JULIANA PEREIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina - Líder
14 resultados
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- Respiratory viruses and postoperative hemodynamics in patients with unrestrictive congenital cardiac communications: a prospective cohort study(2023) ABUD, Kelly C. O.; MACHADO, Clarisse M.; BOAS, Lucy S. Vilas S.; MAEDA, Nair Y.; CARVALHO, Eloisa S.; SOUZA, Maria Francilene S.; GAIOLLA, Paula V.; CASTRO, Claudia R. P.; PEREIRA, Juliana; RABINOVITCH, Marlene; LOPES, Antonio AugustoBackgroundPulmonary vascular abnormalities pose a risk for severe life-threatening hemodynamic disturbances following surgical repair of congenital cardiac communications (CCCs). In the distal lung, small airways and vessels share a common microenvironment, where biological crosstalks take place. Because respiratory cells infected by viruses express a number of molecules with potential impact on airway and vascular remodeling, we decided to test the hypothesis that CCC patients carrying viral genomes in the airways might be at a higher risk for pulmonary (and systemic) hemodynamic disturbances postoperatively.MethodsSixty patients were prospectively enrolled (age 11 [7-16] months, median with interquartile range). Preoperative pulmonary/systemic mean arterial pressure ratio (PAP/SAP) was 0.78 (0.63-0.88). The presence or absence of genetic material for respiratory viruses in nasopharyngeal and tracheal aspirates was investigated preoperatively in the absence of respiratory symptoms using real-time polymerase chain reaction (kit for detection of 19 pathogens). Post-cardiopulmonary bypass (CPB) inflammatory reaction was analyzed by measuring serum levels of 36 inflammatory proteins (immunoblotting) 4 h after its termination. Postoperative hemodynamics was assessed using continuous recording of PAP and SAP with calculation of PAP/SAP ratio.ResultsViral genomes were detected in nasopharynx and the trachea in 64% and 38% of patients, respectively. Rhinovirus was the most prevalent agent. The presence of viral genomes in the trachea was associated with an upward shift of postoperative PAP curve (p = 0.011) with a PAP/SAP of 0.44 (0.36-0.50) in patients who were positive versus 0.34 (0.30-0.45) in those who were negative (p = 0.008). The presence or absence of viral genomes in nasopharynx did not help predict postoperative hemodynamics. Postoperative PAP/SAP was positively correlated with post-CPB levels of interleukin-1 receptor antagonist (p = 0.026), macrophage migration inhibitory factor (p = 0.019) and monocyte chemoattractant protein-1 (p = 0.031), particularly in patients with virus-positive tracheal aspirates.ConclusionsPatients with CCCs carrying respiratory viral genomes in lower airways are at a higher risk for postoperative pulmonary hypertension, thus deserving special attention and care. Preoperative exposure to respiratory viruses and post-CPB inflammatory reaction seem to play a combined role in determining the postoperative behavior of the pulmonary circulation.
- A difficult case of angioimmunoblastic T-cell lymphoma to diagnose(2016) SACHSIDA-COLOMBO, Elisabetta; MARIANO, Livia Caroline Barbosa; BASTOS, Fernanda Queiróz; RASSI, Amanda Bruder; LAGE, Luís Alberto de Pádua Covas; BARRETO, Ariel; SIQUEIRA, Sheila; PEREIRA, Juliana
