ANA MARIA PITA LOTTENBERG

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LIM/10 - Laboratório de Lípides, Hospital das Clínicas, Faculdade de Medicina

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  • article 1 Citação(ões) na Scopus
    Position statement on nutrition therapy for overweight and obesity: nutrition department of the Brazilian association for the study of obesity and metabolic syndrome (ABESO-2022)
    (2023) PEPE, Renata Bressan; LOTTENBERG, Ana Maria; FUJIWARA, Clarissa Tamie Hiwatashi; BEYRUTI, Monica; CINTRA, Dennys Esper; MACHADO, Roberta Marcondes; RODRIGUES, Alessandra; JENSEN, Natalia Sanchez Oliveira; CALDAS, Ana Paula Silva; FERNANDES, Ariana Ester; ROSSONI, Carina; MATTOS, Fernanda; MOTARELLI, Joao Henrique Fabiano; BRESSAN, Josefina; SALDANHA, Juliana; BEDA, Lis Mie Masuzawa; LAVRADOR, Maria Silvia Ferrari; BOSCO, Mariana Del; CRUZ, Patricia; CORREIA, Poliana Espindola; MAXIMINO, Priscila; PEREIRA, Silvia; FARIA, Silvia Leite; PIOVACARI, Silvia Maria Fraga
    Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
  • article 45 Citação(ões) na Scopus
    Dietary interesterified fat enriched with palmitic acid induces atherosclerosis by impairing macrophage cholesterol efflux and eliciting inflammation
    (2016) AFONSO, Milessa Silva; LAVRADOR, Maria Silvia Ferrari; KOIKE, Marcia Kiyomi; CINTRA, Dennys Esper; FERREIRA, Fabiana Dias; NUNES, Valeria Sutti; CASTILHO, Gabriela; GIOIELLI, Luiz Antonio; BOMBO, Renata Paula; CATANOZI, Sergio; CALDINI, Elia Garcia; DAMACENO-RODRIGUES, Nilsa Regina; PASSARELLI, Marisa; NAKANDAKARE, Edna Regina; LOTTENBERG, Ana Maria
    Interesterified fats are currently being used to replace trans fatty acids. However, their impact on biological pathways involved in the atherosclerosis development was not investigated. Weaning male LDLr-KO mice were fed for 16 weeks on a high-fat diet (40% energy as fat) containing polyunsaturated (PUFA), TRANS, palmitic (PALM), palmitic interesterified (PALM INTER), stearic (STEAR) or stearic interesterified (STEAR INTER). Plasma lipids, lipoprotein profile, arterial lesion area, macrophage infiltration, collagen content and inflammatory response modulation were determined. Macrophage cholesterol efflux and the arterial expression of cholesterol uptake and efflux receptors were also performed. The interesterification process did not alter plasma lipid concentrations. Although PALM INTER did not increase plasma cholesterol concentration as much as TRANS, the cholesterol enrichment in the LDL particle was similar in both groups. Moreover, PALM INTER induced the highest IL-1 beta, MCP-1 and IL-6 secretion from peritoneal macrophages as compared to others. This inflammatory response elicited by PALM INTER was confirmed in arterial wall, as compared to PALM. These deleterious effects of PALM INTER culminate in higher atherosclerotic lesion, macrophage infiltration and collagen content than PALM, STEAR, STEAR INTER and PUFA. These events can partially be attributed to a macrophage cholesterol accumulation, promoted by apoAl and HDL2-mediated cholesterol efflux impairment and increased Olr-1 and decreased Abca1 and Nr1h3 expressions in the arterial wall. Interesterified fats containing palmitic acid induce atherosclerosis development by promoting cholesterol accumulation in LDL particles and macrophagic cells, activating the inflammatory process in LDLr-KO mice.
