BRUNO GUALANO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
163 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.
- Creatine supplementation for older adults: Focus on sarcopenia, osteoporosis, frailty and Cachexia(2022) CANDOW, Darren G.; CHILIBECK, Philip D.; FORBES, Scott C.; FAIRMAN, Ciaran M.; GUALANO, Bruno; ROSCHEL, HamiltonSarcopenia refers to the age-related reduction in strength, muscle mass and functionality which increases the risk for falls, injuries and fractures. Sarcopenia is associated with other age-related conditions such as osteoporosis, frailty and cachexia. Identifying treatments to overcome sarcopenia and associated conditions is important from a global health perspective. There is evidence that creatine monohydrate supplementation, primarily when combined with resistance training, has favorable effects on indices of aging muscle and bone. These musculoskeletal benefits provide some rationale for creatine being a potential intervention for treating frailty and cachexia. The purposes of this narrative review are to update the collective body of research pertaining to the effects of creatine supplementation on indices of aging muscle and bone (including bone turnover markers) and present possible justification and rationale for its utilization in the treatment of frailty and cachexia in older adults.
- Erratic control of breathing during exercise in patients with systemic lupus erythematosus: a pilot-study(2011) PRADO, D. M. L. do; GUALANO, B.; MIOSSI, R.; LIMA, F. R.; ROSCHEL, H.; BORBA, E.; BONFA, E.; PINTO, A. L. de SaPurpose: The aim of this study was to provide a comprehensive evaluation of the pattern and timing of breathing during incremental exercise in a sample of women living with systemic lupus erythematosus (SLE). Methods: In this cross-sectional study, 20 women with SLE without pulmonary involvement were compared with 20 gender-, body mass index- (BMI), and age-matched healthy individuals. By using a cardiopulmonary incremental exercise test, the following parameters were assessed: tidal volume (VT); breathing frequency (BF); total respiratory time (TOT); inspiratory time (TI); expiratory time (TE); inspiratory time to total time (TI/TOT); mean inspiratory flow (VT/TI); ventilatory equivalent for carbon dioxide (VE/VCO(2)) and end-tidal carbon dioxide pressure (PETCO(2)). Results: BF and BF/VT were significantly higher in patients with SLE versus controls, whereas VT, TE, TI and TOT were significantly lower in the former group (p < 0.05). Additionally, patients with SLE presented higher VE/VCO(2) and lower PETCO(2) than controls (p < 0.05), suggesting a ventilatory inefficiency. Conclusion: We reported compelling evidence of abnormal pattern and timing of breathing during incremental exercise in SLE. Considering that an erratic control of breathing may play an important role in exercise intolerance and fatigue, respiratory exercises emerge as a potential treatment for these symptoms in patients with SLE. Lupus (2011) 20, 1535-1540.
- 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.
- GLUT4 translocation is not impaired after acute exercise in skeletal muscle of women with obesity and polycystic ovary syndrome(2015) DANTAS, Wagner Silva; MARCONDES, Jose Antonio Miguel; SHINJO, Samuel Katsuyuki; PERANDINI, Luiz Augusto; ZAMBELLI, Vanessa Olzon; NEVES, Willian Das; BARCELLOS, Cristiano Roberto Grimaldi; ROCHA, Michele Patrocinio; YANCE, Viviane Dos Reis Vieira; PEREIRA, Renato Tavares Dos Santos; MURAI, Igor Hisashi; PINTO, Ana Lucia De Sa; ROSCHEL, Hamilton; GUALANO, BrunoObjectiveThe aim of this study was to examine the effects of acute exercise on insulin signaling in skeletal muscle of women with polycystic ovary syndrome (PCOS) and controls (CTRL). MethodsFifteen women with obesity and PCOS and 12 body mass index-matched CTRL participated in this study. Subjects performed a 40-min single bout of exercise. Muscle biopsies were performed before and 60 min after exercise. Selected proteins were assessed by Western blotting. ResultsCTRL, but not PCOS, showed a significant increase in PI3-k p85 and AS160 Thr 642 after a single bout of exercise (P=0.018 and P=0.018, respectively). Only PCOS showed an increase in Akt Thr 308 and AMPK phosphorylation after exercise (P=0.018 and P=0.018, respectively). Total GLUT4 expression was comparable between groups (P>0.05). GLUT4 translocation tended to be significantly higher in both groups after exercise (PCOS: P=0.093; CTRL: P=0.091), with no significant difference between them (P>0.05). ConclusionsA single bout of exercise elicited similar GLUT4 translocation in skeletal muscle of PCOS and CTRL, despite a slightly differential pattern of protein phosphorylation. The absence of impairment in GLUT4 translocation suggests that PCOS patients with obesity and insulin resistance may benefit from exercise training.
- It is over there, next to that fat lady: a qualitative study of fat women's own body perceptions and weight-related discriminations(2020) ULIAN, Mariana Dimitrov; SATO, Priscila de Morals; PINTO, Ana Jessica; BENATTI, Fabiana B.; CAMPOS-FERRAZ, Patricia Lopes de; COELHO, Desire; ROBLE, Odilon J.; SABATINI, Fernanda; PEREZ, Isabel; ABURAD, Luiz; VESSONI, Andre; UNSAIN, Ramiro Fernandez; GUALANO, Bruno; SCAGLIUSI, Fernanda B.We investigated fat women's perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.
