ALINE GRANDI DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Effect of an Exercise Program on Lymphocyte Proliferative Responses of COPD Patients(2018) FERNANDES, Juliana Ruiz; SILVA, Cibele Cristine Berto Marques da; SILVA, Aline Grandi da; PINTO, Regina Maria de Carvalho; DUARTE, Alberto Jose da Silva; CARVALHO, Celso Ricardo; BENARD, GilExercise training has been shown to reduce symptoms and exacerbations in COPD patients; however, the exercise effect on patients' immune response is poorly known. We thus verified if an exercise program (EP) impacted on proliferative T cell response of COPD patients. Fourteen non-O-2 dependent COPD patients on standard treatment were studied. EP consisted in 24 sessions of aerobic and muscular training. Peripheral blood mononuclear cells were stimulated with the mitogen phytohemagglutinin and antigens from Haemophilus influenzae and cytomegalovirus, and the lymphocyte proliferative response (LPR) was assessed through the expression of Ki67 before and after the EP. The Quality of life [COPD assessment test (CAT)], dyspnea [(modified Medical Research Council scale (mMRC)], and 6-min walk distance were also assessed. The EP program increased significantly the LPR of TCD4+ lymphocytes to phytohemagglutinin and cytomegalovirus and H. influenzae antigens, but with TCD8+ lymphocytes the increase was less marked. Consistent with this, a higher proportion of TCD8+ than TCD4+ cells did not express the costimulatory molecule CD28. The EP also resulted in improvement of the quality of life, dyspnea, and physical capacity. The improvement in TCD4+ cell function may represent an additional mechanism through which the EP results in less exacerbations and hospitalizations.
- The role of exercise training in a weight loss program on psychosocial morbidity, sleep quality and physical activity in obese asthmatics: A RCT(2016) FREITAS, Patricia D.; SILVA, Aline G.; FERREIRA, Palmira G.; SILVA, Analuci da; SALGE, Joao M.; CUKIER, Alberto; CARVALHO-PINTO, Regina; BRITO, Claudia M.; MANCINI, Marcio C.; CARVALHO, Celso R. F.
- The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma A Randomized Controlled Trial(2017) FREITAS, Patricia D.; FERREIRA, Palmira G.; SILVA, Aline G.; STELMACH, Rafael; CARVALHO-PINTO, Regina M.; FERNANDES, Frederico L. A.; MANCINI, Marcia C.; SATO, Maria N.; MARTINS, Milton A.; CARVALHO, Celso R. F.Rationale: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. Objectives: To examine the effect of exercise training in a weight loss program on asthma control, quality of life, inflammatory biomarkers, and lung function. Methods: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program plus exercise (WL + E group, n = 28) or a weight-loss program plus sham (WL + S group, n = 27), where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL + E group incorporated aerobic and resistance muscle training, whereas the WL + S group incorporated breathing and stretching exercises. Measurements and Main Results: The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength, and inflammatory/antiinflammatory biomarkers. After 3 months, 51 patients were analyzed. Compared with the WL + S group, the WL + E group demonstrated improved clinical control scores (median [25th to 75th percentile],-0.7 [-1.3 to -0.3] vs. -0.3 [-0.9 to 0.4]; P = 0.01) and greater weight loss (mean +/- SD, -6.8% +/- 3.5 vs. -3.1% +/- 2.6; P < 0.001) and aerobic capacity (median [25th to 75th percentile], 3.0 [2.4 to 4.0] vs. 0.9 [-0.3 to 1.3] ml O-2 X kg(-1) X min(-1); P < 0.001). These improvements in the WL + E group were also accompanied by improvements in lung function, antiinflammatory biomarkers, and vitamin D levels, as well as reductions in airway and systemic inflammation. Conclusions: Adding exercise to a short-term weight-loss program should be considered as a useful strategy for achieving clinical control of asthma in obese patients.
- Mechanisms underlying the role of exercise training as part of a weight loss program on asthma control in obese asthmatics(2016) FREITAS, Patricia; FERREIRA, Palmira G.; SILVA, Aline G.; STELMACH, Rafael; CARVALHO-PINTO, Regina; FERNANDES, Frederico L. A.; MARTINS, Milton A.; MANCINI, Marcio C.; SATO, Maria N.; CARVALHO, Celso R. F.
- Exercise improves physical activity and comorbidities in obese adults with asthma(2018) FREITAS, Patricia D.; SILVA, Aline G.; FERREIRA, Palmira G.; SILVA, Analuci Da; SALGE, Joao M.; CARVALHO-PINTO, Regina M.; CUKIER, Alberto; BRITO, Claudia M.; MANCINI, Marcio C.; CARVALHO, Celso R. F.
