LECTICIA BARBOSA JORGE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina
LIM/12 - Laboratório de Pesquisa Básica em Doenças Renais, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Necrotisans erythema nodosum leprosum with systemic manifestations(2018) ISHIY, Patricia; TRINDADE, Maria Angela; AVANCINI, Joao; PAZZINI, Renato; JORGE, Lecticia; SOTTO, Mirian- Worse renal outcome of subclass IV-G lupus nephritis patients over IV-S(2018) CARNEIRO FILHO, E. J. Duque de Sa; JORGE, L. B.; TESTAGROSSA, L.; BITENCOURT, C.; YU, L.; WORONIK, V.Background International Society of Nephrology/ Renal Pathology Society (ISN/RPS) consensus on the classification of lupus nephritis (LN) subdivided class IV into diffuse segmental (IV-S) and diffuse global (IV-G). Nephrologists and nephropathologists believe that this subclassification would be clinically relevant based on hypothetical distinct immunopathogenesis of those subclasses guiding therapy as well as judging prognosis. Methods All adult patients with a renal biopsy-confirmed diagnosis of LN class IV undergoing regular follow-up in the Nephrology Division between January 2004 and December 2014 were enrolled excluding those with diabetes, hepatitis B, hepatitis C, HIV as well as those with insufficient clinical and hystopathological data. Biopsies were reviewed and reclassified according to ISN/RPS 2003 classification by two experienced pathologists and were examined by light microscopy and direct immunofluorescence. Results On baseline subclass IV-G compared to IV-S showed higher frequency of males and histologically higher activity (7.52.8 vs 5.1 +/- 2.3, p=0.004) and chronicity index (3.4 +/- 1.6 vs 2.4 +/- 1.8, p=0.016) as well as a higher percentage of epithelial crescents (12.9 vs 5.1, p=0.0001) and vessel abnormalities (72% vs 42%, p=0.017). Although renal function on baseline was not different between subclasses, IV-G showed lower levels, although not significant, of estimated glomerular filtration based on CKD-EPI formula (91.0 +/- 34.8 vs 64.4 +/- 44.5, p=0.059) at the end of follow-up. In addition, we observed a higher rate of patients reaching CKD-EPI under 60mL/min/1.73m(2) in subclass IV-G over IV-S on last follow-up. Conclusion Subclasses IV-S and IV-G patients show some clinical and pathological differences that might represent distinct stages of the same disease and they should thus be treated the same.
- Chronic nicotine exposure reduces klotho expression and triggers different renal and hemodynamic responses in klotho-haploinsufficient mice(2018) COELHO, Fernanda Oliveira; JORGE, Lecticia Barbosa; VICIANA, Ana Carolina de Braganca; SANCHES, Talita R.; SANTOS, Fernando dos; HELOU, Claudia M. B.; IRIGOYEN, Maria Claudia; KURO-O, Makoto; ANDRADE, LuciaThe klotho gene, which encodes a single-pass transmembrane protein and a secreted protein, is expressed predominantly by the distal renal tubules and is related to calcium phosphorus metabolism, ion channel regulation, intracellular signaling pathways, and longevity. Klotho deficiency aggravates acute kidney injury and renal fibrosis. Exposure to nicotine also worsens kidney injury. Here, we investigated renal Klotho protein expression in a mouse model of chronic (28-day) nicotine exposure, in which mice received nicotine or vehicle (saccharine) in chinking water, comparing wild-type (WT) mice, klotho-haploinsufficient (kl/+) mice, and their respective controls, in terms of the effects of that exposure. Nicotine exposure was associated with a significant decline in renal Klotho expression in WT and kl/+ mice as well as a reduction in the glomerular filtration rate in WT mice. Although plasma electrolytes were similar among the groups, fractional excretion of sodium was reduced in both nicotine-exposed groups. The nicotine-WT mice presented augmented baroreflex sensitivity to nitroprusside and augmented sympathetic cardiac modulation. However, nicotine-kl/+ mice presented higher plasma levels of urea and aldosterone together with a higher alpha-index (spontaneous baroreflex) and higher peripheral sympathetic modulation, as evaluated by spectral analysis. We can conclude that nicotine downregulates Klotho expression as well as that renal and autonomic responses to nicotine exposure are modified in kl/+ mice.