  • conferenceObject
    Palmitic Interesterified Fat Induces Atherosclerosis and Inflammatory Cytokine Secretion in LDL Receptor Knockout Mice
    (2014) AFONSO, Milessa S.; LAVRADOR, Maria Silvia F.; KOIKE, Marcia; BOMBO, Renata P.; NUNES, Valeria S.; CATANOZI, Sergio; CASTILHO, Gabriela; PASSARELLI, Marisa; NAKANDAKARE, Edna R.; LOTTENBERG, Ana Maria
  • article 30 Citação(ões) na Scopus
    The impact of dietary fatty acids on macrophage cholesterol homeostasis
    (2014) AFONSOA, Milessa da Silva; CASTILHO, Gabriela; LAVRADOR, Maria Silvia Ferrari; PASSARELLI, Marisa; NAKANDAKARE, Edna Regina; LOTTENBERG, Simao Augusto; LOTTENBERG, Ana Maria
    The impact of dietary fatty acids in atherosclerosis development may be partially attributed to their effect on macrophage cholesterol homeostasis. This process is the result of interplay between cholesterol uptake and efflux, which are permeated by inflammation and oxidative stress. Although saturated fatty acids (SAFAs) do not influence cholesterol efflux, they trigger endoplasmic reticulum stress, which culminates in increased lectin-like oxidized LDL (oxLDL) receptor (LOX1) expression and, consequently, oxLDL uptake, leading to apoptosis. Unsaturated fatty acids prevent most SAFAs-mediated deleterious effects and are generally associated with reduced cholesterol efflux, although alpha-linolenic acid increases cholesterol export. Trans fatty acids increase macrophage cholesterol content by reducing ABCA-1 expression, leading to strong atherosclerotic plaque formation. As isomers of conjugated linoleic acid (CLAs) are strong PPAR gamma ligands, they induce cluster of differentiation (CD36) expression, increasing intracellular cholesterol content. Considering the multiple effects of fatty acids on intracellular signaling pathways, the purpose of this review is to address the role of dietary fat in several mechanisms that control macrophage lipid content, which can determine the fate of atherosclerotic lesions.
  • article 3 Citação(ões) na Scopus
    Challenges in familial chylomicronemia syndrome diagnosis and management across Latin American countries: An expert panel discussion
    (2021) SANTOS, Raul D.; LORENZATTI, Alberto; CORRAL, Pablo; NOGUEIRA, Juan Patricio; CAFFERATA, Alberto M.; AIMONE, Daniel; LOURENCO, Charles M.; IZAR, Maria Cristina; LIMA, Josivan G.; LOTTENBERG, Ana Maria; ALONSO, Rodrigo; GARAY, Karla; MORALES, Alvaro Ruiz; VARGAS-URICOECHEA, Hernando; PENA, Christian A. Colon; ROMAN-GONZALEZ, Alejandro
    Familial chylomicronemia syndrome (FCS) is a rare genetic disorder characterized by extremely high triglyceride levels due to impaired clearance of chylomicrons from plasma. This paper is the result of a panel discussion with Latin American specialists who raised the main issues on diagnosis and management of FCS in their countries. Overall FCS is diagnosed late on the course of the disease, is characterized by heterogeneity on the occurrence of pancreatitis, and remains a long time in care of different specialists until reaching a lipidologist. Pancreatitis and secondary diabetes are frequently seen, often due to late diagnosis and inadequate care. Molecular diagnosis is unusual; however, loss of func-tion variants on the lipoprotein lipase gene are apparently the most frequent etiology. A founder effect of the glycosylphosphatidylinositol anchored high density lipoprotein binding protein 1 gene has been de-scribed in the northeast of Brazil. Low awareness of the disease amongst health professionals contributes to inadequate care and an inadequate patient journey.
  • article 17 Citação(ões) na Scopus
    Update of the Brazilian Guideline for Familial Hypercholesterolemia-2021
    (2021) IZAR, Maria Cristina de Oliveira; GIRALDEZ, Viviane Zorzanelli Rocha; BERTOLAMI, Adriana; SANTOS FILHO, Raul Dias dos; LOTTENBERG, Ana Maria; ASSAD, Marcelo Heitor Vieia; SARAIVA, Jose Francisco Kerr; CHACRA, Ana Paula M.; MARTINEZ, Tania L. R.; BAHIA, Luciana Ribeiro; FONSECA, Francisco Antonio Helfenstein; FALUDI, Andre Arpad; SPOSITO, Andrei C.; CHAGAS, Antonio Carlos Palandri; JANNES, Cinthia Elim; AMARAL, Cristiane Kovacs; ARAUJO, Daniel Branco de; CINTRA, Dennys Esper; COUTINHO, Elaine dos Reis; CESENA, Fernando; XAVIER, Hermes Toros; MOTA, Isabela Cardoso Pimentel; GIULIANO, Isabela de Carlos Back; FARIA, Jose Rocha; KATO, Juliana Tieko; BERTOLAMI, Marcelo Chiara; MINAME, Marcio Hiroshi; CASTELO, Maria Helane Costa Gurgel; LAVRADOR, Maria Silvia Ferrari; MACHADO, Roberta Marcondes; SOUZA, Patricia Guedes de; ALVES, Renato Jorge; MACHADO, Valeria Arruda; SALGADO FILHO, Wilson
