MICHELLE REMIAO UGOLINI LOPES
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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conferenceObject Induction of Lupus Nephritisin in Real Situation: Cyclophosphamide or Mycophenolate Mofetil?(2017) MUNHOZ, Gabriela; LACERDA, Maira; LOPES, Michelle; BORBA, Eduardo Ferreira; SEGURO, Luciana; BONFA, Eloisa- Immunogenicity and safety of primary fractional-dose yellow fever vaccine in autoimmune rheumatic diseases(2021) TONACIO, Adriana Coracini; PEDROSA, Tatiana do Nascimento; BORBA, Eduardo Ferreira; AIKAWA, Nadia Emi; PASOTO, Sandra Gofinet; FERREIRA FILHO, Julio Cesar Rente; BARROS, Marilia Mantovani Sampaio; LEON, Elaine Pires; LOMBARDI, Suzete Cleusa Ferreira Spina; MENDRONE JUNIOR, Alfredo; AZEVEDO, Adriana de Souza; SCHWARCZ, Waleska Dias; FULLER, Ricardo; YUKI, Emily Figueiredo Neves; LOPES, Michelle Remiao Ugolini; PEREIRA, Rosa Maria Rodrigues; BARROS, Percival Degrava Sampaio; ANDRADE, Danieli Castro Oliveira de; MEDEIROS-RIBEIRO, Ana Cristina de; MORAES, Julio Cesar Bertacini de; SHINJO, Samuel Katsuyuki; MIOSSI, Renata; DUARTE, Alberto Jose da Silva; LOPES, Marta Heloisa; KALLAS, Esper Georges; SILVA, Clovis Artur Almeida da; BONFA, EloisaBackground Brazil faced a yellow fever(YF) outbreak in 2016-2018 and vaccination was considered for autoimmune rheumatic disease patients(ARD) with low immunosuppression due to YF high mortality. Objective This study aimed to evaluate, prospectively for the first time, the short-term immunogenicity of the fractional YF vaccine(YFV) immunization in ARD patients with low immunossupression. Methods and Results A total of 318 participants(159 ARD and 159 age- and sex-matched healthy controls) were vaccinated with the fractional-dose(one fifth) of 17DD-YFV. All subjects were evaluated at entry(D0), D5, D10, and D30 post-vaccination for clinical/laboratory and disease activity parameters for ARD patients. Post-vaccination seroconversion rate(83.7%vs.96.6%, p = 0.0006) and geometric mean titers(GMT) of neutralizing antibodies[1143.7 (95%CI 1012.3-1292.2) vs.731 (95%CI 593.6-900.2), p< 0.001] were significantly lower in ARD compared to controls. A lower positivity rate of viremia was also identified for ARD patients compared to controls at D5 (53%vs.70%, p = 0.005) and the levels persisted in D10 for patients and reduced for controls(51%vs.19%, p = 0.0001). The viremia was the only variable associated with seroconvertion. No serious adverse events were reported. ARD disease activity parameters remained stable at D30(p>0.05). Conclusion Fractional-dose 17DD-YF vaccine in ARD patients resulted in a high rate of seroconversion rate(> 80%) but lower than controls, with a longer but less intense viremia. This vaccine was immunogenic, safe and did not induce flares in ARD under low immunosuppression and may be indicated in YF outbreak situations and for patients who live or travel to endemic areas.
conferenceObject Is Uric Acid Level a Predictor of Long-Term Renal Outcome in Lupus Nephritis?(2017) LOPES, Michelle; GAVINIER, Samara; LEON, Elaine; VIANA, Vilma; BORBA, Eduardo Ferreira; BONFA, Eloisa- Is serum uric acid a predictor of long-term renal outcome in lupus nephritis?(2019) UGOLINI-LOPES, Michelle Remiao; GAVINIER, Samara S.; LEON, Elaine; VIANA, Vilma Trindade; BORBA, Eduardo Ferreira; BONFA, EloisaBackground/objective Recent studies observed an association between increased serum uric acid (SUA) levels and renal damage in lupus. However, the predictive value of UA for the development of long-term renal dysfunction in lupus nephritis (LN) is still unknown. The aim of this study was to evaluate if SUA may be a predictor of long-term renal outcome in LN. Methods Eighty biopsy-proven LN patients > 7 years of follow-up were selected. SUA levels were measured in sera stored at - 70 degrees C. All patients had serum stored from LN baseline, and 32 also had stored serum from 6 and 12 months after LN. Renal outcome was addressed after 7 years of follow-up to determine if SUA could be a predictor of long-term renal outcome. A good long-term renal outcome in 7 years was defined as a creatinine clearance (CrCl) >= 90.0 mL/min/1.73 m(2), and poor if CrCl < 90 mL/min/1.73 m(2). Patients were divided in two groups according to the renal outcome to assess whether SUA levels at different time points of follow-up could differentiate such groups. An ROC curve was plotted to assess accuracy. Results SUA levels at baseline and 6 months were not able to differentiate good from poor long-term renal outcomes in LN (respectively p = 0.37, p = 0.28), but at 12 months (p = 0.02), they could clearly differentiate the two groups. ROC curve (12 months) accuracy was 0.76. SUA cutoff was 6.05 mg/dL (sensitivity = 0.67, specificity = 0.89, positive predictive value = 0.85, negative predictive value = 0.73). Conclusion SUA levels < 6.05 mg/dL at 12 months of follow-up is a predictor of good long-term renal outcome in lupus nephritis.
