SANDRA GOFINET PASOTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
63 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 63
- Anti-DNase I Antibody A New Serological Reactivity in Primary Sjogren Syndrome(2020) GRIFFO, Priscilla; VIANA, Vilma V. S. T.; PASOTO, Sandra G.; LEON, Elaine P.; BONFA, EloisaBackground and Objective: Primary Sjogren syndrome (pSS) is a systemic autoimmune rheumatic disease that particularly affects exocrine glands. Dry eye is one of the most important features of this syndrome, and a recent study reported reduced deoxyribonuclease I (DNase I) activity in the tear of patients with dry eye. We therefore postulated that patients with pSS might have antibodies targeting DNAse I. Methods: We have evaluated in a cross-sectional study 85 patients with pSS (2002 American-European Consensus Group Criteria), 50 rheumatoid arthritis (RA) patients (1987 American College of Rheumatology Criteria) without sicca symptoms, and 88 healthy volunteers. IgG anti-DNase I was detected by enzyme-linked immunosorbent assay using as antigen bovine pancreas enzyme and confirmed by immunoblotting. Results: Age and sex were alike in the 3 groups (p > 0.05). Anti-DNase I was detected in 43.5% of the pSS patients. In contrast, this reactivity was absent in all RA patients (p = 0.0001). Additional comparison of pSS patients with (n = 37) or without (n = 48) anti-DNase I showed that the former group had higher IgG serum levels (2293.2 +/- 666.2 vs 1483.9 +/- 384.6 mg/dL, p = 0.0001) and greater rate of non-drug-induced leukopenia (43% vs 19%, p = 0.02). A multivariate logistic regression analysis identified that only IgG levels were independently associated with anti-DNase I. Conclusions: We describe a high frequency of anti-DNase I antibodies in pSS patients associated with higher serum IgG levels. The lack of this reactivity in RA patients without sicca symptoms suggests that this antibody may be helpful in the differential diagnosis of these diseases.
- Epidemiological profile and north-south gradient driving baseline systemic involvement of primary Sjogren's syndrome(2020) BRITO-ZERON, Pilar; ACAR-DENIZLI, Nihan; NG, Wan-Fai; HORVATH, Ildiko Fanny; RASMUSSEN, Astrid; SEROR, Raphaele; LI, Xiaomei; BALDINI, Chiara; GOTTENBERG, Jacques-Eric; DANDA, Debashish; QUARTUCCIO, Luca; PRIORI, Roberta; HERNANDEZ-MOLINA, Gabriela; ARMAGAN, Berkan; KRUIZE, Aike A.; KWOK, Seung-Ki; KVARNSTROM, Marika; PRAPROTNIK, Sonja; SENE, Damien; GERLI, Roberto; SOLANS, Roser; RISCHMUELLER, Maureen; MANDL, Thomas; SUZUKI, Yasunori; ISENBERG, David; VALIM, Valeria; WILAND, Piotr; NORDMARK, Gunnel; FRAILE, Guadalupe; BOOTSMA, Hendrika; NAKAMURA, Hideki; GIACOMELLI, Roberto; DEVAUCHELLE-PENSEC, Valerie; HOFAUER, Benedikt; BOMBARDIERI, Michele; TREVISANI, Virginia Fernandes Moca; HAMMENFORS, Daniel; PASOTO, Sandra G.; RETAMOZO, Soledad; GHEITA, Tamer A.; ATZENI, Fabiola; MOREL, Jacques; VOLLENWEIDER, Cristina; ZEHER, Margit; SIVILS, Kathy; XU, Bei; BOMBARDIERI, Stefano; SANDHYA, Pulukool; VITA, Salvatore De; MINNITI, Antonina; SANCHEZ-GUERRERO, Jorge; KILIC, Levent; HEIJDEN, Eefje van der; PARK, Sung-Hwan; WAHREN-HERLENIUS, Marie; MARIETTE, Xavier; RAMOS-CASALS, ManuelObjective. To characterize the systemic phenotype of primary Sjogren's syndrome at diagnosis by analysing the EULAR-SS disease activity index (ESSDAI) scores. Methods. The Sjogren Big Data Consortium is an international, multicentre registry based on worldwide data-sharing cooperative merging of pre-existing databases from leading