  • article 20 Citação(ões) na Scopus
    Position Statement on Fat Consumption and Cardiovascular Health-2021
    (2021) IZAR, Maria Cristina de Oliveira; LOTTENBERG, Ana Maria; GIRALDEZ, Viviane Zorzanelli Rocha; SANTOS FILHO, Raul Dias dos; MACHADO, Roberta Marcondes; BERTOLAMI, Adriana; ASSAD, Marcelo Heitor Vieira; SARAIVA, Jose Francisco Kerr; FALUDI, Andre Arpad; MOREIRA, Annie Seixas Bello; GELONEZE, Bruno; MAGNONI, Carlos Daniel; SCHERR, Carlos; AMARAL, Cristiane Kovacs; ARAUJO, Daniel Branco de; CINTRA, Dennys Esper Correa; NAKANDAKARE, Edna Regina; FONSECA, Francisco Antonio Helfenstein; MOTA, Isabela Cardoso Pimentel; SANTOS, Jose Ernesto dos; KATO, Juliana Tieko; BEDA, Lis Mie Misuzawa; VIEIRA, Lis Proenca; BERTOLAMI, Marcelo Chiara; ROGERO, Marcelo Macedo; LAVRADOR, Maria Silvia Ferrari; NAKASATO, Miyoko; DAMASCENO, Nagila Raquel Teixeira; ALVES, Renato Jorge; SOARES, Lara Roberta; COSTA, Rosana Perim; MACHADO, Valeria Arruda
  • article 15 Citação(ões) na Scopus
    International descriptive and interventional survey for oxycholesterol determination by gas- and liquid-chromatographic methods
    (2018) LUETJOHANN, Dieter; BJORKHEM, Ingemar; FRIEDRICHS, Silvia; KERKSIEK, Anja; GEILENKEUSER, Wolf-Jochen; LOVGREN-SANDBLOM, Anita; ANSORENA, Diana; ASTIASARAN, Iciar; BAILA-RUEDA, Lucia; BARRIUSO, Blanca; BRETILLON, Lionell; BROWNE, Richard W.; CACCIA, Claudio; CENARRO, Ana; CRICK, Peter J.; FAULER, Guenter; GARCIA-LLATAS, Guadalupe; GRIFFITHS, William J.; IULIANO, Luigi; LAGARDA, Maria Jesus; LEONI, Valerio; LOTTENBERG, Ana Maria; MATYSIK, Silke; MCDONALD, Jeff; RIDEOUT, Todd C.; SCHMITZ, Gerd; NUNES, Valeria Sutti; WANG, Yuqin; ZERBINATI, Chiara; DICZFALUSY, Ulf; SCHOETT, Hans-Frieder
    Increasing numbers of laboratories develop new methods based on gas-liquid and high-performance liquid chromatography to determine serum concentrations of oxygenated cholesterol metabolites such as 7 alpha-, 24(S)-, and 27-hydroxycholesterol. We initiated a first international descriptive oxycholesterol (OCS) survey in 2013 and a second interventional survey 2014 in order to compare levels of OCS reported by different laboratories and to define possible sources of analytical errors. In 2013 a set of two lyophilized serum pools (A and B) was sent to nine laboratories in different countries for OCS measurement utilizing their own standard stock solutions. In 2014 eleven laboratories were requested to determine OCS concentrations in lyophilized pooled sera (C and D) utilizing the same provided standard stock solutions of OCS. The participating laboratories submitted results obtained after capillary gas-liquid chromatography-mass selective detection with either epicoprostanol or deuterium labelled sterols as internal standards and high-performance liquid chromatography with mass selective detection and deuterated OCS as internal standard. Each participant received a clear overview of the results in form of Youden-Plots and basic statistical evaluation in its used unit. The coefficients of variation of the concentrations obtained by all laboratories using their individual methods were 58.5-73.3% (survey 1), 56.8-60.3% (survey 2); 36.2-35.8% (survey 1), 56.6-59.8, (survey 2); 61.1-197.7% (survey 1), 47.2-74.2% (survey 2) for 24(S)-, 27-, and 7 alpha-hydroxycholesterol, respectively. We are surprised by the very great differences between the laboratories, even under conditions when the same standards were used. The values of OCS's must be evaluated in relation to the analytical technique used, the efficiency of the ample separation and the nature of the internal standard used. Quantification of the calibration solution and inappropriate internal standards could be identified as major causes for the high variance in the reported results from the different laboratories. A harmonisation of analytical standard methods is highly needed. (C) 2018 Published by Elsevier B.V.
