ANA PAULA MOREIRA SALLES
Projetos de Pesquisa
Unidades Organizacionais
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Analysis of the complete genome of HBV genotypes F and H found in Brazil and Mexico using the next generation sequencing method(2022) GIONDA, Patricia Oliveira; GOMES-GOUVEA, Michele; MALTA, Fernanda de Mello; SEBE, Pedro; SALLES, Ana Paula Moreira; FRANCISCO, Rodrigo Dos Santos; JOSE-ABREGO, Alexis; ROMAN, Sonia; PANDURO, Arturo; PINHO, Joao Renato RebelloIntroduction and Objectives: Hepatitis B Virus is classified into ten different genotypes (A-J). Genotypes F and H cluster apart from others in phylogenetic trees and is particularly frequent in the Americas. The aim of this study was to sequence complete genomes of samples of HBV genotypes F and H from Brazil and Mexico using next generation sequencing (NGS) and to study relevant characteristics for the disease associated with this virus. Materials and methods: Ninety plasma samples with detectable HBV DNA belonging to the F (n=59) and H (n=31) genotypes were submitted to amplification of the complete HBV genome by three different methologies. Data analysis was developed using bioinformatics tools for quality assurance and comprehensive coverage of the genome. Sequences were aligned with reference sequences for subgenotyping and detecting variants in relevant positions. A phylogenetical tree was constructed using Bayesian methods. Results: HBV genome of 31 samples were amplified and 18 of them were sequenced (HBV/F=16 and HBV/H=2). One genotype F sample was co-infected with the F1b and F3 subgenotypes, while the other samples were all F2a subgenotype. Two genotype H samples clustered with other Mexican sequences. The main variants observed were found in preS and S genes (7/18) and mutations in the precore/core region (11/18). Conclusions: A NGS methodology was applied to F and H genotypes samples from Mexico and Brazil to fully characterize their sequences. This methodology will be relevant for clinical and epidemiological studies of hepatitis B in Latin America (C) 2021 Fundacion Clinica Medica Sur, A.C.
- NAFLD in Polycystic Ovary Syndrome: Association with PNPLA3 and Metabolic Features(2022) RECUERO, Amanda Medeiros; GOMES, Larissa Garcia; MACIEL, Gustavo Arantes Rosa; MALTA, Fernanda de Mello; SALLES, Ana Paula Moreira; VEZOZZO, Denise Cerqueira Paranagua; BARACAT, Edmund Chada; PINHO, Joao Renato Rebello; CARRILHO, Flair Jose; STEFANO, Jose Tadeu; OLIVEIRA, Claudia P.Background: The aim of this study was to determine the frequency of the rs738409 polymorphism in the patatin-like phospholipase domain containing 3 (PNPLA3) gene in patients with polycystic ovary syndrome (PCOS) and its impact on nonalcoholic fatty liver disease (NAFLD) risk and severity. We also evaluated other risk factors associated with NAFLD and advanced fibrosis. Methods: This was a cross-sectional study involving 163 patients with PCOS at a tertiary center. Genotyping for the PNPLA3 polymorphism was undertaken using a TaqMan assay. The degree of fibrosis was defined by transient elastography. Results: The prevalence of NAFLD was 72.4%, and the polymorphism was heterozygous in 41.7% and homozygous in 8% of patients. Homeostasis model assessment of insulin resistance >= 2.5 was the main factor associated with the risk of developing NAFLD (OR = 4.313, p = 0.022), and its effect was amplified by the polymorphism (OR = 12.198, p = 0.017). Age > 32 years also conferred a higher risk for NAFLD. HDL values >= 50 mg/dL conferred protection against the outcome. Metabolic syndrome (OR = 13.030, p = 0.020) and AST > 32 U/L (OR = 9.039, p = 0.009) were independent risk factors for advanced fibrosis. Conclusions: In women with PCOS, metabolic characteristics are more relevant than PNPLA3 polymorphism regarding the risk for NAFLD and its advanced forms, but these factors can act synergistically, increasing disease risk.
- Efficacy of sofosbuvir as treatment for yellow fever: protocol for a randomised controlled trial in Brazil (SOFFA study)(2019) FIGUEIREDO-MELLO, Claudia; CASADIO, Luciana Vilas Boas; AVELINO-SILVA, Vivian Lida; Ho Yeh-Li; SZTAJNBOK, Jaques; JOELSONS, Daniel; ANTONIO, Marilia Bordignon; PINHO, Joao Renato Rebello; MALTA, Fernanda de Mello; GOMES-GOUVEA, Michele Soares; SALLES, Ana Paula Moreira; CORA, Aline Pivetta; MOREIRA, Carlos Henrique Valente; RIBEIRO, Ana Freitas; NASTRI, Ana Catharina de Seixas Santos; MALAQUE, Ceila Maria Sant'Ana; TEIXEIRA, Ralcyon Francis Azevedo; BORGES, Luciana Marques Sansao; GONZALEZ, Mario Peribanez; PEREIRA JUNIOR, Luiz Carlos; SOUZA, Tamara Newman Lobato; SONG, Alice Tung Wan; D'ALBUQUERQUE, Luiz Augusto Carneiro; ABDALA, Edson; ANDRAUS, Wellington; MARTINO, Rodrigo Bronze de; DUCATTI, Liliana; ANDRADE, Guilherme Marques; MALBOUISSON, Luiz Marcelo Se; SOUZA, Izabel Marcilio de; CARRILHO, Flair Jose; SABINO, Ester Cerdeira; LEVIN, Anna S.Introduction An ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confirmed cases and 409 deaths since July 2017. To date, there is no specific treatment available for YF. Recently published papers describing in vitro and animal models suggest a potential effect of antiviral drugs (approved for the treatment of hepatitis virus) against flaviviruses, including YF. The primary aim of this study is to analyse the effect of sofosbuvir on viral kinetics and clinical outcomes among patients presenting with YE This is a multicentre open-label randomised controlled trial with 1:1 individual allocation, stratified by severity and by recruiting centre. Methods and analysis Adults with suspected or confirmed YF infection and symptoms lasting up to 15 days are screened. Eligible and consenting patients are randomised to receive oral sofosbuvir 400 mg daily for 10 days or to receive standard clinical care. Viral kinetics are measured daily and the reduction in YF plasma viral load from the sample at inclusion to 72 hours after randomisation will be compared between active and control groups. Clinical outcomes include severity meeting criteria for intensive care support, liver transplantation, in-hospital mortality and mortality within 60 days.
