GUSTAVO ARANTES ROSA MACIEL
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
14 resultados
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- Morfologia das células intersticiais de ovários policísticos de ratas: um estudo experimental(2012) LOMBARDI, Leonardo Augusto; SIMÕES, Ricardo Santos; MAGANHIN, Carla Cristina; SILVA, Cecilia Ferreira da; MACIEL, Gustavo Arantes Rosa; BARACAT, Edmund Chada; SOARES JÚNIOR, José MariaPURPOSES: To evaluate the histomorphometry of ovarian interstitial cells, as well as the blood sex steroid concentrations of female rats with polycystic ovaries induced by continuous light. METHODS: Twenty female rats were divided into two groups: Control Group - in the estrous phase (CtrlG), and a group of rats with polycystic ovaries induced by continuous illumination (POG). CtrlG animals were maintained on a light period from 07:00 a.m. to 07:00 p.m., and POG animals with continuous illumination (400 Lux) for 60 days. After this period all animals were anesthetized and blood was collected for the determination of serum estradiol (E2), progesterone (P4), and testosterone (T), followed by removal of the ovaries that were fixed in 10% formalin and processed for paraffin embedding. Five-µm histological sections were stained with hematoxylin and eosin and used for histomorphometric analysis. Morphological analyses, cyst count, determination of concentration and of the nuclear volume of interstitial cells were performed with the aid of a light microscope adapted to a high resolution camera (AxioCam), whose images were transmitted to and analyzed by the computer using AxioVision Rel 4.8 software (Carl Zeiss). Data were analyzed statistically by the Student's t-test (p<0.05). RESULTS: Morphological analysis showed the presence of ovarian cysts in POG animals and corpora lutea in CtrlG animals, as well as evidence of the origin of interstitial cells from the internal theca of these cysts. POG animals presented increased serum estradiol levels (pg/mL) compared to CtrlG animals (POG=124.9±4.2>CtrlG=73.2±6.5, p<0.05), the same occurring with testosterone levels (pg/mL) (POG=116.9±4.6>CtrlG=80.6±3.9, p<0.05). However, progesterone levels (ng/mL) were higher in CtrlG than in POG animals (CtrlG=16.3±2.0>POG=4.2±1.5, p<0.05). Morphometry showed a significant increase in nuclear volume in POG animals (POG=102.1±5.2>CtrlG=63.6±16.5, p<0.05), as well as in the area occupied (%) by interstitial cells (POG=24.4±6.9>CtrlG=6.9±3.2, p<0.05) compared to CtrlG animals. CONCLUSION: The interstitial cells of the rat polycystic ovary probably originate from ovarian cysts due to the degeneration of granulosa cells and differentiation of the internal theca cells. The elevations of serum testosterone and estradiol were probably due to the significant increase in cell activity and in the area occupied by interstitial cells.
- Systematic review of cell adhesion molecules and estrogen receptor expression in the endometrium of patients with polycystic ovary syndrome(2015) BARACAT, Maria Candida P.; SERAFINI, Paulo C.; SIMOES, Ricardo dos S.; MACIEL, Gustavo A. R.; SOARES- JR., Jose M.; BARACAT, Edmund C.Background: Infertility associated with polycystic ovary syndrome (PCOS) could be related to many mechanisms including endometrial factors. Objectives: To review cell adhesion molecule and estrogen receptor expression in the endometrium. Search strategy: A systematic review was performed of the Medline and Cochrane databases for papers published in any language between 2004 and 2014. The search term was ""'polycystic ovary syndrome' OR 'Stein Leventhal syndrome' OR 'anovulation' AND 'endometrium' OR 'endometria."" Selection criteria: Research studies on endometrial cell adhesion molecules and estrogen receptor expression among women with PCOS diagnosed according to the Rotterdam criteria were included. Data collection and analysis: Data were extracted from identified studies and the quality of assessment was analyzed. Main results: Six studies were included. Data were controversial with respect to MUC1 and alpha V beta 3 integrin expression with significantly higher and lower levels, respectively, in women with PCOS. Estrogen receptor expression was enhanced among patients with PCOS as compared with healthy women. Conclusions: Endometrial factors influence embryo receptivity as indicated by the molecular mediators identified in the studies, including cell adhesion molecules and the estrogen receptor.
- Small leucine-rich proteoglycans (SLRPs) in the endometrium of polycystic ovary syndrome women: a pilot study(2017) SIMOES, Ricardo Santos; SOARES- JR., Jose Maria; SIMOES, Manuel J.; NADER, Helena B.; BARACAT, Maria Candida P.; MACIEL, Gustavo Arantes R.; SERAFINI, Paulo C.; AZZIZ, Ricardo; BARACAT, Edmund C.Background: Small leucine-rich proteoglycans (SLRPs) play an important role in tissue homeostasis and cell proliferation since these proteoglycans sequester multiple growth factors. However, the content of SLRPs in the endometrium of polycystic ovary syndrome (PCOS) women is unknown. Our purpose was to test the hypothesis that excessive endometrial proliferation in PCOS may be partly related to abnormalities in SLRPs. Methods: In a cross section study a total of 20 endometrial samples were collected from 10 patients with PCOS and 10 ovulatory women during their proliferative (pre-ovulatory) phase. The study subjects were matched for age, body mass index and race. The age range was 20 to 35 years. All volunteers were evaluated in reproductive endocrinology clinic, Gynecology Division, Clinics Hospital, University of Sao Paulo Medical School Profile and concentration of small leucine-rich proteoglycans (decorin, lumican, fibromodulin and biglycan) were determined by immunohistochemical testing and Western blotting. Results: Decorin and lumican demonstrated higher immunoreactivity and relative expression in the endometrium of women with PCOS compared to that of women with regular menstrual cycles. Conclusion: Our data suggests that the endometrium of PCOS women demonstrate a greater content of SLRP than controls; decorin and lumican, in particular, were found in higher concentrations in the endometrium of PCOS women during the proliferative phase. These differences may, in part, explain the excess of endometrial proliferation frequently observed in PCOS. Further studies are warranted.
