ALBERTO JOSE DA SILVA DUARTE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Patologia, Faculdade de Medicina - Docente
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
15 resultados
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- Evidence of regulatory myeloid dendritic cells and circulating inflammatory epidermal dendritic cells-like modulated by Toll-like receptors 2 and 7/8 in adults with atopic dermatitis(2017) SANTOS, Vanessa G. dos; ORFALI, Raquel L.; TITZ, Tiago de Oliveira; DUARTE, Alberto J. da Silva; SATO, Maria N.; AOKI, ValeriaBackgroud Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by intense pruritus and xerosis. Dendritic cells (DC) play an essential role in tissue inflammation in atopic dermatitis (AD) skin, especially the inflammatory epidermal dendritic cells (IDEC), a particular subset of myeloid dendritic cells (mDC). The aim of the present study was to assess the phenotype and function of mDC and circulating IDEC-like in peripheral blood mononuclear cells (PBMC) of adults with AD. Methods We selected 21 AD patients and 21 non-AD controls, age and gender matched. Expressions of Fc epsilon RI, CD36, TNF, IFN-gamma , and IL-10 in mDC were analyzed by flow cytometry under various stimuli, such as staphylococcal enterotoxin B (SEB), TLR2 (Pam3CSK4), TLR4 (LPS), and TLR7/8 (CL097) agonists. Results The most prominent findings in AD patients were: (i) enhanced frequency of IL-10 under TLR4 (LPS), and decreased frequency of IFN-gamma and TNF under TLR2 (Pam3CSK4) and 7/8 (CL097) stimulation in classic mDC; (ii) elevation of circulating IDEC-like frequency with TLR2 (Pam3CSK4) stimuli, augmented frequency of IFN-gamma in nonstimulated condition, and of IL-10 under TLR7/8 (CL097) stimuli in IDEC-like population. Conclusions In AD individuals, classic mDC showed an immunomodulatory profile, favoring tolerance in a combined action with IDEC-like, and inducing Th1 polarization. Our findings indicate a potential role of IDEC-like in the maintenance of inflammation in atopic dermatitis patients; moreover, IDEC-like may exert a regulatory impact on T cells of AD individuals through IL-10, often induced by agonist mimicking single stranded RNA virus.
- Low bone mineral density among HIV-infected patients in Brazil(2017) CHABA, Daniela Cardeal da Silva; SOARES, Lismeia R.; PEREIRA, Rosa M. R.; RUTHERFORD, George W.; ASSONE, Tatiane; TAKAYAMA, Liliam; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.; CASSEB, JorgeDecrease in bone mineral density (BMD) has been a complication among people living with HIV/AIDS. To investigate the prevalence of osteopenia/osteoporosis among HIV-infected people living in Sao Paulo city, we studied 108 HIV-infected patients (79 men and 29 women). We extracted data from patients' medical records and BMD was measured by dual-energy X-ray absorptiometry (DXA). Median age of participants was 42 years (interquartile range [IQR] 36-48 years), and the median time since HIV diagnosis was 4.01 years (IQR 2-11 years). Patients had acquired HIV primarily by the sexual route (men who have sex with men 44%, heterosexual 49%). Median age, duration of HIV infection, duration of ART and CD4 nadir were similar for men and women. Plasma viral load was undetectable for 53 patients (49%). Median CD4 T cell count was 399 cells/mu L (IQR 247 - 568). Twenty five patients (23%) had LBMD, and there was no statistically significant difference between men and women (<-1). The associated risk factors for LBMD were older age (>= 50 years old) and smoking with a RR of 3.87 and 2.80, respectively. Thus, despite the lack of statistically significant relationship between the use of ART and LBMD or between duration of ART and LBMD, these factors should be addressed in larger studies.