- Exercise Improves Physical Activity and Comorbidities in Obese Adults with Asthma(2018) FREITAS, Patricia Duarte; SILVA, Aline Grandi; FERREIRA, Palmira Gabriele; SILVA, Analuci Da; SALGE, Joao Marcos; CARVALHO-PINTO, Regina Maria; CUKIER, Alberto; BRITO, Claudia M.; MANCINI, Marcio C.; CARVALHO, Celso R. F.Introduction Obese adults with asthma have an increased number of comorbidities and reduced daily life physical activity (DLPA), which may worsen asthma symptoms. Exercise is recommended to improve asthma outcomes; however, the benefits of exercise for psychosocial comorbidities and physical activity levels in obese adults with asthma have been poorly investigated. Objective This study aimed to assess the effects of exercise on DLPA, asthma symptoms, and psychosocial comorbidities in obese adults with asthma. Methods Fifty-five grade II obese adults with asthma were randomly assigned to either a weight loss program + exercise program (WL + E group, n = 28) or a weight loss program + sham (WL + S group, n = 27). The WL + E group incorporated aerobic and resistance muscle training into the weight loss program (nutrition and psychological therapies), whereas the WL + S group performed breathing and stretching exercises. DLPA, asthma symptoms, sleep quality, and anxiety and depression symptoms were quantified before and after treatment. Results After 3 months, the WL + E group presented a significant increase in daily step counts (3068 2325 vs 729 +/- 1118 steps per day) and the number of asthma symptom-free days (14.5 +/- 9.6 vs 8.6 +/- 11.4 dmonth(-1)) compared with the WL + S group. The proportion of participants with improvements in depression symptoms (76.4% vs 16.6%) and a lower risk of developing obstructive sleep apnea (56.5% vs 16.3%) was greater in the WL + E group than that in the WL + S group (P < 0.05). Significant improvements in sleep efficiency (6.6% +/- 5.1% vs 1.3% +/- 4.7%) and latency (-3.7 +/- 5.9 vs 0.2 +/- 5.6 min) were also observed in the WL + E group. Conclusions Our results strongly suggest that exercise training plus a weight loss program improves DLPA, sleep efficiency, and depression and asthma symptoms in obese adults with asthma.
- Effects of weight loss on dynamic hyperinflation in obese women asthmatics(2019) SILVA, Aline Grandi; FREITAS, Patricia Duarte; FERREIRA, Palmira Gabriele; STELMACH, Rafael; CARVALHO-PINTO, Regina Maria; SALGE, Joao Marcos; MARTINS, Milton Arruda; CARVALHO, Celso R. F.Obese adults with asthma are more likely to develop dynamic hyperinflation (DH) and expiratory flow limitation (EFL) than nonobese asthmatics, and weight-loss seems to improve the breathing mechanics during exercise. However, studies evaluating the effect of weight loss on DH in obese adults with asthma have not been performed. We sought to evaluate the effect of a weight loss program on DH in obese adults with asthma. Forty-two asthma patients were enrolled in a weight loss program (diet, psychological support, and exercise) and were subsequently divided into two groups according to the percentage of weight loss: a >= 5% group (n = 19) and a <5% group (n = 23). Before and after the intervention. DH and EFL (constant load exercise), health-related quality of life (HRQoL). asthma control, quadriceps muscle strength and endurance, body composition, and lung function were assessed. Both groups exhibited a decrease of >= 10% in inspiratory capacity (DH) before intervention, and only the >= 5% group showed clinical improvement in DH compared with the <5% group postintervention (-9.1 +/- 14.5% vs. -125 +/- 13.5%, respectively). In addition, the >= 5% group displayed a significant delay in the onset of both DH and EH, and a clinically significant improvement in HRQoL and asthma control. Furthermore, a correlation was observed between reduced waist circumference and increased inspiratory capacity (r = -0.45, P = 0.05) in the >= 5% group. In conclusion, a weight-loss of >= 5% of the body weight improves DH, which is associated with waist circumference in obese adults with asthma. In addition, the group with greater weight-loss showed a delayed onset of DH and EFL during exercise and improved asthma clinical control and HRQoL. NEW & NOTEWORTHY This is the first study to evaluate dynamic hyperinflation (DH) after a weight loss program in obese patients with asthma. Our results demonstrate that moderate weight loss can improve DH in obese patients with asthma that is associated with a decrease in abdominal fat. Moreover, a minimum of 5% in weight loss delays the onset of DH and expiratory flow limitation besides inducing a clinical improvement in asthma quality of life and clinical control.