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
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
- Daily Leucine Intake Is Positively Associated with Lower Limb Skeletal Muscle Mass and Strength in the Elderly(2021) LIXANDRAO, Manoel E.; LONGOBARDI, Igor; LEITAO, Alice E.; MORAIS, Joao V. M.; SWINTON, Paul A.; AIHARA, Andre Y.; GOES, Paola C. K.; UGRINOWITSCH, Carlos; CANDOW, Darren G.; GUALANO, Bruno; ROSCHEL, HamiltonHigher daily protein intake, with an emphasis on leucine content, is thought to mitigate age-related anabolic resistance, potentially counteracting age-related morphological and functional declines. The present study investigated potential associations between total daily leucine intake and dependent variables, including quadriceps muscle cross-sectional area (CSA) and maximum dynamic muscle strength (1-RM) in a cohort of healthy free-living older individuals of both sexes (n = 67; 34/33 men/women). Participants performed three 24 h dietary recalls and underwent a magnetic resonance imaging exam followed by 1-RM tests. Our results demonstrate moderate associations between total daily leucine and both quadriceps CSA (r = 0.42; p = 0.004) and 1-RM (r = 0.45; p = 0.001). Furthermore, our exploratory biphasic linear regression analyses, adjusted for sex, age, and protein intake relative to body weight, revealed a plateau for daily leucine intake and muscle mass and muscle strength (~7.6-8.0 g & BULL;day(-1)) in older adults. In conclusion, we demonstrated that total daily leucine intake is associated with muscle mass and strength in healthy older individuals and this association remains after controlling for multiple factors, including overall protein intake. Furthermore, our breakpoint analysis revealed non-linearities and a potential threshold for habitual leucine intake, which may help guide future research on the effects of chronic leucine intake in age-related muscle loss.
- A Systematic Risk Assessment and Meta-Analysis on the Use of Oral beta-Alanine Supplementation(2019) DOLAN, Eimear; SWINTON, Paul A.; PAINELLI, Vitor de Salles; HEMINGWAY, Benedict Stephens; MAZZOLANI, Bruna; SMAIRA, Fabiana Infante; SAUNDERS, Bryan; ARTIOLI, Guilherme G.; GUALANO, Brunobeta-Alanine supplementation is one of the world's most commonly used sports supplements, and its use as a nutritional strategy in other populations is ever-increasing, due to evidence of pleiotropic ergogenic and therapeutic benefits. Despite its widespread use, there is only limited understanding of potential adverse effects. To address this, a systematic risk assessment and meta-analysis was undertaken. Four databases were searched using keywords and Medical Subject Headings. All human and animal studies that investigated an isolated, oral, beta-alanine supplementation strategy were included. Data were extracted according to 5 main outcomes, including 1) side effects reported during longitudinal trials, 2) side effects reported during acute trials, 3) effect of supplementation on circulating health-related biomarkers, 4) effect of supplementation on skeletal muscle taurine and histidine concentration, and 5) outcomes from animal trials. Quality of evidence for outcomes was ascertained using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework, and all quantitative data were meta-analyzed using multilevel models grounded in Bayesian principles. In total, 101 human and 50 animal studies were included. Paraesthesia was the only reported side effect and had an estimated OR of 8.9 [95% credible interval (CrI): 2.2, 32.6] with supplementation relative to placebo. Participants in active treatment groups experienced similar dropout rates to those receiving the placebo treatment. beta-Alanine supplementation caused a small increase in circulating alanine aminotransferase concentration (effect size, ES: 0.274, CrI: 0.04, 0.527), although mean data remained well within clinical reference ranges. Meta-analysis of human data showed no main effect of beta-alanine supplementation on skeletal muscle taurine (ES: 0.156; 95% CrI: -0.38, 0.72) or histidine (ES: -0.15; 95% CrI: -0.64, 0.33) concentration. A main effect of beta-alanine supplementation on taurine concentration was reported for murine models, but only when the daily dose was >= 3% beta-alanine in drinking water. The results of this review indicate that beta-alanine supplementation within the doses used in the available research designs, does not adversely affect those consuming it.
