CELIA REGINA FURUCHO
Projetos de Pesquisa
Unidades Organizacionais
LIM/48 - Laboratório de Imunologia, Hospital das Clínicas, Faculdade de Medicina
5 resultados
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- Polymorphisms on IFNG, IL12B and IL12RB1 genes and paracoccidioidomycosis in the Brazilian population(2016) CARVALHO, F. M. C.; BUSSER, F. D.; FREITAS, V. L. T.; FURUCHO, C. R.; SADAHIRO, A.; KONO, A. S. G.; CRIADO, P. R.; MORETTI, M. L.; SATO, P. K.; SHIKANAI-YASUDA, M. A.Paracoccidioidomycosis (PCM) is a systemic chronic mycosis, endemic in Latin America, especially Brazil, and is the eighth leading cause of death among chronic and recurrent infectious diseases. PCM infection is characterized by the presence of Th1 immune response; the acute form, by a mixed Th2/Th9, while the chronic form is characterized by Th17/Th22 profiles. The occurrence and severity of human PCM may also be associated with genetic factors such as single nucleotide polymorphisms (SNP) on cytokines encoding genes. We investigated the association between these polymorphisms and the different clinical forms of PCM. We included 156 patients with PCM(40 with the acute form, 99 with the chronic multifocal and 17 with the chronic unifocal form) and assayed their DNA samples for IFNG + 874 T/A SNP by PCR-ARMS (Amplification Refractory Mutational System), IL12B + 1188 A/C SNP on 3' UTR and IL12RB1 641 A/G SNP on exon 7 by PCR-RFLP (Restriction Fragment Length Polymorphism). We found similar genotypic and allelic frequencies of the investigated SNPs among the clinical forms of PCM. Considering male patients, the IL12RB1 641 AA genotype was more frequent in the chronic multifocal form while heterozygosis was in the chronic unifocal form of PCM (p = 0.048). Although our data suggest that the AA genotype (IL12RB1) may be associated with the more disseminated chronic disease, more patients of the chronic unifocal PCM group need to be analyzed as well as the secretion patterns of IFN-gamma combined with the IL-12R beta 1 expression for a better comprehension of this association.
- Interdisciplinary approach at the primary healthcare level for Bolivian immigrants with Chagas disease in the city of Sao Paulo(2017) YASUDA, Maria Aparecida Shikanai; SATOLO, Camila Goncalves; CARVALHO, Noemia Barbosa; ATALA, Magda Maya; FERRUFINO, Rosarlo Quiroga; LEITE, Ruth Moreira; FURUCHO, Celia Regina; LUNA, Expedito; SILVA, Rubens Antonio; HAGE, Marcia; OLIVEIRA, Caroline Medeji Ramos de; BUSSER, Felipe Delatorre; FREITAS, Vera Lucia Teixeira de; WANDERLEY, Dalva Marli Valerio; MARTINELLI, Luzia; ALMEIDA, Sonia Regina; VINAS, Pedro Albajar; CARNEIRO JR., NivaldoBackground/Methods In a pioneering cross-sectional study among Bolivian immigrants in the city of Sao Paulo, Brazil, the epidemiological profile, clinical manifestations and morbidity of Chagas disease were described. The feasibility of the management of Chagas disease at primary healthcare clinics using a biomedical and psychosocial interdisciplinary approach was also tested. Previously, a Trypanosoma cruzi (T. cruzi) infection rate of 4.4% among 633 immigrants was reported. The samples were screened using two commercial enzyme-linked immunoassay (ELISA) tests generated with epimastigote antigens, and those with discrepant or seropositive results were analyzed by confirmatory tests: indirect immunofluorescence (IFI), TESA-blot and a commercial recombinant ELISA. PCR and blood cultures were performed in seropositive patients. Results The majority of the 28 seropositive patients were women, of whom 88.89% were of childbearing age. The predominant clinical forms of Chagas disease were the indeterminate and atypical cardiac forms. Less than 50% received the recommended antiparasitic treatment of benznidazole. An interdisciplinary team was centered on primary healthcare physicians who applied guidelines for the management of patients. Infectologists, cardiologists, pediatricians and other specialists acted as reference professionals. Confirmatory serology and molecular biology tests, as well as echocardiography, Holter and other tests, were performed for the assessment of affected organs in secondary healthcare centers. The published high performance of two commercial ELISA tests was not confirmed. Conclusion An interdisciplinary approach including antiparasitic treatment is feasible at the primary healthcare level for the management of Chagas disease in Bolivian immigrants. The itinerant feature of immigration was associated with a lack of adherence to antiparasitic treatment and was considered a main challenge for the clinical management of this population. This approach is recommended for management of the infected population in endemic and nonendemic areas, although different strategies are needed depending on the severity of the disease and the structure of the healthcare system.
