GUILHERME ALVES LEPSKI
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/26 - Laboratório de Pesquisa em Cirurgia Experimental, Hospital das Clínicas, Faculdade de Medicina - Líder
9 resultados
Resultados de Busca
Agora exibindo 1 - 9 de 9
- Adult Neurogenesis and Glial Oncogenesis: When the Process Fails(2014) BATISTA, Chary Marquez; MARIANO, Eric Domingos; BARBOSA, Breno Jose Alencar Pires; MORGALLA, Matthias; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; LEPSKI, GuilhermeMalignant brain tumors, including glioblastoma multiforme (GBM), are known for their high degree of invasiveness, aggressiveness, and lethality. These tumors are made up of heterogeneous cell populations and only a small part of these cells (known as cancer stem cells) is responsible for the initiation and recurrence of the tumor. The biology of cancer stem cells and their role in brain tumor growth and therapeutic resistance has been extensively investigated. Recent work suggests that glial tumors arise from neural stem cells that undergo a defective process of differentiation. The understanding of this process might permit the development of novel treatment strategies targeting cancer stem cells. In the present review, we address the mechanisms underlying glial tumor formation, paying special attention to cancer stem cells and the role of the microenvironment in preserving them and promoting tumor growth. Recent advancements in cancer stem cell biology, especially regarding tumor initiation and resistance to chemo-or radiotherapy, have led to the development of novel treatment strategies that focus on the niche of the stem cells that make up the tumor. Encouraging results from preclinical studies predict that these findings will be translated into the clinical field in the near future.
- Everything old is new again. revisiting hypophysectomy for the treatment of refractory cancer-related pain: a systematic review(2024) ALMEIDA, Timoteo; MONACO, Bernardo A.; VASCONCELOS, Fernando; PIEDADE, Guilherme S.; MORELL, Alexis; OGOBUIRO, Ifeanyichukwu; LEPSKI, Guilherme A.; FURLANETTI, Luciano L.; CORDEIRO, Karina K.; BENJAMIN, Carolina; JAGID, Jonathan R.; CORDEIRO, Joacir G.Cancer-related pain is a common and debilitating condition that can significantly affect the quality of life of patients. Opioids, NSAIDs, and antidepressants are among the first-line therapies, but their efficacy is limited or their use can be restricted due to serious side effects. Neuromodulation and lesioning techniques have also proven to be a valuable instrument for managing refractory pain. For patients who have exhausted all standard treatment options, hypophysectomy may be an effective alternative treatment. We conducted a comprehensive systematic review of the available literature on PubMed and Scielo databases on using hypophysectomy to treat refractory cancer-related pain. Data extraction from included studies included study design, treatment model, number of treated patients, sex, age, Karnofsky Performance Status (KPS) score, primary cancer site, lead time from diagnosis to treatment, alcohol injection volume, treatment data, and clinical outcomes. Statistical analysis was reported using counts (N, %) and means (range). The study included data from 735 patients from 24 papers treated with hypophysectomy for refractory cancer-related pain. 329 cancer-related pain patients were treated with NALP, 216 with TSS, 66 with RF, 55 with Y90 brachytherapy, 51 with Gamma Knife radiosurgery (GK), and 18 with cryoablation. The median age was 58.5 years. The average follow-up time was 8.97 months. Good pain relief was observed in 557 out of 735 patients, with complete pain relief in 108 out of 268 patients. Pain improvement onset was observed 24 h after TSS, a few days after NALP or cryoablation, and a few days to 4 weeks after GK. Complications varied among treatment modalities, with diabetes insipidus (DI) being the most common complication. Although mostly forgotten in modern neurosurgical practice, hypophysectomy is an attractive option for treating refractory cancer-related pain after failure of traditional therapies. Radiosurgery is a promising treatment modality due to its high success rate and reduced risk of complications.
- Cell Transplantation for Spinal Cord Injury: A Systematic Review(2013) LI, Jun; LEPSKI, GuilhermeCell transplantation, as a therapeutic intervention for spinal cord injury (SCI), has been extensively studied by researchers in recent years. A number of different kinds of stem cells, neural progenitors, and glial cells have been tested in basic research, and most have been excluded from clinical studies because of a variety of reasons, including safety and efficacy.. e signaling pathways, protein interactions, cellular behavior, and the differentiated fates of experimental cells have been studied in vitro in detail. Furthermore, the survival, proliferation, differentiation, and effects on promoting functional recovery of transplanted cells have also been examined in different animal SCI models. However, despite significant progress, a ""bench to bedside"" gap still exists. In this paper, we comprehensively cover publications in the field from the last years. The most commonly utilized cell lineages were covered in this paper and specific areas covered include survival of grafted cells, axonal regeneration and remyelination, sensory and motor functional recovery, and electrophysiological improvements. Finally we also review the literature on the in vivo tracking techniques for transplanted cells.
- Petroclival meningiomas: Remaining controversies in light of minimally invasive approaches(2017) WAYHS, Samia Yasin; LEPSKI, Guilherme Alves; FRIGHETTO, Leonardo; ISOLAN, Gustavo RassierSurgical resection of petroclival meningiomas remains challenging due to their deep location and relationship to vital neurovascular structures. Although the natural history of these tumors involves a slow course, the incidence of cranial nerve deficits and the extent of tumor resection vary widely in the literature. Some reviews on this topic have been conducted, but data remain fragmentary and based on retrospective case series, which hinders attempts at meta-analysis. Within this context, research into the use of minimally invasive approaches, including in neuroendoscopy, continues to emerge. The objective of this narrative review is to analyze the available literature on the surgical treatment of petroclival meningiomas, with a focus on attempts at endoscopy-assisted resection.