conferenceObject Sex, But Not Age, Associates With Whole Muscle Carnosine Content Of Trained Men And Women(2020) DOLAN, Eimear; SWINTON, Paul A.; OLIVEIRA, Luana Farias de; REZENDE, Nathalia Saffioti; MAZZOLANI, Bruna Caruso; BESTETTI, Giulia Cazetta; SMAIRA, Fabiana Infante; DUMAS, Alina; PERIM, Pedro; RIANI, Luiz; GUALANO, Bruno; SAUNDERS, Bryan- A Statistical Framework to Interpret Individual Response to Intervention : Paving the Way for Personalized Nutrition and Exercise Prescription(2018) SWINTON, Paul A.; HEMINGWAY, Ben Stephens; SAUNDERS, Bryan; GUALANO, Bruno; DOLAN, EimearThe concept of personalized nutrition and exercise prescription represents a topical and exciting progression for the discipline given the large inter-individual variability that exists in response to virtually all performance and health related interventions. Appropriate interpretation of intervention-based data from an individual or group of individuals requires practitioners and researchers to consider a range of concepts including the confounding influence of measurement error and biological variability. In addition, the means to quantify likely statistical and practical improvements are facilitated by concepts such as confidence intervals (CIs) and smallest worthwhile change (SWC). The purpose of this review is to provide accessible and applicable recommendations for practitioners and researchers that interpret, and report personalized data. To achieve this, the review is structured in three sections that progressively develop a statistical framework. Section 1 explores fundamental concepts related to measurement error and describes how typical error and CIs can be used to express uncertainty in baseline measurements. Section 2 builds upon these concepts and demonstrates how CIs can be combined with the concept of SWC to assess whether meaningful improvements occur post-intervention. Finally, section 3 introduces the concept of biological variability and discusses the subsequent challenges in identifying individual response and non-response to an intervention. Worked numerical examples and interactive Supplementary Material are incorporated to solidify concepts and assist with implementation in practice.
conferenceObject Non-placebo Controls To Determine The Magnitude Of Ergogenic Interventions: A Systematic Review And Meta-analysis(2021) MARTICORENA, Felipe Miguel; CARVALHO, Arthur; OLIVEIRA, Luana Farias de; DOLAN, Eimear; GUALANO, Bruno; SWINTON, Paul; SAUNDERS, Bryan- Association between physical activity and immunogenicity of an inactivated virus vaccine against SARS-CoV-2 in patients with autoimmune rheumatic diseases(2022) GUALANO, Bruno; LEMES, Italo R.; SILVA, Rafael P.; PINTO, Ana J.; MAZZOLANI, Bruna C.; I, Fabiana Smaira; SIECZKOWSKA, Sofia M.; AIKAWA, Nadia E.; PASOTO, Sandra G.; MEDEIROS-RIBEIRO, Ana C.; SAAD, Carla G. S.; YUKI, Emily F. N.; SILVA, Clovis A.; SWINTON, Paul; HALLAL, Pedro C.; ROSCHEL, Hamilton; BONFA, EloisaObjectives: To investigate whether physical activity is associated with enhanced immunogenicity of a SARS-CoV-2 inactivated vaccine (Coronavac) in patients with autoimmune rheumatic diseases (ARD) (n = 898) and in nonARD (n = 197) individuals without pre-existing immunogenicity to SARS-CoV-2. Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial. Immunogenicity was assessed after vaccination by measuring seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG (SC), geometric mean titers of anti-S1/S2 IgG (GMT), factor-increase in GMT (FI-GMT), frequency of neutralizing antibody (NAb), and median neutralizing activity. Physical activity (active being defined as > 150 min/week) and sedentary behavior (>8h/day) were assessed by questionnaire. Results: Physically active ARD patients (n = 494) were younger and less frequently used prednisone/biologics than inactive patients (n = 404). After controlling for covariates, active patients exhibited greater SC (OR: 1.4 [95%CI: 1.1-2.0]), GMT (32% [95%CI: 8.8-60) and FI-GMT (33% [95%CI: 9.6-63%]) vs. inactive. Cluster analysis (physical activity/sedentary status) revealed greater GMT (43.0% [95% CI: 11.0-84.0%) and FI-GMT (48.0% [95%CI: 14.0-92.0%]) in active/non-sedentary vs. inactive/sedentary ARD patients. A dose-response was observed, with greater benefits for the group of patients performing > 350 min/week of physical activity (OR: 1.6 [95%CI: 1.1-2.4]; 41% [95%CI: 10-80%]; 35% [95%CI: 4.3-74], for SC, GMT, and FI-GMT, respectively) vs. the least active group (<= 30 min/week). Greater SC (OR: 9.9 [95%CI: 1.1-89.0]) and GMT (26% [95% CI: 2.2-56.0%]) were observed in active vs. inactive non-ARD. Conclusions: A physically active lifestyle may enhance SARS-CoV-2 vaccine immunogenicity, a finding of particular clinical relevance for immunocompromised patients.