- Emergence of colistin resistance in the largest university hospital complex of Sao Paulo, Brazil, over five years(2017) ROSSI, Flavia; GIRARDELLO, Raquel; CURY, Ana Paula; GIOIA, Thais Sabato Romano Di; ALMEIDA JR., Joao Nobrega de; DUARTE, Alberto Jose da SilvaColistin resistance involving Gram-negative bacilli infections is a challenge for health institutions around of the world. Carbapenem-resistance among these isolates makes colistin the last therapeutic option for this treatment. Colistin resistance among Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. was evaluated between 2010 and 2014 years, at Hospital das Clinicas, Sao Paulo, Brazil. Over five years 1346 (4.0%) colistin resistant Gramnegative bacilli were evaluated. Enterobacteriaceae was the most frequent (86.1%) pathogen isolated, followed by Acinetobacter spp. (7.6%), and Pseudomonas spp. (6.3%). By temporal analysis there was a trend for an increase of colistin resistance among Enterobacteriaceae, but not among non-fermentative isolates. Among 1346 colistin resistant isolates, carbapenem susceptibility was observed in 21.5%. Colistin resistance in our hospital has been alarmingly increased among Klebsiella pneumoniae isolates in both KPC positive and negative, thus becoming a therapeutic problem. (C) 2016 Sociedade Brasileira de Infectologia.
- Plasmid-mediated mcr-1 in carbapenem-susceptible Escherichia coli ST156 causing a blood infection: an unnoticeable spread of colistin resistance in Brazil?(2017) ROSSI, Flavia; GIRARDELLO, Raquel; MORAIS, Carlos; CURY, Ana Paula; MARTINS, Layla Farage; SILVA, Aline Maria da; ABDALA, Edson; SETUBAL, Joao Carlos; DUARTE, Alberto Jose da SilvaOBJECTIVE: We describe an IncX4 pHC891/16mcr plasmid carrying mcr-1 in a colistin-resistant and carbapenem-susceptible E. coli isolate (HC891/16), ST156, which caused a blood infection in a Brazilian patient with gallbladder adenocarcinoma. METHODS: Strain HC891/16 was subjected to whole genome sequencing using the MiSeq Platform (Illumina, Inc., USA). Assembly was performed using Mira and ABACAS. RESULTS: The isolates showed resistance only to ciprofloxacin, ampicillin and cefoxitin, and whole-genome sequencing revealed the presence of aac(6')Ib-cr and bla(TEM1). CONCLUSION: Our findings warn of the possible silent dissemination of colistin resistance by carbapenem-susceptible mcr-1 producers, as colistin susceptibility is commonly tested only among carbapenem-resistant isolates.
conferenceObject Engineering of novel Class II Transactivator gene delivery systems as molecular adjuvants to improve genetic immunotherapies by inducing de novo MHC II expression in human cells(2017) PALMA, Mariana de Lucena; DUANGKHAE, Parichat; DOURADINHA, Bruno; DHALIA, Rafael; MAILLIARD, Robbie B.; BARRATT-BOYES, Simon; OSHIRO, Telma Miyuki; MARQUES, Ernesto Torres de Azevedo; DUARTE, Alberto Jose da Silva- Carbapenem-resistant Enterobacteriaceae in patients admitted to the emergency department: prevalence, risk factors, and acquisition rate(2017) SALOMAO, M. C.; GUIMARAES, T.; DUAILIBI, D. F.; PERONDI, M. B. M.; LETAIF, L. S. H.; MONTAL, A. C.; ROSSI, F.; CURY, A. P.; DUARTE, A. J. S.; LEVIN, A. S.; BOSZCZOWSKI, I.Background: Carbapenem-resistant Enterobacteriaceae (CRE) have been reported worldwide and are associated with high mortality rates. Intestinal colonization acts as a reservoir and fosters exchange of resistance mechanisms. Aim: To investigate the prevalence of patients harbouring CRE on hospital admission, risk factors associated, and the acquisition rate within the emergency department (ED). Methods: This was a cross-sectional survey with 676 patients consecutively admitted to the ED study during the months of May to July 2016. A questionnaire was performed and rectal swabs were collected from patients on admission, for culture and for multiplex real-time polymerase chain reaction (PCR). If the patient was hospitalized for more than one week in the ED, samples were taken again to determine the acquisition rate of CRE. Findings: Forty-six patients were colonized; all positive PCR were Klebsiella pneumoniae carbapenemase. The acquisition rate was 18%. Previous exposure to healthcare in the last year, liver disease, and use of antibiotics in the last month were risk factors for colonization. Six patients with no previous exposure to healthcare were CRE-colonized on admission, suggesting transmission of CRE within the community. Conclusion: Screening of high-risk patients on admission to the ED is a strategy to early identify CRE carriage and may contribute to control CRE dissemination.
