ROBERTO TAKAOKA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Methotrexate for refractory adult atopic dermatitis leads to alterations in cutaneous IL-31 and IL-31RA expression(2024) SAMORANO, Luciana Paula; MANFRERE, Kelly Cristina Gomes; PEREIRA, Naiura Vieira; TAKAOKA, Roberto; VALENTE, Neusa Yuriko Sakai; SOTTO, Mirian Nacagami; SILVA, Luiz Fernando Ferraz; SATO, Maria Notomi; AOKI, ValeriaBackground: Methotrexate (MTX) is an alternative treatment for patients with moderate/severe atopic dermatitis (AD). Objective: The authors evaluated the effect of MTX on the cutaneous expression of cytokines and chemokines that are involved in the inflammatory response in adult AD patients who received treatment with methotrexate for 24 weeks. Methods: The authors conducted a prospective single-institution cohort study with 12 adults with moderate/severe AD who received oral MTX (15 mg/wk for 24 wks) and 10 non-atopic matched controls. The comparison was made of skin biopsies of lesional and non-lesional skin, pre- and post MTX treatment. The authors analyzed mean epidermal thickness and expression of IL-31, IL-31RA, OSMR, TSLP, Ki67, IL-4 mRNA, IL-6, IL-10, TNF-alpha, IFN-gamma, TARC, and CCL-22. Results: There was a reduction in mean epidermal thickness (p = 0.021), an increase in IL-31RA expression (immunohistochemistry) in the epidermis (p = 0.016) and a decrease in IL-31 gene expression (p = 0.019) on lesional AD skin post-MTX treatment. No significant changes in the cutaneous expression of the other evaluated markers were identified. Study limitations: Small sample size and limited length of follow-up. Conclusions: Treatment with MTX in adults with moderate/severe AD reduced epidermal hyperplasia and changed the cutaneous expression of inflammatory cytokines and receptors that are mainly related to pruritus, including IL-31 and IL-31RA. (c) 2023 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Dermatologia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
- Consensus on the therapeutic management of atopic dermatitis - Brazilian Society of Dermatology: an update on phototherapy and systemic therapy using e-Delphi technique(2023) ORFALI, Raquel Leao; LORENZINI, Daniel; BRESSAN, Aline; TANAKA, Anber Ancel; CERQUEIRA, Ana Maria Mosca de; HIRAYAMA, Andre da Silva; RAMOS, Andrea Machado Coelho; PROENCA, Carolina Contin; SILVA, Claudia Marcia de Resende; LACZYNSKI, Cristina Marta Maria; CARNEIRO, Francisca Regina; DUARTE, Gleison; HANS FILHO, Gunter; GONCALVES, Heitor de Sa; MELO, Ligia Pessoa de; AZULAY-ABULAFIA, Luna; WEBER, Magda Blessmann; RIVITTI-MACHADO, Maria Cecilia; ZANIBONI, Mariana Colombini; OGAWA, Marilia; PIRES, Mario Cezar; IANHEZ, Mayra; FELIX, Paulo Antonio Oldani; BONAMIGO, Renan; TAKAOKA, Roberto; LAZZARINI, Rosana; CESTARI, Silmara; MAYOR, Silvia Assumpcao Soutto; CESTARI, Tania; OLIVEIRA, Zilda Najjar Prado de; SPULS, Phyllis I.; GERBENS, Louise A. A.; AOKI, ValeriaThis publication is an update of the ""Consensus on the therapeutic management of atopic dermatitis - Brazilian Society of Dermatology"" published in 2019, considering the novel, targeted-oriented systemic therapies for atopic dermatitis. The initial recommendations of the current consensus for systemic treatment of patients with atopic dermatitis were based on a recent review of scientific published data and a consensus was reached after voting. The Brazilian Society of Dermatology invited 31 experts from all regions of Brazil and 2 international experts on atopic dermatitis who fully contributed to the process. The methods included an e-Delphi study to avoid bias, a literature search and a final consensus meeting. The authors added novel approved drugs in Brazil and the indication for phototherapy and systemic therapy for AD. The therapeutical response to systemic treatment is hereby reported in a suitable form for clinical practice and is also part of this updated manuscript. (c) 2023 Sociedade Brasileira de Dermatologia.
- Atopic dermatitis: A global health perspective(2024) FAYE, Ousmane; FLOHR, Carsten; KABASHIMA, Kenji; MA, Lin; PALLER, Amy S.; RAPELANORO, Fahafahantsoa Rabenja; STEINHOFF, Martin; SU, John C.; TAKAOKA, Roberto; WOLLENBERG, Andreas; YEW, Yik Weng; POSTIGO, Jose A. Ruiz; SCHMID-GRENDELMEIER, Peter; TAIEB, AlainThe International Society of AD (ISAD) organized a roundtable on global aspects of AD at the WCD 2023 in Singapore. According to the Global Burden of Disease (GBD) consortium, at least 171 million individuals were affected with AD in 2019, corresponding to 2.23% of the world population, with age-standardized prevalence and incidence rates that were relatively stable from 1990 to 2019. Based on the panel experience, most AD cases are mild-to-moderate. Without parallel data on disease prevalence and severity, the GBD data are difficult to interpret in many regions. This gap is particularly important in countries with limited medical infrastructure, but indirect evidence suggests a significant burden of AD in low-and-medium resource settings, especially urban areas. The Singapore roundtable was an opportunity to compare experiences in World Bank category 1 (Madagascar and Mali), 3 (Brazil, China) and 4 (Australia, Germany, Qatar, USA, Singapore, Japan) countries. The panel concluded that current AD guidelines are not adapted for low resource settings and a more pragmatic approach, as developed by WHO for skin NTDs, would be advisable for minimal access to moisturizers and topical corticosteroids. The panel also recommended prioritizing prevention studies, regardless of the level of existing resources. For disease long-term control in World Bank category 3 and most category 4 countries, the main problem is not access to drugs for most mild-to-moderate cases, but rather poor compliance due to insufficient time at visits. Collaboration with WHO, patient advocacy groups and industry may promote global change, improve capacity training and fight current inequalities. Finally, optimizing management of AD and its comorbidities needs more action at the primary care level, because reaching specialist care is merely aspirational in most settings. Primary care empowerment with store and forward telemedicine and algorithms based on augmented intelligence is a future goal.