- Prevalence of Trypanosoma cruzi infection among Bolivian immigrants in the city of Sao Paulo, Brazil(2017) LUNA, Expedito J. A.; FURUCHO, Celia R.; SILVA, Rubens A.; WANDERLEY, Dalva M.; CARVALHO, Noemia B.; SATOLO, Camila G.; LEITE, Ruth M.; SILVEIRA, Cassio; SILVA, Lia M. B.; AITH, Fernando M.; CARNEIRO JR., Nivaldo; SHIKANAI-YASUDA, Maria A.With the urbanisation of the population in developing countries and the process of globalisation, Chagas has become an emerging disease in the urban areas of endemic and non-endemic countries. In 2006, it was estimated that the prevalence of Chagas disease among the general Bolivian population was 6.8%. The aim of the present study was to determine the prevalence of Trypanosoma cruzi infection among Bolivian immigrants living in Sao Paulo, Brazil. This study had a sample of 633 volunteers who were randomly selected from the clientele of primary care units located in the central districts of Sao Paulo, Brazil. Infection was detected by two different ELISA assays with epimastigote antigens, followed by an immunoblot with trypomastigote antigens as a confirmatory test. The prevalence of the infection was 4.4%. Risk factors independently associated with the infection were: a history of rural jobs in Bolivia, knowledge of the vector involved in transmission, and having relatives with Chagas disease. Brazil has successfully eliminated household vector transmission of T. cruzi, as well as its transmission by blood transfusion. The arrival of infected immigrants represents an additional challenge to primary care clinics to manage chronic Chagas disease, its vertical transmission, and the blood derivatives and organ transplant programs.
- Assessment of biomarkers and clinical parameters as predictors of survival in patients with chagasic heart failure(2023) BOCCHI, Edimar Alcides; GUIMARAES, Guilherme Veiga; ROMERO, Cristhian Espinoza; SATO, Paula Keiko; FREITAS, Vera Lucia Teixeira de; KANASHIRO, Edite Hatsumi Yamashiro; FURUCHO, Celia Regina; CRUZ, Fatima Das Dores; NAKANISHI, Erika Shimoda; BUSSER, Felipe Delatorre; BEZERRA, Rita Cristina; WESTPHALEN, Elizabeth Visone Nunes; ROCHA, Mussya Cisotto; YASUDA, Maria Aparecida ShikanaiBackground Chagas disease, endemic in Latin America and spreading globally due to emigration, has a significant health burden, particularly in relation to chagasic heart failure (HF). Chagasic cardiomyopathy (CCM) is characterized by chronic inflammatory myocardial disease. This study aimed to identify inflammatory parameters and biomarkers that could aid in the management of patients with chagasic HF. Methods and findings A cohort study was conducted at a tertiary cardiology single-center over a mean follow-up period of 2.4 years. The study included patients with HF secondary to CCM enrolled between October 2013 and July 2017. Various clinical parameters, echocardiography findings, parasitemia status, brain natriuretic peptide (BNP) and troponin T (TnT) levels, and inflammatory biomarkers (IL-6, IL-10, IL-12p70, IL-17A, adiponectin, and IFN-gamma) were assessed. The study encompassed a cohort of 103 patients, with a median age of 53 years and 70% being male. The left ventricular ejection fraction (LVEF) was 28%, with 40% of patients classified as NYHA II functional class. The median BNP level was 291 pg/ml. The observed mortality rate during the study period was 38.8%. Predictors of lower survival were identified as elevated levels of BNP, TnT, reduced LVEF, and increased adiponectin (thresholds: BNP > 309 pg/ml, TnT > 27.5 ng/ml, LVEF < 25.5%, adiponectin > 38 mu g/mL). Notably, there was no evidence indicating a relationship between parasitemia and the inflammatory parameters with lower survival in these patients, including INF-gamma, IL-6, IL-10, IL12-(p70), and IL17a. Conclusion Despite the presence of a chronic inflammatory process, the evaluated inflammatory biomarkers in this cohort were not predictive of survival in patients with chagasic HF with reduced ejection fraction (HFrEF). However, reduced LVEF, elevated BNP, adiponectin levels, and troponin T were identified as predictors of lower survival in these patients.
- Recurrent and disseminated pityriasis versicolor: A novel clinical form consequent to Malassezia-host interaction?(2017) ROMERO-SANDOVAL, Karina; COSTA, Anderson Alves; SOUSA, Maria Gloria Teixeira; FURUCHO, Celia Regina; VALENTE, Neusa; CRIADO, Paulo R.; AOKI, Valeria; BENARD, GilPityriasis versicolor is a superficial fungal infection caused by Malassezia spp. The aim of this study is to propose the definition of a new clinical entity: the recurrent and disseminated pityriasis versicolor (RDPV). All patients with RDPV were enrolled over an eight-month period. Clinical and epidemiological data were obtained, Malassezia (M.) species were isolated in cultures and identified by phenotypic and molecular characterization, skin biopsies were taken from active lesions, serum levels of immunoglobulin E were obtained and therapeutic schemes were evaluated. A total of 16 patients were included (11 male, 5 female). The most frequently isolated species were M. japonica (n = 3) and M. furfur (n = 3). This is the first study that isolates M. japonica in patients with pityriasis versicolor; interestingly, those were recalcitrant patients. Seven patients (43.8%) had no cure with any of the proposed treatments; among those, 5 (71.4%) had increased serum IgE levels. The most effective treatment was itraconazole 200 mg daily for 28 days. The RDPV has very different features from the classic form, including a poor response to treatment, and the isolation of different Malassezia species; therefore, we propose a hypothesis for the definition of a new clinical condition (RDPV), which could be a result of the interaction Malassezia-host.