conferenceObject PARAOXONASE 3 POLYMORPHISMS ARE NOT ASSOCIATED WITH PROGRESSION FREE SURVIVAL AND OVERALL SURVIVAL IN DIFFUSE LARGE B-CELL LYMPHOMA PATIENTS(2012) BYDLOWSKI, Sergio; SINI, Bruno; FLORES, Milagros; CHAVES, Denise; MASELLI, Luciana; PEREIRA, Juliana; LEVY, DeboraBackground: Diffuse large B-cell lymphoma (DLBCL) is the most common type of aggressive lymphoma. It is a heterogeneous disease. Approximately 40% of the patients respond well to chemotherapy based on rituximab-CHOP (R-CHOP). The prognosis for the other 60% is poor and only half of the patients survive 5 years after the onset of the disease. The paraoxonase (PON) gene family is composed of three members (PON1, PON2, PON3). All the three proteins have been shown to exhibit antioxidant and anti-inflammatory properties. Evidences exist indicating that the PON family plays an important role in a variety of human illnesses such as cardiovascular disease, diabetes mellitus, metabolic syndrome, obesity, non-alcoloholic steatohepatitis and several mental disorders. However, their role inDLBCL is still unknown. Methods: 106 DLBCL patients treated with R-CHOP or CHOP were studied. Control group included 130 healthy blood donors. Blood was drawn and DNA extracted by conventional methods. Polymorphisms of PON3 were performed by real time polymerase chain reaction using TaqMan system. Results: Forty-six (43.4%) patients were in stage III-IV and 42 (39.6%) had more than 2 factors established by the International Prognostic Index (IPI). Seventy-nine (74.5%) achieved complete response (IC95%: 77-93%); 6 (5.6%) had partial response (RD) and 21 (19.9%) patients had refractory disease. Eighteen (16.9%) patients died in a follow up median of 29.6 months (5.5 to 72.7). Polymorphisms frequencies in control group were:76% and 24%, respectively, for the alleles PON3-10340T and PON3-10340G; 8% and 92%, respectively, for the alleles PON3-2115A and PON3-2115T; and 4% and 96%, respectively, for the alleles PON3-45486A and PON3-45486C. The frequencies in the group of patients were: 76% and 24% for the alleles PON3-10340T and PON3-10340G, respectively; 9% and 91% for the alleles PON3-2115A and PON3-2115T, respectively; and 1% and 99% for the alleles PON3-45486A and PON3-45486C, respectively. Fisher exact test showed no significant difference between groups. The overall response and progression-free survival of patients with DLBCL were not related to PON3 polymorphisms. Conclusion: The present data shows that PON3 polymorphisms do not play a role in diffuse large B-cell lymphoma.- Primary nodal peripheral T-cell lymphomas: diagnosis and therapeutic considerations(2015) LAGE, Luis Alberto de Pádua Covas; CABRAL, Tamara Carvalho dos Santos; COSTA, Renata de Oliveira; GONÇALVES, Marianne de Castro; LEVY, Debora; ZERBINI, Maria Cláudia Nogueira; PEREIRA, JulianaNodal peripheral T-cell lymphomas are a rare group of neoplasms derived from post-thymic and activated T lymphocytes. A review of scientific articles listed in PubMed, Lilacs, and the Cochrane Library databases was performed using the term ""peripheral T-cell lymphomas"". According to the World Health Organization classification of hematopoietic tissue tumors, this group of neoplasms consists of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS), angioimmunoblastic T-cell lymphoma (AITL), anaplastic large cell lymphoma-anaplastic lymphoma kinase positive (ALCL-ALK+), and a provisional entity called anaplastic large cell lymphoma-anaplastic lymphoma kinase negative (ALCL-ALK-). Because the treatment and prognoses of these neoplasms involve different principles, it is essential to distinguish each one by its clinical, immunophenotypic, genetic, and molecular features. Except for anaplastic large cell lymphoma-anaplastic lymphoma kinase positive, which has no adverse international prognostic index, the prognosis of nodal peripheral T-cell lymphomas is worse than that of aggressive B-cell lymphomas. Chemotherapy based on anthracyclines provides poor outcomes because these neoplasms frequently have multidrug-resistant phenotypes. Based on this, the current tendency is to use intensified cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) regimens with the addition of new drugs, and autologous hematopoietic stem cell transplantation. This paper describes the clinical features and diagnostic methods, and proposes a therapeutic algorithm for nodal peripheral T-cell lymphoma patients.