centres in clinical research in Sjogren's syndrome from the five continents. Results. The cohort included 10 007 patients (9352 female, mean 53 years) with recorded ESSDAI scores available. At diagnosis, the mean total ESSDAI score was 6.1; 81.8% of patients had systemic activity (ESSDAI score >= 1). Males had a higher mean ESSDAI (8.1 vs 6.0, P < 0.001) compared with females, as did patients diagnosed at <35 years (6.7 vs 5.6 in patients diagnosed at >65 years, P < 0.001). The highest global ESSDAI score was reported in Black/African Americans, followed by White, Asian and Hispanic patients (6.7, 6.5, 5.4 and 4.8, respectively; P < 0.001). The frequency of involvement of each systemic organ also differed between ethnic groups, with Black/African American patients showing the highest frequencies in the lymphadenopathy, articular, peripheral nervous system, CNS and biological domains, White patients in the glandular, cutaneous and muscular domains, Asian patients in the pulmonary, renal and haematological domains and Hispanic patients in the constitutional domain. Systemic activity measured by the ESSDAI, clinical ESSDAI (clinESSDAI) and disease activity states was higher in patients from southern countries (P < 0.001). Conclusion. The systemic phenotype of primary Sjogren's syndrome is strongly influenced by personal determinants such as age, gender, ethnicity and place of residence, which are key geoepidemiological players in driving the expression of systemic disease at diagnosis.
- Immunogenicity and safety of the 2009 non-adjuvanted influenza A/H1N1 vaccine in a large cohort of autoimmune rheumatic diseases(2011) SAAD, Carla G. S.; BORBA, Eduardo F.; AIKAWA, Nadia E.; SILVA, Clovis A.; PEREIRA, Rosa M. R.; CALICH, Ana Luisa; MORAES, Julio C. B.; RIBEIRO, Ana C. M.; VIANA, Vilma S. T.; PASOTO, Sandra G.; CARVALHO, Jozelio F.; FRANCA, Ivan L. A.; GUEDES, Lissiane K. N.; SHINJO, Samuel K.; SAMPAIO-BARROS, Percival D.; CALEIRO, Maria T.; GONCALVES, Celio R.; FULLER, Ricardo; LEVY-NETO, Mauricio; TIMENETSKY, Maria do Carmo S.; PRECIOSO, Alexander R.; BONFA, EloisaBackground Despite the WHO recommendation that the 2010-2011 trivalent seasonal flu vaccine must contain A/California/7/2009/H1N1-like virus there is no consistent data regarding its immunogenicity and safety in a large autoimmune rheumatic disease (ARD) population. Methods 1668 ARD patients (systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic sclerosis, psoriatic arthritis (PsA), Behcet's disease (BD), mixed connective tissue disease, primary antiphospholipid syndrome (PAPS), dermatomyositis (DM), primary Sjogren's syndrome, Takayasu's arteritis, polymyositis and Granulomatosis with polyangiitis (Wegener's) (GPA)) and 234 healthy controls were vaccinated with a non-adjuvanted influenza A/California/7/2009(H1N1) virus-like strain flu. Subjects were evaluated before vaccination and 21 days post-vaccination. The percentage of seroprotection, seroconversion and the factor increase in geometric mean titre (GMT) were calculated. Results After immunisation, seroprotection rates (68.5% vs 82.9% p < 0.0001), seroconversion rates (63.4% vs 76.9%, p < 0.001) and the factor increase in GMT (8.9 vs 13.2 p < 0.0001) were significantly lower in ARD than controls. Analysis of specific diseases revealed that seroprotection significantly reduced in SLE (p < 0.0001), RA (p < 0.0001), PsA (p=0.0006), AS (p=0.04), BD (p=0.04) and DM (p=0.04) patients than controls. The seroconversion rates in SLE (p < 0.0001), RA (p < 0.0001) and PsA (p=0.0006) patients and the increase in GMTs in SLE (p < 0.0001), RA (p < 0.0001) and PsA (p < 0.0001) patients were also reduced compared with controls. Moderate and severe side effects were not reported. Conclusions The novel recognition of a diverse vaccine immunogenicity profile in distinct ARDs supports the notion that a booster dose may be recommended for diseases with suboptimal immune responses. This large study also settles the issue of vaccine safety. (ClinicalTrials.gov #NCT01151644)