conferenceObject Early Proteinuria Response in Real Life Situation Predicts Long-Term Lupus Renal Outcome in Ethnically Diverse Group with Biopsy-Proven Nephritis(2016) LOPES, Michelle; SEGURO, Luciana; CASTRO, Maite; DAFFRE, Danielle; BORBA, Eduardo Ferreira; BONFA, EloisaconferenceObject Effectiveness of Renoprotective Approaches in Lupus Nephritis: More Than Just Immunosuppression(2015) CASTRO, Maite; BORBA, Eduardo Ferreira; LOPES, Michelle; PASOTO, Sandra G.; BONFA, Eloisa; SEGURO, LucianaconferenceObject Short-Term Safety of Fractional-Dose Yellow Fever Vaccination in Autoimmune Rheumatic Diseases and Kinetics of White Blood Cells(2018) TONACIO, Adriana C.; PEDROSA, Tatiana N.; FERREIRA FILHO, Julio C. R.; SAMPAIO-BARROS, Marilia M.; FULLER, Ricardo; LOPES, Michelle; BORBA, Eduardo Ferreira; PASOTO, Sandra G.; NEVES, Emilly; SILVA, Clovis A.; PEREIRA, Rosa M. R.; SAMPAIO-BARROS, Percival; ANDRADE, Danieli; RIBEIRO, Ana C. M.; MORAES, Julio C. B.; SHINJO, Samuel K.; MIOSSI, Renata; HIGASHINO, Hermes; COSTA, Silvia; DUARTE, Alberto; LEON, Elaine P.; LOPES, Marta; AIKAWA, Nadia E.; BONFA, Eloisa- Serum uric acid levels are associated with lupus nephritis in patients with normal renal function(2018) CALICH, Ana Luisa; BORBA, Eduardo Ferreira; UGOLINI-LOPES, Michelle Remiao; ROCHA, Luiza Fuoco da; BONFA, Eloisa; FULLER, RicardoUric acid has been recognised as a potential marker of endothelial dysfunction and kidney disease but there are scarce data about its importance in systemic lupus erythematosus (SLE) nephritis. This study aimed to evaluate serum uric acid (UA) levels in lupus nephritis (LN), by comparing SLE patients with normal renal function, with and without nephritis. Forty-six female SLE patients were consecutively selected and divided in two groups according to renal activity at the evaluation: presence of a recently diagnosed lupus nephritis (LN+, n = 18) and absence of lupus nephritis (LN-, n = 28). Age-matched healthy women were selected (CONTROL, n = 28). Patients with gout, creatinine clearance lower than 80 ml/min and use of drugs that interfere in UA were excluded. Laboratory and clinical data were analysed by appropriate tests. A multivariate analysis was performed, and a receiver operating characteristic (ROC) curve was plotted, and the area under the curve was calculated to assess the diagnostic strength of UA in LN. The mean age was similar among LN+, LN- and CONTROL groups (32.44 +/- 6.09 vs. 30.68 +/- 5.36 vs. 30.86 +/- 5.00 years, p = 0.52). UA was significantly higher in LN+ compared to LN- (5.54 +/- 1.67 vs. 3.65 +/- 1.090 mg/dL, p < 0.001) and CONTROL (5.54 +/- 1.67 vs. 3.92 +/- 0.95 mg/dL p < 0.001). Multivariate analysis confirmed that high UA was an independent variable related to LN (p < 0.001). The cut-off value for UA using the ROC curve was 4.47 mg/dL (AUC 0.86, p = 0.00004, CI 95% 0.75-0.96). Lupus nephritis was associated with higher UA. Hyperuricemia as a predictor of renal damage in SLE needs to be evaluated in further studies.
- Clinical and laboratory features of overlap syndromes of idiopathic inflammatory myopathies associated with systemic lupus erythematosus, systemic sclerosis, or rheumatoid arthritis(2014) AGUILA, Lisbeth Aranbicia; LOPES, Michelle Remiao Ugolini; PRETTI, Flavia Zon; SAMPAIO-BARROS, Percival Degrava; SOUZA, Fernando Henrique Carlos de; BORBA, Eduardo Ferreira; SHINJO, Samuel KatsuyukiBecause overlap syndromes (OSs) are rarely described, we analyzed retrospectively their frequencies and correlations in Brazilian series of 31 patients with dermatomyositis (DM)/polymyositis (PM) associated with systemic lupus erythematosus (SLE), systemic sclerosis (SSc), or rheumatoid arthritis (RA) attended at a referral single center. Myositis-specific autoantibodies (MSAs: anti-Jo-1, anti-PL-7, anti-PL-12, anti-EJ, anti-OJ, anti-SRP, anti-Mi-2) and myositis-associated autoantibodies (MAAs: anti-PM-Scl75, anti-PM-Scl100, anti-Ku) as well as specific autoantibodies related to SLE, SSc, and RA were investigated. The mean age of the OS patients (9 DM and 22 PM) was 44.6 +/- 15.4 years, with a predominance of women (83.9 %) and white ethnicity (58.1 %). PM was the most frequent inflammatory myopathy, and the clinical presentation of DM/PM was significantly different among the OS groups. Overlap was found with SSc (48.4 %), SLE (29.0 %), and RA (22.6 %). The clinical manifestations of DM/PM were identified simultaneously with SSc and RA in the majority of cases, in contrast to identification in the SLE group (p < 0.05). All patients were positive for antinuclear antibodies, and the prevalence of MSA and MAA was 38.8 % in all OS groups, mutually exclusive, and more frequent in the SSc group. Comparing the clinical and laboratory features, there was a higher frequency of vascular (skin ulcers, Raynaud's phenomenon) and pulmonary (interstitial lung disease) involvement in the SSc group (p < 0.05). Moreover, there were no differences among the groups in relation to disease relapse and deaths. Concluding, this is the first study to show the different characteristics of a series of patients with connective tissue disease (CTD)-OS in the heterogeneous Brazilian population.