ANA JULIA DE FARIA COIMBRA LICHTENFELS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina
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- PERSONAL EXPOSURE TO AIR POLLUTION INFLUENCED DISEASE ACTIVITY AND EXHALED BREATH BIOMARKERS: A PROSPECTIVE STUDY IN A CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS POPULATION(2016) GOULART, M. F. G.; ALVES, A. G. F.; BRAGA, A. L. F.; SALUM, A. M. E.; PEREIRA, L. A. A.; COIMBRA, A. J. F.; CARVALHO, T. D. S.; NAKAGAWA, N. K.; SILVA, C. A.; FARHAT, S. C. L.
- Inflammatory and functional responses after (bio)diesel exhaust exposure in allergic sensitized mice. A comparison between diesel and biodiesel(2019) TIMMERMAN, Tirza; BRITO, Jose Mara de; ALMEIDA, Natalia Madureira de; ALMEIDA, Francine Maria de; ARANTES-COSTA, Fernanda Magalhaes; GUIMARAES, Eliane Tigre; LICHTENFELS, Ana Julia Faria Coimbra; RIVERO, Dolores Helena Rodriguez Ferreira; OLIVEIRA, Regiani Carvalho de; LACERDA, Joao Paulo Amorim de; MORAES, Jamille Moreira; PIMENTAL, Danilo Augusto; SARAIVA-ROMANHOLO, Beatriz Mangueira; SALDIVA, Paulo Hilario Nascimento; VIEIRA, Rodolfo de Paula; MAUAD, ThaisMany cities fail to meet air quality standards, which results in increased risk for pulmonary disorders, including asthma. Human and experimental studies have shown that diesel exhaust (DE) particles are associated with worsening of allergic asthma. Biodiesel (BD), a cleaner fuel from renewable sources, was introduced in the eighties. Because of the reduction in particulate matter (PM) emissions, BD was expected to cause fewer adverse pulmonary effects. However, only limited data on the effect of BD emissions in asthma are available. Objective: Determine whether BD exhaust exposure in allergic sensitized mice leads to different effects on inflammatory and functional responses compared to DE exposure. Methods: Balb/C mice were orotracheally sensitized with House Dust Mite (HDM) or a saline solution with 3 weekly instillations. From day 9 until day 17 after sensitization, they were exposed daily to filtered air (FA), DE and BD exhaust (concentration: 600 mu g/m(3) PM2.5). Lung function, bronchoalveolar lavage fluid (BALF) cell counts, cytokine levels (IL-2, IL-4, IL-5, IL-17, TNF-alpha, TSLP) in the BALF, peribronchiolar eosinophils and parenchymal macrophages were measured. Results: HDM-sensitized animals presented increased lung elastance (p = 0.046), IgG1 serum levels (p = 0.029), peribronchiolar eosinophils (p = 0.028), BALF levels of total cells (p = 0.020), eosinophils (p = 0.028), IL-5 levels (p = 0.002) and TSLP levels (p = 0.046) in BALF. DE exposure alone increased lung elastance (p = 0.000) and BALF IL-4 levels (p = 0.045), whereas BD exposure alone increased BALF TSLP levels (p = 0.004). BD exposure did not influence any parameters after HDM challenge, while DE exposed animals presented increased BALF levels of total cells (p = 0.019), lymphocytes (p = 0.000), neutrophils (p = 0.040), macrophages (p = 0.034), BALF IL-4 levels (p = 0.028), and macrophagic inflammation in the lung tissue (p = 0.037), as well as decreased IgG1 (p = 0.046) and lgG2 (p = 0.043) levels when compared to the HDM group. Conclusion: The results indicate more adverse pulmonary effects of DE compared to BD exposure in allergic sensitized animals.