conferenceObject Salivary gland damage in Sjogren's syndrome: are endothelial and vascular alterations associated with the secretion of IL-17?(2018) LOURENCO, Silvia V.; BOLOGNA, Sheyla B.; CAVALCANTE, Wanessa S.; PASOTO, Sandra G.; FLOREZI, Giovanna P.- 2019-EULAR/ACR classification criteria domains at diagnosis: predictive factors of long-term damage in systemic lupus erythematosus(2022) INSFRAN, Carlos E.; AIKAWA, Nadia E.; PASOTO, Sandra G.; FILHO, Dilson M. N.; FORMIGA, Francisco F. C.; PITTA, Ana C.; BORBA, Eduardo F.; RIBEIRO, Carolina T.; SILVA, Clovis A.; BONFA, EloisaThe objective of this study is to assess the role of the 2019-European League Against Rheumatism/American College of Rheumatology (2019-EULAR/ACR) classification criteria at diagnosis and its domains in predicting long-term damage in systemic lupus erythematosus(SLE). We performed a retrospective analysis using an electronic chart database utilized in routine clinical care of SLE patients and established in 2000 in a tertiary hospital. Two hundred and nine consecutive SLE patients with disease onset >= 18 years old and long disease duration were included. Cumulative damage at the last visit was scored using the SLICC/ACR-Damage Index (SDI). The median age at SLE diagnosis was 28 years (18-63), disease duration was 14 years (8-25), and 88% were females. Damage (SDI >= 1) was observed in 116/209 (55%). Patients with (SDI >= 1, n=116) and without damage (SDI=0, n=93) had similar median disease duration [14 (8-25) vs. 12 (8-25) years, p=0.090[ and age at diagnosis [23 (18-55) vs. 23 (18-56) years, p=0.998[. No correlation was observed between total 2019-EULAR/ACR score at diagnosis and SDI at last visit (r=0.007, p=0.913). Presence of renal domain at diagnosis was associated with renal damage at last visit (OR=3.6, 95%CI 1.2-10.4, p=0.017) and antiphospholipid antibodies domain predicted neuropsychiatric damage (OR=3.0, 95%CI 1.2-7.6, p=0.015). A ROC analysis identified that a cut-off >24 in 2019-EULAR/ACR score could predict a trend for renal damage (p=0.077) with a lower renal survival (Kaplan-Meier curve) for patients above this limit (p=0.029). A multivariate logistic regression analysis revealed that 2019-EULAR/ACR score >24 at diagnosis (OR 4.583, 95%CI 1.052-19.962, p=0.043) was independently associated with renal damage. Specific domains in the 2019-EULAR/ACR criteria at diagnosis were associated with long-term organspecific damage, particularly renal and neuropsychiatric harm. A 2019-EULAR/ACR score >24 predicted worse renal survival.