- Physical activity and antibody persistence 6 months after the second dose of CoronaVac in immunocompromised patients(2022) GUALANO, Bruno; LEMES, Italo Ribeiro; SILVA, Rafael Pires da; PINTO, Ana Jessica; MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; SIECZKOWSKA, Sofia Mendes; AIKAWA, Nadia Emi; PASOTO, Sandra; MEDEIROS-RIBEIRO, Ana Cristina; SAAD, Carla; YUK, Emily; SILVA, Clovis; SWINTON, Paul; HALLAL, Pedro Curi; ROSCHEL, Hamilton; BONFA, EloisaThis prospective cohort study within an open-label, single-arm, phase 4 vaccination trial ( #NCT04754698) aimed to investigate the association between physical activity and persistent anti-SARS-CoV-2 antibodies 6 months after two-dose schedule of CoronaVac in autoimmune rheumatic diseases (ARD) patients (n = 748). Persistent immunogenicity 6 months after the full-course vaccination was assessed using seroconversion rates of total anti-SARS-CoV-2 S1/S2 IgG, geometric mean titers of anti-S1/S2 IgG (GMT), and frequency of positive neutralizing antibodies (NAb). Physical activity was assessed trough questionnaire. Adjusted point estimates from logistic regression models indicated that physically active patients had greater odds of seroconversion rates (OR: 1.5 [95%CI: 1.1 to 2.1]) and NAb positivity (OR: 1.5 [95%CI: 1.0 to 2.1]), and approximately 43% greater GMT (42.8% [95%CI: 11.9 to 82.2]) than inactive ones. In conclusion, among immunocompromised patients, being physically active was associated with an increment in antibody persistence through 6 months after a full-course of an inactivated SARS-CoV-2 vaccine.
- No Associations Between Physical Activity and Immunogenicity in SARS-CoV-2 Seropositive Patients With Autoimmune Rheumatic Diseases Prior to and After Vaccination(2023) SMAIRA, Fabiana Infante; MAZZOLANI, Bruna Caruso; LEMES, italo Ribeiro; SILVA, Rafael Pires da; PINTO, Ana J.; SIECZKOWSKA, Sofia M.; AIKAWA, Nadia E.; PASOTO, Sandra G.; MEDEIROS-RIBEIRO, Ana C.; SAAD, Carla G. S.; YUK, Emily F. N.; SILVA, Clovis A.; SWINTON, Paul; KUPA, Leonard de Vinci Kanda; HALLAL, Pedro C.; ROSCHEL, Hamilton; GUALANO, Bruno; BONFA, EloisaAim: To investigate the association between physical activity and immunogenicity among SARS-CoV-2 seropositive patients with autoimmune rheumatic diseases prior to and following a 2-dose schedule of CoronaVac (Sinovac inactivated vaccine). Methods: This was a prospective cohort study within an open-label, single-arm, phase 4 vaccination trial conducted in Sao Paulo, Brazil. In this substudy, only SARS-CoV-2 seropositive patients were included. Immunogenicity was assessed by seroconversion rates of total anti-SARS-CoV-2 S1/S2 immunoglobulin G (IgG), geometric mean titers of anti-S1/S2 IgG, frequency of positive neutralizing antibodies, and neutralizing activity before and after vaccination. Physical activity was assessed through a questionnaire. Model-based analyses were performed controlling for age (<60 or>_60 y), sex, body mass index (<25, 25-30, and >30 kg/m2), and use of prednisone, immunosuppressants, and biologics. Results: A total of 180 seropositive autoimmune rheumatic disease patients were included. There was no association between physical activity and immunogenicity before and after vaccination. Conclusions: This study suggests that the positive association between physical activity and greater antibody responses seen in immunocompromised individuals following vaccination is overridden by previous SARS-CoV-2 infection, and does not extend to natural immunity.
- Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study(2021) GIL, Saulo; JACOB FILHO, Wilson; SHINJO, Samuel Katsuyuki; FERRIOLLI, Eduardo; BUSSE, Alexandre Leopold; AVELINO-SILVA, Thiago Junqueira; LONGOBARDI, Igor; OLIVEIRA JUNIOR, Gersiel Nascimento de; SWINTON, Paul; GUALANO, Bruno; ROSCHEL, HamiltonBackground Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID-19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID-19 patients. Methods We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS-CoV-2 during hospitalization and were excluded from the analyses. Results The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (+/- 15) years, body mass index of 29.5 (+/- 6.9) kg/m(2). The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07-2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex-specific mean and standard deviation (1.23 [95% CI: 1.06-1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 +/- 6.1 days) versus others (9.2 +/- 8.4 days). Evidence of associations were also present for vastus lateralis cross-sectional area. The crude HR identified shorter hospital stay for patients with greater sex-specific standardized values (1.20 [95% CI: 1.03-1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross-sectional area (0.63 [95% CI: 0.46-0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross-sectional area was longer (10.8 +/- 8.8 days) versus others (7.7 +/- 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross-sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID-19, which stresses the value of muscle health in prognosis of this disease.
- Comment on ""Health Coaching: 100 Strategies for Weight Loss: A Systematic Review and Meta-Analysis"" Reply(2021) SIECZKOWSKA, Sofia Mendes; LIMA, Alisson Padilha de; SWINTON, Paul Alan; DOLAN, Eimear; ROSCHEL, Hamilton; GUALANO, Bruno
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