LUCIANA PARENTE COSTA SEGURO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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
8 resultados
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- Lower P1NP serum levels: a predictive marker of bone loss after 1 year follow-up in premenopausal systemic lupus erythematosus patients(2015) SEGURO, L. P. C.; CASELLA, C. B.; CAPARBO, V. F.; OLIVEIRA, R. M.; BONFA, A.; BONFA, E.; PEREIRA, R. M. R.Predictors of bone mineral density (BMD) loss are additional tools in the management of osteoporosis in premenopausal women with systemic lupus erythematosus (SLE). This study provides original evidence that N-terminal propeptide of type 1 collagen (P1NP), the most specific bone formation marker, is a predictor of BMD loss in this group of women. SLE is associated with a high risk of low bone mass/fractures but this risk is still controversial in premenopausal women. Our aim was to determine the 1 year incidence of BMD loss in premenopausal SLE women and the value of bone turnover markers as predictors of this complication. This study enrolled a convenience sample of 63 premenopausal SLE patients. BMD was evaluated by dual X-ray absorptiometry at lumbar spine and hip at baseline and after 12 months. BMD changes above the least significant change were considered significant. Serum levels of P1NP and CTX (electrochemiluminescence), OPG, and RANKL (ELISA) were determined at baseline. Mean age was 31.1 +/- 6.8 years, and disease duration was 5.25 +/- 3.8 years. 36.5 % of patients presented BMD loss and 17.5 % BMD gain at lumbar spine and/or hip. Patients were divided in three groups: BMD loss (BL), no BMD change (NC), and BMD gain (BG). Patients with BL and NC received similar cumulative/mean/maximum glucocorticoid doses during the study, but patients with BG received lower doses (p < 0.05). Baseline P1NP levels were different in the groups (BL: 36.95 +/- 23.37 vs. NC: 54.63 +/- 30.82 vs. BG: 84.09 +/- 43.85 ng/mL; p = 0.031 BL vs. NC, p < 0.001 BL vs. BG, and p = 0.039 NC vs. BG). There was no difference in CTX, OPG, or RANKL levels. After multivariate analysis, P1NP remained as an independent risk factor for BMD loss (p < 0.03). This study provides original evidence that lower levels of P1NP, the most specific bone formation marker, are predictive of BMD loss over 12 months in premenopausal SLE patients.
- ABO blood group in primary antiphospholipid syndrome: influence in the site of thrombosis?(2015) NASCIMENTO, Natalia Mastantuono; BYDLOWSKI, Sergio Paulo; SOARES, Rosangela Paula Silva; ANDRADE, Danieli Castro Oliveira de; BONFA, Eloisa; SEGURO, Luciana Parente Costa; BORBA, Eduardo FerreiraAntiphospholipid syndrome (APS) is characterized by vascular thrombosis and/or obstetric complications associated with presence of antiphospholipid antibodies (aPL) but additional factors would also induce thrombosis. ABO (H) blood groups are known to be closely related to thrombosis, especially non-O blood type with venous events. The aim of this study was to investigate possible role of ABO (H) blood types in the thrombotic events in primary APS (PAPS). Seventy PAPS patients were selected for the study and were divided according to ABO blood group in: O PAPS (n = 26) and non-O PAPS (n = 44). ABO blood group phenotyping was performed by indirect technique. aPL anticardiolipin (aCL) and anti-beta eta2 glycoprotein-1 (a beta 2GPI) and the concentrations and activities of von Willebrand factor (VWF) were measured with ELISA. Lupus anticoagulant (LA) was detected by coagulation assays. A significant higher frequency of venous events was observed in non-O PAPS group (72.7 vs. 46.2 %, p = 0.040). In contrast, the frequency of arterial events was significantly higher in the O PAPS compared to the non-O PAPS group (69.2 vs. 36.4 %, respectively; p = 0.013). Frequencies of aCL, LA, a beta 2GPI and triple aPL positivity were similar in both groups (p > 0.05). VWF antigen (75.54 +/- A 8.68 vs. 79.51 +/- A 7.07 IU/dl, p = 0.041) and activity (70.23 +/- A 11.96 vs. 77.92 +/- A 13.67 %, p = 0.020) were decreased in O PAPS compared to non-O blood group. VWF:CB/VWF:Ag ratio was similar among groups (p > 0.05). This is the first report that confirms the role of ABO blood system in thrombosis of PAPS and suggests that non-O blood group was related with venous events and O blood group with arterial thrombosis.