conferenceObject HOW ETHNICITY MODIFIES SYSTEMIC ACTIVITY OF PRIMARY SJOGREN SYNDROME: ANALYSIS OF BASELINE ESSDAI SCORES IN A MULTI-ETHNIC INTERNATIONAL COHORT(2018) RETAMOZO, Soledad; HERNANDEZ-MOLINA, Gabriela; VALIM, Valeria; TREVISANI, Virginia Fernandes Moca; PASOTO, Sandra G.; ACAR-DENIZLI, Nihan; ZEHER, Margit; SIVILS, Kathy; MANDL, Thomas; SEROR, Raphaele; LI, Xiaomei; BALDINI, Chiara; MARIETTE, Xavier; GOTTENBERG, Jacques-Ericn; DANDA, Debashish; PRIORI, Roberta; QUARTUCCIO, Luca; ARMAGAN, Berkan; KRUIZE, Aike A.; KWOK, Seung-Ki; WAHREN-HERLENIUS, Marie; PRAPROTNIK, Sonja; SENE, Damien; BARTOLONI, Elena; RISCHMUELLER, Maureen; SOLANS, Roser; SUZUKI, Yasunori; ISENBERG, David; WILAND, Piotr; NORDMARK, Gunnel; FRAILE, Guadalupe; BOOTSMA, Hendrika; NAKAMURA, Takashi; GIACOMELLI, Roberto; DEVAUCHELLE-PENSEC, Valerie; HOFAUER, Benedikt; BOMBARDIERI, Michele; HAMMENFORS, Daniel; CARSONS, Steven E.; GHEITA, Tamer A.; ATZENI, Fabiola; MOREL, Jacques; VOLLENVEIDER, Cristina; RAMOS-CASALS, Manuel; BRITO-ZERON, Pilar- Hydroxychloroquine blood levels in stable lupus nephritis under low dose (2-3 mg/kg/day): 12-month prospective randomized controlled trial(2021) ZANETTI, Caio B.; PEDROSA, Tatiana; KUPA, Leonard de V. K.; AIKAWA, Nadia E.; BORBA, Eduardo F.; VENDRAMINI, Margarete B. G.; SILVA, Clovis A.; PASOTO, Sandra G.; BONFA, EloisaIntroduction The American Academy of Ophthalmology (2016-AAO) recommended hydroxychloroquine (HCQ) dose not to exceed 5 mg/kg/day (real body weight). Recently, it was reported that prescribed 2016-AAO dose provided adequate HCQ levels for most lupus nephritis (LN) patients, with low flare risk. However, the minimum HCQ dose required to keep adequate levels is unknown. Objectives To evaluate if a further reduction in 2016-AAO dose (2-3 mg/kg/day) would sustain 12-month HCQ levels in LN patients with stable inactive disease. Methods Seventy-three stable LN patients under prescribed full HCQ 2016-AAO dose for >= 6 months and adequate baseline HCQ levels (>= 613.5 ng/mL) were divided in two groups: reduced 2016-AAO dose (2-3 mg/kg/day), n = 32, and full 2016-AAO dose (5 mg/kg/day), n = 41. All patients were assessed at baseline, 3, 6, and 12 months. HCQ levels were measured by liquid chromatography-tandem mass spectrometry. Flare was defined as augment >= 3 in SLE Disease Activity Index-2000 and/or change in treatment. Rigorous clinical/laboratorial surveillance was performed. Results Prospective evaluation revealed for reduced 2016-AAO dose group a decrease of HCQ levels from baseline to 3 months (1,404.9 +/- 492.0 vs. 731.6 +/- 385.0 ng/mL, p < 0.01), and sustained levels at 6 months (p = 0.273) and 12 months (p = 0.091) compared to 3 months. For the full 2016-AAO dose group, a decrease occurred only from baseline to 12 months (1343.5 +/- 521.5 vs. 991.6 +/- 576.3 ng/mL, p < 0.001). Frequencies of patients with inadequate levels at 6 months was higher in reduced 2016-AAO group than full 2016-AAO dose (59% vs. 24%, p = 0.005), as well as at 12 months (66% vs. 32%, p = 0.002). Six-month and 12-month flare frequencies were comparable for both groups (p > 0.05). Conclusions Prescribed HCQ low-dose regimen (2-3 mg/kg/day) does not sustain, for most patients, 6- and 12-month adequate HCQ levels. Full 2016-AAO dose maintained HCQ levels way above this limit. Trail registration: NCT03122431, registered on April 20, 2017
conferenceObject Ultrasonography of major salivary glands in juvenile Sjogren's syndrome: an international multicentre study(2018) HAMMENFORS, Daniel S.; VALIM, Valeria; BICA, Blanca E. R. G.; PASOTO, Sandra G.; LILLEBY, Vibke; NIETO-GONZALEZ, Juan Carlos; SILVA, Clovis A.; MOSSEL, Esther; PEREIRA, Rosa M. R.; COELHO, Aline; BOOTSMA, Hendrika; THATAYATIKOM, Akaluck; BRUN, Johan G.; JONSSON, Roland; JONSSON, Malin V.