- Adult stem cells in neural repair: Current options, limitations and perspectives(2015) MARIANO, Eric Domingos; TEIXEIRA, Manoel Jacobsen; MARIE, Suely Kazue Nagahashi; LEPSKI, GuilhermeStem cells represent a promising step for the future of regenerative medicine. As they are able to differentiate into any cell type, tissue or organ, these cells are great candidates for treatments against the worst diseases that defy doctors and researchers around the world. Stem cells can be divided into three main groups: (1) embryonic stem cells; (2) fetal stem cells; and (3) adult stem cells. In terms of their capacity for proliferation, stem cells are also classified as totipotent, pluripotent or multipotent. Adult stem cells, also known as somatic cells, are found in various regions of the adult organism, such as bone marrow, skin, eyes, viscera and brain. They can differentiate into unipotent cells of the residing tissue, generally for the purpose of repair. These cells represent an excellent choice in regenerative medicine, every patient can be a donor of adult stem cells to provide a more customized and efficient therapy against various diseases, in other words, they allow the opportunity of autologous transplantation. But in order to start clinical trials and achieve great results, we need to understand how these cells interact with the host tissue, how they can manipulate or be manipulated by the microenvironment where they will be transplanted and for how long they can maintain their multipotent state to provide a full regeneration.
- Current perspectives in stem cell therapy for spinal cord repair in humans: a review of work from the past 10 years(2014) MARIANO, Eric Domingos; BATISTA, Chary Marquez; BARBOSA, Breno Jose Alencar Pires; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; MORGALLA, Matthias; TATAGIBA, Marcos; LI, Jun; LEPSKI, GuilhermeSpinal cord injury (SCI) and amyotrophic laterals sclerosis (ALS) are devastating neurological conditions that affect individuals worldwide, significantly reducing quality of life, both for patients and their relatives. Objective: The present review aims to summarize the multiple restorative approaches being developed for spinal cord repair, the use of different stem cell types and the current knowledge regarding stem cell therapy. Method: Review of the literature from the past 10 years of human studies using stem cell transplantation as the main therapy, with or without adjuvant therapies. Conclusion: The current review offers an overview of the state of the art regarding spinal cord restoration, and serves as a starting point for future studies.
- Intraoperative assistive technologies and extent of resection in glioma surgery: a systematic review of prospective controlled studies(2015) BARBOSA, Breno Jose Alencar Pires; MARIANO, Eric Domingos; BATISTA, Chary Marquez; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; PEREIRA, Carlos Umberto; TATAGIBA, Marcos Soares; LEPSKI, Guilherme AlvesSeveral studies published to date about glioma surgery have addressed the validity of using novel technologies for intraoperative guidance and potentially improved outcomes. However, most of these reports are limited by questionable methods and/or by their retrospective nature. In this work, we performed a systematic review of the literature to address the impact of intraoperative assistive technologies on the extent of resection (EOR) in glioma surgery, compared to conventional unaided surgery. We were also interested in two secondary outcome variables: functional status and progression-free survival. We primarily used PubMed to search for relevant articles. Studies were deemed eligible for our analysis if they (1) were prospective controlled studies; (2) used EOR as their primary target outcome, assessed by MRI volumetric analysis; and (3) had a homogeneous study population with clear inclusion criteria. Out of 493 publications identified in our initial search, only six matched all selection criteria for qualitative synthesis. Currently, the evidence points to 5-ALA, DTI functional neuronavigation, neurophysiological monitoring, and intraoperative MRI as the best tools for improving EOR in glioma surgery. Our sample and conclusions were limited by the fact that studies varied in terms of population characteristics and in their use of different volumetric analyses. We were also limited by the low number of prospective controlled trials available in the literature. Additional evidence-based high-quality studies assessing cost-effectiveness should be conducted to better determine the benefits of intraoperative assistive technologies in glioma surgery.
- Chordoid glioma: Case report and review of the literature(2015) MORAIS, Barbara A.; MENENDEZ, Djalma F. S.; MEDEIROS, Raphael S. S.; TEIXEIRA, Manoel J.; LEPSKI, Guilherme A.INTRODUCTION: Chordoid glioma is a rare low-grade brain tumor originating from the anterior wall of the third ventricle. CASE PRESENTATION: A 13-year-old female with progressive intermittent holocranial headaches and a diagnosis of chordoid glioma underwent tumor resection in our neuro-oncology unit. DISCUSSION: We review all 79 cases of chordoid glioma reported in the literature so far, focusing on the diagnostic criteria, treatment options and prognosis. CONCLUSION: Efficient treatment of chordoid glioma depends upon radical surgical resection. Based on the reviewed data, which showed high morbi-mortality rates for this kind of tumor, we recommend a more conservative treatment approach. (C) 2015 The Authors.
- Stem cells in neurology - current perspectives(2014) BATISTA, Chary Ely Marquez; MARIANO, Eric Domingos; MARIE, Suely Kazue Nagahashi; TEIXEIRA, Manoel Jacobsen; MORGALLA, Matthias; TATAGIBA, Marcos; LI, Jun; LEPSKI, GuilhermeCentral nervous system (CNS) restoration is an important clinical challenge and stem cell transplantation has been considered a promising therapeutic option for many neurological diseases. Objective: The present review aims to briefly describe stem cell biology, as well as to outline the clinical application of stem cells in the treatment of diseases of the CNS. Method: Literature review of animal and human clinical experimental trials, using the following key words: ""stem cell"", neurogenesis"", ""Parkinson"", ""Huntington"", ""amyotrophic lateral sclerosis"", ""traumatic brain injury"", ""spinal cord injury"", ""ischemic stroke"", and ""demyelinating diseases"". Conclusion: Major recent advances in stem cell research have brought us several steps closer to their effective clinical application, which aims to develop efficient ways of regenerating the damaged CNS.