DAGOBERTO CALLEGARO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina

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Colaboração internacional: Inglaterra × search.filters.applied.f.dateIssued: 2020 × Tipo de acesso: restrictedAccess ×

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  • article 17 Citação(ões) na Scopus
    CSF levels of glutamine synthetase and GFAP to explore astrocytic damage in seronegative NMOSD
    (2020) KLEEREKOOPER, Iris; HERBERT, Megan K.; KUIPERIJ, H. Bea; SATO, Douglas Kazutoshi; FUJIHARA, Kazuo; CALLEGARO, Dagoberto; MARIGNIER, Romain; SAIZ, Albert; SENEL, Makbule; TUMANI, Hayrettin; JONG, Brigit A. De; TRIP, S. Anand; NAKASHIMA, Ichiro; VERBEEK, Marcel M.; PETZOLD, Axel
    Objective To explore levels of astrocytopathy in neuromyelitis optica spectrum disorder (NMOSD) by measuring levels of the astrocytic enzyme glutamine synthetase (GS) and glial fibrillary acidic protein (GFAP), an established astrocytic biomarker known to be associated with disease activity in multiple sclerosis. Methods Cerebrospinal fluid concentrations of GS and GFAP were measured by ELISA in patients with NMOSD (n=39, 28 aquaporin-4 (AQP4)-Ab-seropositive, 3 double-Ab-seronegative, 4 myelin oligodendrocyte glycoprotein (MOG)-Ab-seropositive and 4 AQP4-Ab-seronegative with unknown MOG-Ab-serostatus), multiple sclerosis (MS) (n=69), optic neuritis (n=5) and non-neurological controls (n=37). Results GFAP and GS concentrations differed significantly across groups (both p<0.001), showing a similar pattern of elevation in patients with AQP4-Ab-seropositive NMOSD. GS and GFAP were significantly correlated, particularly in patients with AQP4-Ab-seropositive NMOSD (r(s)=0.70, p<0.001). Interestingly, GFAP levels in some patients with double-Ab-seronegative NMOSD were markedly increased. Conclusions Our data indicate astrocytic injury occurs in some patients with double-Ab-seronegative NMOSD, which hints at the possible existence of yet undiscovered astrocytic autoimmune targets. We hypothesise that elevated GS and GFAP levels could identify those double-Ab-seronegative patients suitable to undergo in-depth autoimmune screening for astrocytic antibodies.
  • article 103 Citação(ões) na Scopus
    Treatment of MOG-IgG-associated disorder with rituximab: An international study of 121 patients
    (2020) WHITTAM, Daniel H.; COBO-CALVO, Alvaro; LOPEZ-CHIRIBOGA, A. Sebastian; PARDO, Santiago; GORNALL, Matthew; CICCONI, Silvia; BRANDT, Alexander; BEREK, Klaus; BERGER, Thomas; JELCIC, Ilijas; GOMBOLAY, Grace; OLIVEIRA, Luana Micheli; CALLEGARO, Dagoberto; KANEKO, Kimihiko; MISU, Tatsuro; CAPOBIANCO, Marco; GIBBONS, Emily; KARTHIKEAYAN, Venkatraman; BROCHET, Bruno; AUDOIN, Bertrand; MATHEY, Guillaume; LAPLAUD, David; THOUVENOT, Eric; COHEN, Mikael; TOURBAH, Ayman; MAILLART, Elisabeth; CIRON, Jonathan; DESCHAMPS, Romain; BIOTTI, Damien; ROSTASY, Kevin; NEUTEBOOM, Rinze; HEMINGWAY, Cheryl; FORSYTH, Rob; MATIELLO, Marcelo; WEBB, Stewart; HUNT, David; MURRAY, Katy; HACOHEN, Yael; LIM, Ming; LEITE, M. Isabel; PALACE, Jacqueline; SOLOMON, Tom; LUTTEROTTI, Andreas; FUJIHARA, Kazuo; NAKASHIMA, Ichiro; BENNETT, Jeffrey L.; PANDIT, Lekha; CHITNIS, Tanuja; WEINSHENKER, Brian G.; WILDEMANN, Brigitte; SATO, Douglas Kazutoshi; KIM, Su-Hyun; HUDA, Saif; KIM, Ho Jin; REINDL, Markus; LEVY, Michael; JARIUS, Sven; TENEMBAUM, Silvia; PAUL, Friedemann; PITTOCK, Sean; MARIGNIER, Romain; JACOB, Anu
    Objective: To assess the effect of anti-CD20 B-cell depletion with rituximab (RTX) on relapse rates in myelin oligodendrocyte glycoprotein antibody-associated disorder (MOGAD). Methods: Retrospective review of RTX-treated MOGAD patients from 29 centres in 13 countries. The primary outcome measure was change in relapse rate after starting rituximab (Poisson regression model). Results: Data on 121 patients were analysed, including 30 (24.8%) children. Twenty/121 (16.5%) were treated after one attack, of whom 14/20 (70.0%) remained relapse-free after median (IQR) 11.2 (6.3-14.1) months. The remainder (101/121, 83.5%) were treated after two or more attacks, of whom 53/101 (52.5%) remained relapse-free after median 12.1 (6.3-24.9) months. In this 'relapsing group', relapse rate declined by 37% (95%CI=19-52%, p<0.001) overall, 63% (95%CI=35-79%, p = 0.001) when RTX was used first line (n = 47), and 26% (95%CI=2-44%, p = 0.038) when used after other steroid-sparing immunotherapies (n = 54). Predicted 1-year and 2-year relapse-free survival was 79% and 55% for first-line RTX therapy, and 38% and 18% for second-/third-line therapy. Circulating CD19(+)B-cells were suppressed to <1% of total circulating lymphocyte population at the time of 45/57 (78.9%) relapses. Conclusion: RTX reduced relapse rates in MOGAD. However, many patients continued to relapse despite apparent B-cell depletion. Prospective controlled studies are needed to validate these results.