- Increased Levels of Circulating Endothelial Progenitor Cells in Human T-cell Lymphotropic Virus Type I Carriers(2011) MEIRELES, Ana Luisa L. Pedroso; HALLACK NETO, Abrahao Elias; COSTA, Renata de Oliveira; PEREIRA, JulianaBackground and Aims. HTLV-I-transformed T cells secrete biologically active forms of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b-FGF). In addition, HTLV-I-transformed cells have a high capacity of adhesion to endothelial cells. Methods. We measured the circulating endothelial progenitor cells (EPCs) and mature endothelial cells (MECs) by flow cytometry in 27 HTLV-I carriers in comparison to 30 healthy, age- and gender-matched subjects. All subjects had HTLV-I positivity confirmed by Western blot and/or polymerase chain reaction (PCR). The numbers of different subpopulations of EPCs and MECSs were evaluated by four-color flow cytometry using a panel of monoclonal antibodies. All reactions were done in duplicate to confirm reproducibility of the results. Results. The median age of all 27 HTLV-I carriers enrolled in this study was 45 years (range: 27-65 years); 11(41%) were male and 16 (59%) were female. The median age of the 30 healthy subjects in the control group was 45.5 years (range: 20-63 years); 11 (36.6%) were male and 19 (63.4%) were female. The number of EPCs was significantly higher in HTLV-I carriers (median 0.8288 cells/mu L, range: 0.0920-3.3176 cells/mu L) as compared to control group (median 0.4905 cells/mu L, range: 0.0000-1.5660 cells/mu L) (p = 0.035). In contrast, the median of the MECs in the HTLV-I carriers was 0.6380 cells/mu L (range: 0.0473-5.7618 cells/mu L) and 0.4950 cells/mu L (range: 0.0000-4.0896 cells/mu L) in the control group, with no statistical difference (p = 0.697). Conclusions. We demonstrated that EPCs, but not MECs, are increased in the peripheral blood of HTLV-I carriers. (C) 2011 IMSS.
- Autologous bone marrow transplantation in patients relapsed one year after R-CHOP?(2012) PEREIRA, Juliana
- Presence of t(14;18) translocation in healthy individuals varies according to ethnic background in the Brazilian population(2017) LEVY, D.; BERTOLDI, E. R. M.; RUIZ, J. L. M.; PEREIRA, J.; BYDLOWSKI, S. P.Several groups have demonstrated that healthy individuals can present the t(14;18) translocation. In this report, the presence of the translocation was examined in healthy blood donors in Brazil, a country considered an ethnic melting pot. The translocation was detected by nested PCR in 227 peripheral blood samples from individuals with different ethnic backgrounds. The t(14;18) translocation was found in 45 of 85 White individuals (52.94%); in 57 of 72 Black individuals (79.17%); and in 68 of 70 individuals (97.14%) of Japanese-descent. In conclusion, the frequency of the t(14;18) translocation in the Brazilian population varies according to the ethnic background.
- Bone marrow necrosis: literature review(2016) CABRAL, Tamara C. S.; FERNANDES, Carolina M.; LAGE, Luis Alberto C.; ZERBINI, Maria Claudia; PEREIRA, JulianaABSTRACT Introduction: Bone marrow necrosis (BMN) is a rare pathologic entity that is commonly undiagnosed, and often associated with hematologic diseases. Methodology: We conducted a literature review at PubMed using ""bone marrow necrosis"" as key words. Our search retrieved 25 articles written in English, and a further 65 case reports. Results and discussion: BMN pathophysiology is not well understood, but appears to be associated with vascular injuries that lead to oxygen and nutrient deprivation. Destructive tumor necrosis factor alpha (TNF-α) activity is also likely involved in the development of endothelial and bone marrow sinusoidal lesions. Diagnoses of BMN are commonly indicated by anemia, thrombocytopenia, high levels of lactic dehydrogenase and alkaline phosphatase, and the identification of leukoerythroblastic reactions. Bone marrow (BM) aspirate and biopsy, and magnetic nuclear resonance imaging are the main diagnostic options. The only available treatments are those directed against the primary cause, with associated supportive care for what is ordinarily a rapidly lethal state. Conclusion: The search for an underlying associated malignancy is important for the management of BMN.