  • article 37 Citação(ões) na Scopus
    Omega-6 polyunsaturated fatty acids prevent atherosclerosis development in LDLr-KO mice, in spite of displaying a pro-inflammatory profile similar to trans fatty acids
    (2012) MACHADO, Roberta M.; NAKANDAKARE, Edna R.; QUINTAO, Eder C. R.; CAZITA, Patricia M.; KOIKE, Marcia K.; NUNES, Valeria S.; FERREIRA, Fabiana D.; AFONSO, Milessa S.; BOMBO, Renata P. A.; MACHADO-LIMA, Adriana; SORIANO, Francisco G.; CATANOZI, Sergio; LOTTENBERG, Ana Maria
    The development of atherosclerosis and the inflammatory response were investigated in LDLr-KO mice on three high-fat diets (40% energy as fat) for 16 weeks: trans (TRANS), saturated (SAFA) or omega-6 polyunsaturated (PUFA) fats. The following parameters were measured: plasma lipids, aortic root total cholesterol (TC), lesion area (Oil Red-O), ABCA1 content and macrophage infiltration (immunohistochemistry), collagen content (Picrosirius-red) and co-localization of ABCA1 and macrophage (confocal microscopy) besides the plasma inflammatory markers (IL-6, TNF-alpha) and the macrophage inflammatory response to lipopolysaccharide from Escherichia coli (LPS). As expected, plasma TC and TG concentrations were lower on the PUFA diet than on TRANS or SAFA diets. Aortic intima macrophage infiltration, ABCA1 content, and lesion area on PUFA group were lower compared to TRANS and SAFA groups. Macrophages and ABCA1 markers did not co-localize in the atherosclerotic plaque, suggesting that different cell types were responsible for the ABCA1 expression in plaques. Compared to PUFA, TRANS and SAFA presented higher collagen content and necrotic cores in atherosclerotic plaques. In the artery wall, TC was lower on PUFA compared to TRANS group; free cholesterol was lower on PUFA compared to TRANS and SAFA; cholesteryl ester concentration did not vary amongst the groups. Plasma TNF-alpha concentration on PUFA and TRANS-fed mice was higher compared to SAFA. No difference was observed in IL-6 concentration amongst groups. Regarding the macrophage inflammatory response to LPS, TRANS and PUFA presented higher culture medium concentrations of IL-6 and TNF-alpha as compared to SAFA. The PUFA group showed the lowest amount of the anti-inflammatory marker IL-10 compared to TRANS and SAFA groups. In conclusion, PUFA intake prevented atherogenesis, even in a pro-inflammatory condition.
  • article 24 Citação(ões) na Scopus
    Dietary phytosterol does not accumulate in the arterial wall and prevents atherosclerosis of LDLr-KO mice
    (2013) BOMBO, Renata P. A.; AFONSO, Milessa S.; MACHADO, Roberta M.; LAVRADOR, Maria Silvia Ferrari; NUNES, Valeria S.; QUINTAO, Eder R.; KOIKE, Marcia; CATANOZI, Sergio; LIN, Chin Jia; NAKANDAKARE, Edna R.; LOTTENBERG, Ana Maria
    Scope: There have been conflicting reports on the usefulness of phytosterols (PS) in preventing atherosclerosis. We evaluated the effects of dietary PS supplementation in LDLr-KO male mice on the plasma and aorta sterol concentrations and on atherosclerotic lesion development. Methods and results: Mice were fed a high fat diet (40% of energy) supplemented with or without PS (2% w/w, n = 10). Plasma and arterial wall cholesterol and PS concentrations, lesion area, macrophage infiltration, and mRNA expression from LOX-1, CD36, ABCA1 and ABCG1 in peritoneal macrophages were measured. After 16 weeks, the plasma cholesterol concentration in PS mice was lower than that in the controls (p = 0.02) and in the arterial wall (p = 0.03). Plasma PS concentrations were higher in PS-fed animals than in controls (p < 0.0001); however, the arterial wall PS concentration did not differ between groups. The atherosclerotic lesion area in the PS group (n = 5) was smaller than that in controls (p = 0.0062) and the macrophage area (p = 0.0007). PS correlates negatively with arterial lipid content and macrophage (r = -0.76; p < 0.05). PS supplementation induced lower ABCG1 mRNA expression (p < 0.05). Conclusions: Despite inducing an increase in PS plasma concentration, PS supplementation is not associated with its accumulation in the arterial wall and prevents atherosclerotic lesion development.