- Air pollution influence on serum inflammatory interleukins: A prospective study in childhood-onset systemic lupus erythematous patients(2021) FARHAT, Sylvia Costa Lima; EJNISMAN, Carolina; ALVES, Andressa Guariento Ferreira; GOULART, Maria Fernanda Giacomin; LICHTENFELS, Ana Julia de Faria Coimbra; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador; ELIAS, Adriana Maluf; SILVA, Clovis A.Objective To assess the effect of individual exposure, in real-time, to traffic-related pollutants on serum interleukin levels of childhood-onset lupus erythematous systemic (c-SLE) patients. Methods A longitudinal and observational design was conducted in 12 repeated measures of serum samples and clinical evaluations (totaling 108 measurements) of c-SLE patients over 30 consecutive months. Real-time, individual exposure to fine particles (PM2.5) and nitrogen dioxide (NO2) was measured with portable monitors. Generalized estimating equation was used to evaluate the association between exposure to PM2.5 and NO2 and the following serum cytokine levels on the 7 days preceding clinical assessment and serum collection: MCP1, IL-6, IL-8, IL-10, IL-17, IFN-alpha, and TNF-alpha. Disease activity and other risk factors were also controlled. Results An interquartile range (IQR) increase in PM2.5 daily concentration was significantly associated with increased levels of TNF-alpha on the third, fourth, and seventh day after exposure; IL-10 on the third and fourth day after exposure; IL-17 on the third and seventh day after exposure; and INF-alpha on the third day after exposure (p < 0.05). An IQR increase in 7-day moving average of PM2.5 was associated with a 6.2 pg/mL (95% CI: 0.5; 11.8; p = 0.04) increase in serum IFN-alpha level. An unexpected significant association was observed between an IQR increase in NO(2)7-day cumulative concentration and a decrease of 1.6 pg/mL (95% CI: -2.6; -0.7; p < 0.001) in serum IL-17. Conclusion Real-time exposure to PM2.5 prospectively associated with increased serum TNF-alpha, INF-alpha, IL-10, and IL-17 levels in c-SLE patients.
- Influence of air pollution on renal activity in patients with childhood-onset systemic lupus erythematosus(2020) GOULART, Maria Fernanda Giacomin; ALVES, Andressa Guariento Ferreira; FARHAT, Juliana; BRAGA, Alfesio Luis Ferreira; PEREIRA, Luiz Alberto Amador; LICHTENFELS, Ana Julia de Faria Coimbra; CAMPOS, Lucia Maria de Arruda; SILVA, Clovis Artur Almeida da; ELIAS, Adriana Maluf; FARHAT, Sylvia Costa LimaBackground Childhood-onset systemic lupus erythematosus (cSLE) is an autoimmune and multifactorial disease that can affect the renal system. Exposure to air pollution can trigger systemic inflammation in cSLE patients and increase risk of disease activity. We evaluated effects of individual real-time exposure to air pollutants on renal activity in cSLE patients using the Systemic Lupus Erythematosus Disease Activity Index 2000. Methods Longitudinal panel study of 108 repetitive measures from 9 pediatric lupus patients. Over three consecutive weeks, daily individual levels of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were measured, as well as weekly clinical evaluation and laboratory tests. This was repeated every 10 weeks over a 1-year period. Specific generalized estimating equation models were used to evaluate the impact of these pollutants on risk of nephritis and anti-dsDNA > 20 UI/mL and on 24-h urine protein and serum complement (C3) levels. Results An interquartile range (IQR) increase of 18.12 mu g/m(3) in PM2.5 daily concentration was associated with increased risk of nephritis and positive results for anti-dsDNA. Moreover, increase in 24-h urine protein and decrease in C3 serum levels also associated with exposure to pollutants. An IQR increase in PM(2.5)7-day moving average was associated with increased risks of leukocyturia (3.4; 95% CI 2.6:4.3), positive anti-dsDNA (3.1; 95% CI 2.1:4.0), and 36.3-mg increase (95% IC 20.2:52.3) in 24-h urine protein. An IQR increase (63.1 mu g/m(3)) in 7-day cumulative NO2 levels was associated with decreased serum C3 levels. Conclusions This prospective study suggests exposure to air pollution can trigger renal activity in cSLE patients.