- Profile of differentially expressed Toll-like receptor signaling genes in the natural killer cells of patients with Sezary syndrome(2017) MANFRERE, Kelly C. G.; TORREALBA, Marina P.; MIYASHIRO, Denis R.; PEREIRA, Natalli Z.; YOSHIKAWA, Fabio S. Y.; OLIVEIRA, Luana de M.; CURY-MARTINS, Jade; DUARTE, Alberto J. S.; SANCHES, Jose A.; SATO, Maria N.Sezary syndrome (SS), an aggressive and leukemic form of cutaneous T-cell lymphoma, usually results in shortened survival. Improving innate immunity in SS by targeting natural killer (NK) cells with Toll-like receptor (TLR) agonists could be an interesting modulatory strategy. We evaluated the NK cell populations in SS patients assessing activating and inhibitory receptors expression and profiled the differential expression of TLR signaling pathway genes in unstimulated NK cells and after TLR7/8 stimulation. We observed preserved CD56(bright) NK cells and a low percentage of CD56(dim) NK cells in the peripheral blood of SS patients compared to those in the healthy control group. Both NK cell populations showed down-modulation of NKG2C and NKG2D expression, which was associated with high serum levels of the soluble form of NKG2D ligands. In contrast, an expansion of ""memory"" CD57+ NKG2C+ NK cells and high cytomegalovirus antibody titers were detected in SS patients. Profiling of the TLR signaling genes in NK cells from SS patients showed an abundance of differentially expressed genes (DEGs) in NK cells in the unstimulated condition, with mostly up-regulation of NF kappa B/JNK p38 pathway genes, but there was down-regulation of type I (IFN-alpha/beta) and II (IFN-gamma) interferon and IL-12A. After activation of NK cells with TLR7/8 agonist, the down-regulated genes correlated with the IFN response, and IL-12 became up-regulated, together with other antitumor factors. NK cell activation with a dual agonist for TLR7 and TLR8 is able to induce the expression of IFN-gamma and type I IFN, which can improve immunity in SS patients.
- Development of potent class II transactivator gene delivery systems capable of inducing de novo MHC II expression in human cells, in vitro and ex vivo(2017) PALMA, M. L.; DUANGKHAE, P.; DOURADINHA, B.; VIANA, I. F. T.; RIGATO, P. O.; DHALIA, R.; MAILLIARD, R. B.; BARRATT-BOYES, S. M.; NASCIMENTO, E. J. M.; OSHIRO, T. M.; DUARTE, A. J. da Silva; MARQUES, E. T. A.Class II transactivator (CIITA) induces transcription of major histocompatibility complex (MHC) II genes and can potentially be used to improve genetic immunotherapies by converting non-immune cells into cells capable of presenting antigens to CD4(+) T cells. However, CIITA expression is tightly controlled and it remains unclear whether distinct non-immune cells differ in this transactivator regulation. Here we describe the development of gene delivery systems capable of promoting the efficient CIITA expression in non-immune cell lines and in primary human cells of an ex vivo skin explant model. Different human cell types undergoing CIITA overexpression presented high-level de novo expression of MHC II, validating the delivery systems as suitable tools for the CIITA evaluation as a molecular adjuvant for gene therapies.
conferenceObject Engineering of novel Class II Transactivator gene delivery systems as molecular adjuvants to improve genetic immunotherapies by inducing de novo MHC II expression in human cells(2017) PALMA, Mariana de Lucena; DUANGKHAE, Parichat; DOURADINHA, Bruno; DHALIA, Rafael; MAILLIARD, Robbie B.; BARRATT-BOYES, Simon; OSHIRO, Telma Miyuki; MARQUES, Ernesto Torres de Azevedo; DUARTE, Alberto Jose da SilvaconferenceObject Comparison of high-sensitivity cardiac troponin I and T for the prediction of cardiac complications after non-cardiac surgery(2017) GUALANDRO, D. M.; PUELACHER, C.; LURATI-BUSE, G.; STRUNZ, C.; CARDOZO, F. A.; YU, P. C.; JAFFE, A.; TWERENBOLD, R.; HAMMERER-LERCHER, A.; MELO, E. S.; CALDERARO, D.; DUARTE, A. J. S.; LUCCIA, N.; CARAMELLI, B.; MUELLER, C.