral anticoagulation with warfarin and the safety of acute exercise in regard to thrombosis and bleeding risk. Eighteen physically inactive women with PAPS (Sydney criteria) with exclusive venous events and without thrombocytopenia were included. All patients were under stable warfarin therapy (PT/INR target: 2.0-3.0). Eighteen age-matched healthy sedentary women without thrombosis/bleeding disorders were selected as controls. All subjects performed a maximal exercise test, and capillary blood samples were obtained pre-, post- and at 1-h post-exercise (recovery time) for PT/INR analysis using a portable CoaguCheck. PAPS patients and controls had similar mean age (31.50 +/- A 8.06 vs. 29.61 +/- A 7.05 years, p = 0.46) and body mass index (24.16 +/- A 3.67 vs. 24.66 +/- A 2.71 kg/m(2), p = 0.65). PAPS had a mild but significant increase in PT/INR value at 1-h post-exercise (recovery) compared with pre- (2.33 +/- A 0.34 vs. 2.26 +/- A 0.29, p = 0.001) and post-exercise (2.33 +/- A 0.34 vs. 2.26 +/- A 0.32, p = 0.001) that was observed in 61.11 % of these patients. None of the subjects had thrombotic or bleeding complications related to the acute exercise. Acute exercise in patients with PAPS with exclusive venous thrombosis was safe with a minor increase in PT/INR. This is an important step to introduce regular exercise training as a therapeutic tool in the management of these patients.
- BLOOD FLOW RESTRICTED RESISTANCE TRAINING ATTENUATES MYOSTATIN GENE EXPRESSION ON A PATIEINIT WITH ONCLUSION BODY MYOSITIS(2014) SANTOS, A. R.; NEVES JR., M. T.; GUALANO, B.; LAURENTINO, G. C.; JR, A. H. Lancha; UGRINOWITSCH, C.; LIMA, F. R.; AOKI, M. S.Inclusion body myositis is a rare idiopathic inflammatory myopathy that produces extreme muscle weakness. Blood flow restricted resistance training has been shown to improve muscle strength and muscle hypertrophy in inclusion body myositis. Objective: The aim of this study was to evaluate the effects of a resistance training programme on the expression of genes related to myostatin (MSTN) signalling in one inclusion body myositis patient. Methods: A 65-year-old man with inclusion body myositis underwent blood flow restricted resistance training for 12 weeks. The gene expression of MSTN, follistatin, follistatin-like 3, activin II B receptor, SMAD-7, MyoD, FOXO-3, and MURF-2 was quantified. Results: After 12 weeks of training, a decrease (25%) in MSTN mRNA level was observed, whereas follistatin and follistatin-like 3 gene expression increased by 40% and 70%, respectively. SMAD-7 mRNA level was augmented (20%). FOXO-3 and MURF-2 gene expression increased by 40% and 20%, respectively. No change was observed in activin II B receptor or MyoD gene expression. Conclusions: Blood flow restricted resistance training attenuated MSTN gene expression and also increased expression of myostatin endogenous inhibitors. Blood flow restricted resistance training evoked changes in the expression of genes related to MSTN signalling pathway that could in part explain the muscle hypertrophy previously observed in a patient with inclusion body myositis.
- Creatine supplementation and resistance training in vulnerable older women: A randomized double-blind placebo-controlled clinical trial(2014) GUALANO, Bruno; MACEDO, Andre Regis; ALVES, Christiano Robles Rodrigues; ROSCHEL, Hamilton; BENATTI, Fabiana Braga; TAKAYAMA, Liliam; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; PEREIRA, Rosa Maria RodriguesThis study aimed to examine the efficacy of creatine supplementation, associated or not with resistance training, in vulnerable older women. A 24-week, double-blind, randomized, placebo-controlled trial was performed. Sixty subjects were assigned to compose the following groups: placebo (PL), creatine supplementation (CR), placebo with resistance training (PL + RT), and creatine supplementation with resistance training (CR + RT). The subjects were assessed at baseline and after 24 weeks. The primary outcome was muscle strength, as assessed by one-repetition maximum (1-RM) tests. Secondary outcomes included appendicular lean mass, bone mass, biochemical bone markers, and physical function tests. The changes in 1-RM leg press were significantly greater in the CR + RT group (+ 19.9%) than in the PL (+ 2.4%) and the CR groups (+ 3.7%), but not than in the PL + RT group (+ 15%) (p = 0.002, p = 0.002, and p = 0.357, respectively). The CR+ RT group showed superior gains in 1-RM bench press (+ 10%) when compared with all the other groups (p <= 0.05). The CR + RT group (+ 1.31%) showed greater appendicular lean mass accrual than the PL (-1.2%), the CR (+ 0.3%), and the PL + RT groups (-0.2%) (p = 0.05). The CR and the PL + RT groups experienced comparable gains in appendicular lean mass (p = 0.62), but superior to those seen in the PL group. Changes in fat mass, bone mass and serum bone markers did not significantly differ between the groups (p > 0.05). In conclusion, creatine supplementation combined with resistance training improved appendicular lean mass and muscle function, but not bone mass, in older vulnerable women. Clinicaltrials.gov: NCT01472393.
- Spondyloptosis in athlete(2014) ASSAD, Ana Paula Luppino; ABREU, Andressa Silva; SEGURO, Luciana Parente Costa; GUEDES, Lissiane Karine Noronha; LIMA, Fernanda Rodrigues; PINTO, Ana Lucia de SaThe adolescent athletes are at greater risk of low back pain and structural spine injuries. Spondylolysis is responsible for the majority of back pain cases in young athletes, rarely occurring in adults. We report a case of a 13-year-old judo female athlete, who came to our service with 5 months of progressive low back pain during training which was initially attributed to mechanical causes, without any further investigation by imaging methods. At admission, the patient had lumbar deformity, antalgic posture and bilaterally positive unipodalic lumbar hyperextension maneuver. After a research which showed spondyloptosis, the patient underwent surgery. In this article, we discuss, based on this case report, the diagnostic approach to low back pain in young athletes, since the complaint of chronic back pain can be a marker of a structural lesion that may be permanent and bring irreversible functional loss.