- Inflammatory and functional responses after (bio)diesel exhaust exposure in an asthmatic mice model - A comparison between diesel and biodiesel(2015) TIMMERMAN, Tirza; LICHTENFELS, Ana Julia De Faria Coimbra; RIVERO, Dolores Ferreira; COSTA, Fernanda Arantes; MAUAD, Thais
- Acute exposure to diesel and sewage biodiesel exhaust causes pulmonary and systemic inflammation in mice(2018) BRITO, Jose Mara de; MAUAD, Thais; CAVALHEIRO, Guilherme Franco; YOSHIZAKI, Kelly; ANDRE, Paulo Afonso de; LICHTENFELS, Ana Julia F. C.; GUIMARAES, Eliane Tigre; RIVERO, Dolores Helena Rodriguez Ferreira; ANTONANGELO, Leila; OLIVEIRA, Luciano Basto; PEDROSO, Luiz Roberto Martins; MACCHIONE, Mariangela; SALDIVA, Paulo Hilario NascimentoBiodiesel is a renewable energy source that reduces particle emission, but few studies have assessed its effects. To assess the effects of acute inhalation of two doses (600 and 1200 mu g/m(3)) of diesel (DE) and biodiesel (BD) fuels on the inflammatory pulmonary and systemic profile of mice. Animals were exposed for 2 h in an inhalation chamber inside the Container Laboratory for Fuels. Heart rate, heart rate variability (HRV) and blood pressure were determined 30 min after exposure. After 24 h. we analyzed the lung inflammation using bronchoalveolar lavage fluid (BALF); neutrophil and macrophage quantification in the lung parenchyma was performed, and blood and bone marrow biomarkers as well as receptor of endothelin-A (ET-Ar), receptor of endothelin-B (ET-Br), vascular cell adhesion molecule 1 (VCAM-1), inducible nitric oxide synthase (iNOs) and isoprostane (ISO) levels in the pulmonary vessels and bronchial epithelium were evaluated. HRV increased for BD600, D600 and D1200 compared to filtered air (FA). Both fuels (DE and BD) produced alterations in red blood cells independent of the dose. BALI from the BD600 and BD1200 groups showed an increase in neutrophils compared to those of the FA group. Numeric density of the polyrnorphonuclear and mononudear cells was elevated with BD600 compared to FA. In the peribronchiolar vessels, there was an increase in ET-Ar and ET-Br expression following BD600 compared to IA; and there was a reduction in the iNOs expression for BD1200 and the VCAM-1 for D1200 compared to FA. In the bronchial epithelium, there was an increase in ETAr at BD600, ET-Br at two doses (600 and 1200 mu g/m(3)) of DE and BD, iNOs at D600 and VCAM-1 at BD1200 and D600; all groups were compared to the FA group. Acute exposure to DE and BD derived from sewage methyl esters triggered pulmonary and cardiovascular inflammatory alterations in mice.
conferenceObject Inhalation of exhaust particles of biodiesel fuel promotes similar alterations on heart rate variability induced by diesel fuel(2014) MACCHIONE, Mariangela; BRITO, Jose Mara; CAVALHEIRO, Guilherme; YOSHIZAKI, Kelly; GUIMARAES, Eliane; LICHTENFELS, Ana Julia; ANDRE, Paulo; RIVERO, Dolores; SALDIVA, Paulo- Influence of air pollution on airway inflammation and disease activity in childhood-systemic lupus erythematosus(2018) ALVES, Andressa Guariento Ferreira; GIACOMIN, Maria Fernanda de Azevedo; BRAGA, Alfesio Luis Ferreira; SALLUM, Adriana Maluf Elias; PEREIRA, Luiz Alberto Amador; FARHAT, Luis Carlos; STRUFALDI, Fernando Louzada; LICHTENFELS, Ana Julia de Faria Coimbra; CARVALHO, Tomas de Santana; NAKAGAWA, Naomi Kondo; SILVA, Clovis Artur; FARHAT, Sylvia Costa LimaExposure to fine particles may trigger pulmonary inflammation/systemic inflammation. The objective of this study was to investigate the association between daily individual exposure to air pollutants and airway inflammation and disease activity in childhood-onset systemic lupus erythematosus (cSLE) patients. A longitudinal panel study was carried out in 108 consecutive appointments with cSLE