- Short-term Accrual 2019 European League Against Rheumatism/American College of Rheumatology Domains and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage in Lupus Patients With and Without Nephritis at Disease Onset(2023) MUNHOZ, Gabriela A.; AIKAWA, Nadia E.; SILVA, Clovis A.; PASOTO, Sandra G.; PEDROSA, Tatiana N.; SEGURO, Luciana P. C.; BONFA, Eloisa; BORBA, Eduardo F.ObjectiveTo determine in a historical inception cohort the impact of lupus nephritis at disease onset in short-term accrual 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) domains. The possible association with treatment and damage was also investigated.MethodsOne hundred thirty-three consecutive adult systemic lupus erythematosus patients according to the 2019 EULAR/ACR criteria were divided according to the presence (RENAL-lupus) or absence of renal involvement (NONRENAL-lupus) at disease onset. The 2019 EULAR/ACR score and Systemic Lupus International Collaborating Clinics/ACR (SDI) were longitudinally evaluated over 3 years.ResultsRENAL-lupus (n = 49 [36.8%]) and NONRENAL-lupus (n = 84 [63.2%]) were similar regarding age (p = 0.704), female sex (p = 0.313), and black race (p = 0.506). At study entry, RENAL-lupus had higher 2019 EULAR/ACR total domains (30 [12-42] vs. 22 [10-36], p < 0.001) and used more often glucocorticoid (p < 0.001), mycophenolate mofetil (p = 0.007), and cyclophosphamide (p = 0.001). After 3 years, a stable number of domain scores was observed for the RENAL-lupus (30 [12-42] vs. 30 [12-42], p = 0.125), whereas an increase was observed for the NONRENAL-lupus (22 [10-36] vs. 23 [10-40], p < 0.001) compared with baseline. Accordingly, RENAL-lupus patients had a lower frequency of additional domains (3/49 [6.1%] vs. 37/84 [44.0%], p < 0.0001). New kidney involvement occurred in 15 (44.1%) of 34 patients of the NONRENAL-lupus. Both groups evolved with a comparable increase in frequency of patients with damage (SDI >= 1) at the end of the study (23/49 [46.9%] vs. 34/89 [40.54%], p = 0.585) with a similar median of SDI (1 [0-4] vs. 0 [0-2], p = 0.132).ConclusionsThe distinct pattern of accrual 2019 EULAR/ACR domains in patients with and without nephritis at disease onset suggests that close surveillance for additional organ involvement, including kidney, is mandatory in NONRENAL lupus in the first 3 years of disease. The unexpected comparable early damage in both groups despite milder disease and less intense immunosuppression in NONRENAL lupus reinforces the need for new and tailored therapies for these patients.
conferenceObject How Immunological Profile Drives Clinical Phenotype of Primary Sjogren's Syndrome at Diagnosis: Analysis of 10.500 Patients (Sjogren Big Data Project)(2018) RETAMOZO, Soledad; ACAR-DENIZLI, Nihan; NG, Wan-Fai; ZEHER, Margit; RASMUSSEN, Astrid; MANDL, Thomas; SEROR, Raphaele; LI, Xiaomei; BALDINI, Chiara; GOTTENBERG, Jacques-Eric; DANDA, Debashish; QUARTUCCIO, Luca; PRIORI, Roberta; HERNANDEZ-MOLINA, Gabriela; ARMAGAN, Berkan; KRUIZE, Aike A.; KWOK, Seung-Ki; KVARNSTROM, Marika; PRAPROTNIK, Sonja; SENE, Damien; BARTOLONI, Elena; SOLANS, Roser; RISCHMUELLER, Maureen; SUZUKI, Yasunori; ISENBERG, David A.; VALIM, Valeria; WILAND, Piotr; NORDMARK, Gunnel; FRAILE, Guadalupe; BOOTSMA, Hendrika; NAKAMURA, Takashi; GIACOMELLI, Roberto; DEVAUCHELLE-PENSEC, Valerie; KNOPF, Andreas; BOMBARDIERI, Michele; TREVISANI, Virginia Fernandes; HAMMENFORS, Daniel S.; PASOTO, Sandra G.; GHEITA, Tamer A.; ATZENI, Fabiola; MOREL, Jacques; VOLLENVEIDER, Cristina; HORVATH, Ildiko-Fanny; SIVILS, Kathy L.; OLSSON, Peter; VITA, Salvatore De; SANCHEZ-GUERRERO, Jorge; KILIC, Levent; WAHREN-HERLENIUS, Marie; MARIETTE, Xavier; RAMOS-CASALS, Manuel; BRITO-ZERON, Pilar