- Updating the Phylodynamics of Yellow Fever Virus 2016-2019 Brazilian Outbreak With New 2018 and 2019 Sao Paulo Genomes(2022) SALLES, Ana Paula Moreira; NASTRI, Ana Catharina de Seixas Santos; HO, Yeh-Li; CASADIO, Luciana Vilas Boas; AMGARTEN, Deyvid Emanuel; AREVALO, Santiago Justo; GOMES-GOUVEA, Michele Soares; CARRILHO, Flair Jose; MALTA, Fernanda de Mello; PINHO, Joao Renato RebelloThe recent outbreak of yellow fever (YF) in Sao Paulo during 2016-2019 has been one of the most severe in the last decades, spreading to areas with low vaccine coverage. The aim of this study was to assess the genetic diversity of the yellow fever virus (YFV) from Sao Paulo 2016-2019 outbreak, integrating the available genomic data with new genomes from patients from the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HCFMUSP). Using phylodynamics, we proposed the existence of new IE subclades, described their sequence signatures, and determined their locations and time of origin. Plasma or urine samples from acute severe YF cases (n = 56) with polymerase chain reaction (PCR) positive to YFV were submitted to viral genome amplification using 12 sets of primers. Thirty-nine amplified genomes were subsequently sequenced using next-generation sequencing (NGS). These 39 sequences, together with all the complete genomes publicly available, were aligned and used to determine nucleotide/amino acids substitutions and perform phylogenetic and phylodynamic analysis. All YFV genomes generated in this study belonged to the genotype South American I subgroup E. Twenty-one non-synonymous substitutions were identified among the new generated genomes. We analyzed two major clades of the genotypes IE, IE1, and IE2 and proposed the existence of subclades based on their sequence signatures. Also, we described the location and time of origin of these subclades. Overall, our findings provide an overview of YFV genomic characterization and phylodynamics of the 2016-2019 outbreak contributing to future virological and epidemiological studies.
- Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases(2019) CASADIO, Luciana Vilas Boas; SALLES, Ana Paula Moreira; MALTA, Fernanda de Mello; LEITE, Gabriel Fialkovitz; HO, Yeh-Li; GOMES-GOUVEA, Michele Soares; MALBOUISSON, Luiz Marcelo Sa; LEVIN, Anna S.; AZEVEDO NETO, Raymundo Soares de; CARRILHO, Flair Jose; NASTRI, Ana Catharina Seixas Santos; PINHO, Joao Renato RebelloBACKGROUND Despite a highly efficacious vaccine, yellow fever (YF) is still a major threat in developing countries and a cause of outbreaks. In 2018, the Brazilian state of Sao Paulo witnessed a new YF outbreak in areas where the virus has not been detected before. OBJECTIVE The aim is to describe the clinical and laboratorial characteristics of severe cases of YF, evaluate viral to determine markers associated with fatal outcome. METHODS Acute severe YF cases (n = 62) were admitted to the Intensive Care Unit of a reference hospital and submitted to routine laboratorial evaluation on admission. YFV-RNA was detected in serum and urine by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and then sequenced. Patients were classified in two groups: survival or death. FINDINGS In the univariate analysis the following variables were associated with outcome: alanin aminotransferase (ALT), aspartat aminotransferase (AST), AST/ALT ratio, total bilirubin (TB), chronic kidney disease epidemiology collaboration (CKD-EPI), ammonia, lipase, factor V, international normalised ratio (INR), lactate and bicarbonate. Logistic regression model showed two independent variables associated with death: lipase [odds ratio (OR) 1.018, 95% confidence interval (CI) 1.007 to 1.030, p = 0.002], and factor V (OR -0.955, 95% CI 0.929 to 0.982, p = 0.001). The estimated lipase and factor V cut-off values that maximised sensitivity and specificity for death prediction were 147.5 U/L [area under the curve (AUC) = 0.879], and 56.5% (AUC = 0.913). MAIN CONCLUSIONS YF acute severe cases show a generalised involvement of different organs (liver, spleen, heart, kidneys, intestines and pancreas), and different parameters were related to outcome. Factor V and lipase are independent variables associated with death, reinforcing the importance of hemorrhagic events due to fulminant liver failure and pointing to pancreatitis as a relevant event in the outcome of the disease.