patients without respiratory diseases. Over four consecutive weeks, daily individual measures of nitrogen dioxide (NO2), fine particulate matter (PM2.5), ambient temperature, and humidity were obtained. This cycle was repeated every 2.5 months along 1 year, and cytokines of exhaled breath condensate-EBC [interleukins (IL) 6, 8, 17 and tumoral necrose factor-alpha (TNF-alpha)], fractional exhaled NO (FeNO), and disease activity parameters were collected weekly. Specific generalized estimation equation models were used to assess the impact of these pollutants on the risk of Systemic Lupus Erythematous Disease Activity Index 2000 (SLEDAI-2K) ae 8, EBC cytokines, and FeNO, considering the fixed effects for repetitive measurements. The models were adjusted for inflammatory indicators, body mass index, infections, medication, and weather variables. An IQR increase in PM2.5 4-day moving average (18.12 mu g/m(3)) was associated with an increase of 0.05 pg/ml (95% CI 0.01; 0.09, p = 0.03) and 0.04 pg/ml (95% CI 0.02; 0.06, p = 0.01) in IL-17 and TNF-alpha EBC levels, respectively. Additionally, a short-term effect on FeNO was observed: the PM2.5 3-day moving average was associated with a 0.75 ppb increase (95% CI 0.38; 1.29, p = 0.03) in FeNO. Also, an increase of 1.47 (95% CI 1.10; 1.84) in the risk of SLEDAI-2K ae 8 was associated with PM2.5 7-day moving average. Exposure to inhalable fine particles increases airway inflammation/pulmonary and then systemic inflammation in cSLE patients.
conferenceObject Short-term exposure at different doses of diesel and biodiesel exhaust particles inhalation induces lung inflammation(2014) MACCHIONE, Mariangela; BRITO, Jose Mara; CAVALHEIRO, Guilherme; YOSHIZAKI, Kelly; GUIMARAES, Eliane; LICHTENFELS, Ana Julia; ANDRE, Paulo; RIVERO, Dolores; SALDIVA, Paulo- Intrauterine exposure to diesel exhaust diminishes adult ovarian reserve(2013) OGLIARI, Karolyn Sassi; LICHTENFELS, Ana Julia de Faria Coimbra; MARCHI, Mary Rosa Rodrigues de; FERREIRA, Alice Teixeira; DOLHNIKOFF, Marisa; SALDIVA, Paulo Hilario NascimentoObjective: To analyze ovarian and uterine morphologic changes resulting from intrauterine and postnatal exposure to diesel exhaust. Design: Crossover study. Experimental groups: intrauterine and postnatal clean air exposure; intrauterine exposure to diesel only; postnatal exposure to diesel only; and intrauterine and postnatal exposure to diesel. Setting: Laboratory of Experimental Air Pollution. Animal(s): Swiss mice. Intervention(s): Mice exposed to diesel exhaust with doses that correspond to the daily average PM2.5 levels (fine particles in the ambient air 2.5 mu m or less in size) reported by the World Health Organization. Main Outcome Measure(s): Morphometric analyses of the ovaries and uterus were performed to define the relative area occupied by follicles, corpus luteum, and stroma and the proportionate area of glands, epithelial layer, and stroma within the uterine endometrium. Result(s): A significant reduction in the proportion of primordial follicles was observed in intrauterine-exposed animals, those exposed during the postnatal period, and in animals exposed during both phases. Primary follicle proportion was reduced in animals exposed during pregnancy. No significant changes were detected in uterine morphology. Conclusion(s): Intrauterine exposure to acceptable levels of diesel exhaust compromises the reproductive potential of female mice, diminishing ovarian reserve when sexual maturity is achieved. This effect could increase the risk of premature menopause. The findings raise concern about current environmental guidelines for diesel exposure, warranting more careful examination of this issue in humans by regulatory authorities. ((c) 2013 by American Society for Reproductive Medicine.)