- Brain Perfusion Alterations Induced by Standalone and Combined Non-Invasive Brain Stimulation over the Dorsolateral Prefrontal Cortex(2022) RAZZA, Lais Boralli; SILVA, Pedro Henrique Rodrigues da; BUSATTO, Geraldo F.; DURAN, Fabio Luis de Souza; PEREIRA, Juliana; SMET, Stefanie De; KLEIN, Izio; ZANAO, Tamires A.; LUETHI, Matthias S.; BAEKEN, Chris; VANDERHASSELT, Marie-Anne; BUCHPIGUEL, Carlos Alberto; BRUNONI, Andre RussowskyNon-invasive brain stimulation (NIBS) interventions are promising for the treatment of psychiatric disorders. Notwithstanding, the NIBS mechanisms of action over the dorsolateral prefrontal cortex (DLPFC), a hub that modulates affective and cognitive processes, have not been completely mapped. We aimed to investigate regional cerebral blood flow (rCBF) changes over the DLPFC and the subgenual anterior cingulate cortex (sgACC) of different NIBS protocols using Single-Photon Emission Computed Tomography (SPECT). A factorial, within-subjects, double-blinded study was performed. Twenty-three healthy subjects randomly underwent four sessions of NIBS applied once a week: transcranial direct current stimulation (tDCS), intermittent theta-burst stimulation (iTBS), combined tDCS + iTBS and placebo. The radiotracer 99m-Technetium-ethylene-cysteine-dimer was injected intravenously during the NIBS session, and SPECT neuroimages were acquired after the session. Results revealed that the combination of tDCS + iTBS increased right sgACC rCBF. Cathodal and anodal tDCS increased and decreased DLPFC rCBF, respectively, while iTBS showed no significant changes compared to the placebo. Our findings suggest that the combined protocol might optimize the activity in the right sgACC and encourage future trials with neuropsychiatric populations. Moreover, mechanistic studies to investigate the effects of tDCS and iTBS over the DLPFC are required.
conferenceObject IN VITRO AND IN VIVO ANTITUMOR EFFECTS OF AZIDOTHYMIDINE IN A HUMAN MULTIPLE MYELOMA CELL LINE(2012) LEVY, Debora; RUIZ, Jorge Luis; BROCARDO, Graciela; FERREIRA, Adilson; QUEIROZ, Rodrigo; MARIA, Durvanei; BYDLOWSKI, Sergio; PEREIRA, JulianaBackground: Azidothymidine (AZT) is an antiretroviral nucleoside analogous inhibitor ofreverse transcriptase with known effects on cell proliferation, apoptosis, and angiogenesis Multiple myeloma is a severe disease and one of the steps involved in the malignant transformation of plasma cells is the activation of the nuclear factor kappa B (NF-κB) pathway. Objective: Evaluate the in vitro cytotoxic activity of AZT in human myeloma cell lines (RPMI 8226/S and RPMI 8226/Dx5) as well as in other cell lines: human T cell lymphoblast-like, T cell leukemia, uterine sarcoma and HUVEC. The in vivo effect was also evaluated in tumor xenograft model of human multiple myeloma in nude mice. Methods: Cells were treated with increasing concentrations of AZT (32.2 to 500μM) for 24 to 72 hours. Cytotoxicity was measured by MTT. Cell cycle and proteins Bcl-2 and p53 were evaluated by flow cytometry. For the in vivo experiments, 1x107 RPMI 8226/S cells were injected SC in the right flank of nude mice. After 7 days, animals were treated or not with AZT 12.5 μM IV every other day for 5 weeks. Thirty five genes were then investigated in the grafted tumor cells by real time polymerase chain reaction. Results: AZT showed in vitro antitumor activity in cell lines 8226/S and 8226/Dx5 in a dose and time dependent way (p = 0.02), but not in the other studied cells. Histological signs of apoptosis were seen, such as cytoplasmic blebs, nuclear condensation. A significant decrease of Bcl-2 (p<0.001) and p53 (p = 0.0139) proteins was observed in cells treated with AZT. A cell cycle arrest in Sphase was also seen after 72 hours of treatment with AZT 62.5 μM. Tumor volume in nude mice reated with AZT was reduced (p = 0.0003). In these tumors, AZT decreased the expression of genes associated with cell proliferation (AKT1, MYC, STAT1, MAPK8, MAPK9, CCL-3, Bcl-3 and Cyclin D2), angiogenesis (VEGF, IL8), cell adhesion (ICAM1 and FN1) and NF-κB. Moreover, also in tumors, AZT induced expression of the tumor suppressor gene FOXP1, pro-apoptotic genes BID, Bcl-10 and caspase-8. Conclusion: Azidothymidine promotes a cytotoxic effect in human multiple myeloma cells both in vitro and in vivo. This action involves the cell cycle arrest in S phase, inhibition of expression of genes that activate cell proliferation, as well as proangiogenic genes and NF- κB, and activation of apoptosis genes. Therefore, AZT could be potentially promising in the treatment of multiple myeloma.