- Seasonality and Autoimmunity(2015) SEGURO, L. P. C.; PASOTO, S. G.Some autoimmune diseases have a seasonal pattern of clinical manifestations, disease onset, and/or month of birth of affected individuals. The seasonal features of these diseases may reflect the role of environmental factors including infectious agents and environmental pollutants triggering the abnormal autoimmune regulation in genetically predisposed subjects. Additionally, vitamin D, whose production is dependent on sunlight exposure, affects immune system function and is associated with the prevalence and activity of certain autoimmune diseases. Melatonin, whose secretion presents seasonal variations, may influence symptom expression of infectious and autoimmune diseases, as well as affective disorders since it has effects on immune responses and various functions of the body. Seasonal characteristics may include worsening of symptoms and increase in disease activity that should be considered in the management of patients with several autoimmune diseases. © 2015 Elsevier B.V. All rights reserved.
bookPart Lombociatalgia e Cervicalgia(2015) FULLER, Ricardo; COSTA-SEGURO, Luciana ParenteconferenceObject Effectiveness of Renoprotective Approaches in Lupus Nephritis: More Than Just Immunosuppression(2015) CASTRO, Maite; BORBA, Eduardo Ferreira; LOPES, Michelle; PASOTO, Sandra G.; BONFA, Eloisa; SEGURO, LucianaconferenceObject Chronic Arthritis in Systemic Lupus Erythematosus: Distinct Features in 336 Pediatric and 1,830 Adult Patients(2015) GORMEZANO, Natali W.; SILVA, Clovis A.; AIKAWA, Nadia E.; BARROS, Diego L.; SILVA, Mariana A. da; OTSUZI, Carini I.; KOZU, Katia T.; SEGURO, Luciana; PEREIRA, Rosa M. R.; BONFA, EloisaconferenceObject Visceral Adiposity in Premenopausal Lupus Patients: Correlation with Systemic Inflammation(2015) SEGURO, Luciana; CAPARBO, Valeria; BONFA, Eloisa; PEREIRA, Rosa M. R.- RANKL and OPG gene polymorphisms: associations with vertebral fractures and bone mineral density in premenopausal systemic lupus erythematosus(2015) BONFA, A. C.; SEGURO, L. P. C.; CAPARBO, V.; BONFA, E.; PEREIRA, R. M. R.A Summary Premenopausal women with systemic lupus erythematosus (SLE) have a higher prevalence of low bone mineral density and vertebral fractures. Multiple genetic loci for osteoporotic fracture were identified in recent genome-wide association studies. This study provides a novel data demonstrating that receptor activator of NF-kappa B ligand (RANKL)/osteoprotegerin (OPG) polymorphisms likely plays an important role in the bone remodeling process in SLE premenopausal women. Introduction The purpose of this study was to evaluate single-nucleotide polymorphisms (SNPs) of the RANKL, RANK, and OPG genes in premenopausal SLE patients and their association with sRANKL and OPG serum levels, vertebral fractures, and bone mineral density (BMD). Methods A total of 211 premenopausal SLE patients (American College of Rheumatology (ACR) criteria) and 154 healthy controls were enrolled. SNPs of RANKL 290A > G (rs2277438), OPG 1181G > C (rs2073618), 245T > G (rs3134069), 163A > G (rs3102735), and RANK A > G (rs3018362) were obtained by real-time PCR. sRANKL/OPG serum levels were determined by ELISA. BMD and vertebral fractures were evaluated by dual-energy X-ray absorptiometry (DXA). Results SLE patients and controls had similar frequencies of the RANKL 290 G allele (p = 0.94), OPG 1181 C allele (p = 0.85), OPG 245 G allele (p = 0.85), OPG 163 G allele (p = 0.78), and RANK G allele (p = 0.87). Further analysis of the SLE patients revealed that the frequency of the RANKL 290 G allele was lower in patients with fractures than that in patients without fractures (28.1 vs 46.9 %, p = 0.01). In addition, the frequency of the OPG 245 G allele was higher in patients with low BMD than that in patients with normal BMD (31.4 vs 18.1 %, p = 0.04). No association of OPG 1181 G > C, OPG 163 A > G, and RANK A > G SNPs with BMD/fractures was found. Additionally, no association was observed between RANKL/OPG/RANK SNPs and sRANKL/OPG serum levels. Conclusions Our study provides novel data demonstrating that RANKL/OPG genetic variations appear to play a role in bone remodeling, particularly in its major complication, fracture, in premenopausal patients with SLE.