- Placebo in sports nutrition: a proof-of-principle study involving caffeine supplementation(2017) SAUNDERS, B.; OLIVEIRA, L. F. de; SILVA, R. P. da; PAINELLI, V. de Salles; GONCALVES, L. S.; YAMAGUCHI, G.; MUTTI, T.; MACIEL, E.; ROSCHEL, H.; ARTIOLI, G. G.; GUALANO, B.We investigated the effects of supplement identification on exercise performance with caffeine supplementation. Forty-two trained cyclists (age 37 +/- 8years, body mass [BM] 74.3 +/- 8.4kg, height 1.76 +/- 0.06m, maximum oxygen uptake 50.0 +/- 6.8mL/kg/min) performed a similar to 30min cycling time-trial 1h following either 6mg/kgBM caffeine (CAF) or placebo (PLA) supplementation and one control (CON) session without supplementation. Participants identified which supplement they believed they had ingested (caffeine, placebo, don't know) pre- and post-exercise. Subsequently, participants were allocated to subgroups for analysis according to their identifications. Overall and subgroup analyses were performed using mixed-model and magnitude-based inference analyses. Caffeine improved performance vs PLA and CON (P0.001). Correct pre- and post-exercise identification of caffeine in CAF improved exercise performance (+4.8 and +6.5%) vs CON, with slightly greater relative increases than the overall effect of caffeine (+4.1%). Performance was not different between PLA and CON within subgroups (all P>0.05), although there was a tendency toward improved performance when participants believed they had ingested caffeine post-exercise (P=0.06; 87% likely beneficial). Participants who correctly identified placebo in PLA showed possible harmful effects on performance compared to CON. Supplement identification appeared to influence exercise outcome and may be a source of bias in sports nutrition.
- Exercise Enhances the Effect of Bariatric Surgery in Markers of Cardiac Autonomic Function(2021) GIL, Saulo; PECANHA, Tiago; DANTAS, Wagner S.; MURAI, Igor Hisashi; MEREGE-FILHO, Carlos Alberto Abujabra; SA-PINTO, Ana Lucia de; PEREIRA, Rosa Maria Rodrigues; CLEVA, Roberto de; SANTO, Marco Aurelio; REZENDE, Diego Augusto Nunes; KIRWAN, John P.; GUALANO, Bruno; ROSCHEL, HamiltonBackground Bariatric surgery improves cardiovascular health, which might be partly ascribed to beneficial alterations in the autonomic nervous system. However, it is currently unknown whether benefits from surgery on cardiac autonomic regulation in post-bariatric patients can be further improved by adjuvant therapies, namely exercise. We investigated the effects of a 6-month exercise training program on cardiac autonomic responses in women undergoing bariatric surgery. Methods Sixty-two women eligible for bariatric surgery were randomly allocated to either standard of care (control) or an exercise training intervention. At baseline (PRE) and 3 (POST3) and 9 (POST9) months after surgery, we assessed chronotropic response to exercise (CR%; i.e., percentage change in heart rate from rest to peak exercise) and heart rate recovery (HRR30s, HRR60s, and HRR120s; i.e., decay of heart rate at 30, 60, and 120 s post exercise) after a maximal exercise test. Results Between-group absolute changes revealed higher CR% (Delta = 8.56%, CI95% 0.22-19.90, P = 0.04), HRR30s (Delta = 12.98 beat/min, CI95% 4.29-21.67, P = 0.01), HRR60s (Delta = 22.95 beat/min, CI95% 11.72-34.18, P = 0.01), and HRR120s (Delta = 34.54 beat/min, CI95% 19.91-49.17, P < 0.01) in the exercised vs. non-exercised group. Conclusions Our findings demonstrate that exercise training enhanced the benefits of bariatric surgery on cardiac autonomic regulation. These results highlight the relevance of exercise training as a treatment for post-bariatric patients, ensuring optimal cardiovascular outcomes.
- 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.
- Number of high-protein containing meals correlates with muscle mass in pre-frail and frail elderly(2020) HAYASHI, Ana Paula; CAPITANI, Mariana Dutilh de; DIAS, Samara Fernandes; GONCALVES, Livia de Souza; FERNANDES, Alan Lins; JAMBASSI-FILHO, Jose Claudio; SANTANA, Davi Alves de; LIXANDRAO, Manoel; PEREIRA, Renato Tavares dos Santos; RIANI, Luiz; HEVIA-LARRAIN, Victoria; PEREIRA, Rosa Maria Rodrigues; GUALANO, Bruno; ROSCHEL, HamiltonBackground Aging is accompanied by the inability to optimally respond to anabolic stimulus of nutrition, with consequent loss of muscle mass and functionality. It has been speculated that not only total protein intake, but also the per meal protein dose may have important implications to protein balance and, hence, muscle mass in middle-aged and older adults, but evidence is lacking in a more vulnerable population such as the frail elderly. The aim was to investigate possible associations between total protein intake and its per meal dose with multiple measures of muscle mass, strength, and functionality in a cohort of pre-frail and frail elderly individuals. Methods One-hundred-and-fifty-seven pre-frail and frail elderly individuals were assessed for total and per meal protein intake (food diaries), total and appendicular lean mass (DXA), vastus lateralis cross-sectional area [(CSA) B-mode ultrasound], and muscle function [leg-press and bench press 1-RM, timed-stands test, timed-up-and-go test, handgrip, and risk of falls (Biodex Balance System (R))]. Results Protein intake and number of meals with either >= 20 g or >= 30 g of protein were significantly associated (after controlling for confounding factors) with greater total and appendicular lean mass and vastus lateralis CSA. Conclusions We found that not only total protein intake but also the number of high-protein containing meals are associated with muscle mass in frail and pre-frail elderly.