- Impact of hormone therapy on the bone density of women with premature ovarian insufficiency: A systematic review(2023) COSTA, Giulia Paiva Oliveira; FERREIRA-FILHO, Edson Santos; SIMOES, Ricardo dos Santos; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; MACIEL, Gustavo Arantes RosaIntroduction: Women with premature ovarian insufficiency (POI) are exposed to a long period of estrogenic deficiency, which potentially brings higher health risks, especially regarding bone health. We performed a systematic review of the literature to evaluate the effect of hormone therapy (HT) on bone mineral density (BMD) in women with POI.Materials and methods: A systematic search was performed of the MEDLINE and EMBASE databases up to September 2021. We included studies that analyzed women with idiopathic (spontaneous) POI treated with HT, and those who had BMD evaluated. Analysis of risk of bias of studies selected was performed.Results: We found 335 articles and selected 16 studies according to the inclusion criteria. Most of the studies revealed lower bone density in both the femoral neck and lumbar spine of women with POI compared with healthy women. Bone mass had the tendency to remain stable in women treated with estrogen + progestin therapy. However, in women already with bone mass loss, the therapy -in the doses most frequently used -was not able to revert the loss. Higher doses of estrogen seem to have a positive impact on BMD, as did combined oral contraceptives used continuously. Also, the interruption of HT for longer than one year was linked to significant bone loss.Conclusion: Although HT brings clear benefits, further studies are needed to establish its long-term effects, as well as doses and formulations with better protective effects on the bone mass of these women.
bookPart Esteroides sexuais: androgênios(2014) SIMõES, Ricardo dos Santos; DAMáSIO, Lia Cruz Vaz da Costa; MACIEL, Gustavo Arantes Rosa; JúNIOR, José Maria Soares; BARACAT, Edmund Chada- Kisspeptin Influence on Polycystic Ovary Syndrome-a Mini Review(2020) ARAUJO, Bruna Silva; BARACAT, Maria Candida P.; SIMOES, Ricardo dos Santos; NUNES, Camila de Oliveira; MACIEL, Gustavo Arantes Rosa; LOBO, Rogerio A.; JR, Jose Maria Soares; BARACAT, Edmund ChadaPolycystic ovary syndrome (PCOS) affects 6% to 20% of reproductive age women and is the most frequent cause of anovulatory infertility. Its physiopathology may result in part from hypothalamic alterations in the pulsatile secretion of gonadotropin-releasing hormone (GnRH). The neuropeptide kisspeptin participates in the mechanism through stimulation of the hormone's production. The purpose of this study was to review the articles which compared kisspeptin levels in women with PCOS with those of controls. A systematic review of observational studies was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The selected studies encompassed a population of patients with PCOS and controls, whose serum kisspeptin levels were evaluated. The studies were retrieved from the Medline, Cochrane, and Embase databases, and four of them were chosen for the review. In most studies, the serum kisspeptin levels were higher in women with PCOS than in controls notwithstanding the BMI. One of the articles showed that circulating plasma levels of kisspeptin were significantly higher in women with PCOS whose BMI was lower than 25 than in obese and overweight women. Our data suggest a higher concentration of serum kisspeptin in women with PCOS irrespective of their BMI. Further experimental and clinical studies are needed to ascertain the role of kisspeptin in PCOS.
- Impact of the prolactin levels in breast cancer: a systematic review and meta-analysis(2022) ARANHA, Aline F.; ANJOS, Laura G. dos; TURRI, Jose A. O.; SIMOES, Ricardo S.; MACIEL, Gustavo A. R.; BARACAT, Edmund C.; SOARES-JUNIOR, Jose Maria; CARVALHO, Katia C.Prolactin (PRL) acts stimulating the mammary glands development, and its deregulation has been associated to the emergence of several types of tumors, including breast cancer. Breast cancer represents the most prevalent malignancy in women, and the second cause of death in several countries. This tumor can be arise due to several molecular alterations, among them PRL has been the object of increasing interest from researchers worldwide. Objective: To assess the association between elevated levels of plasma prolactin and breast cancer development. Methods: A total of 158 studies were found in search databases (48 from PubMed, 69 from Scopus, 88 from Cochrane, 25 from Embase and 10 retrieved from the gray literature) after removing duplicates. Of these, 104 studies were excluded after title and abstract reading, and 54 studies were then read in full, of which only 14 were selected for this review because they had evaluated the association between PRL and breast cancer. Meta-analysis was carried out using the relative risk (RR), mean and standard deviation, confidence interval (95% CI), and the total number of patients for each study. Fixed- and random-effect models were used as applicable and, for the analysis. Results: The meta-analysis showed a positive association between elevated levels of PRL and breast cancer occurrence (RR 1.26; 95%CI 1.15-1.37). Additionally, the patient sub-group analyses showed a positive association between PRL and invasive breast cancer (1.42; 1.24-1.60), ER+/PR+ (1.49; 1.23-1.75), and post-menopausal status (1.29; 1.16-1.43). Conclusion: The results showed a positive association between plasma prolactin levels and breast cancer, especially in women with ER+/PR + tumors, of post-menopausal age and those with invasive cancer.
- Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis(2019) MURGEL, Ana Carolina Firmino; SIMOES, Ricardo Santos; MACIEL, Gustavo Arantes Rosa; SOARES JR., Jose Maria; BARACAT, Edmund Chada5 Introduction: Sexual dysfunction occurs in any phase of sexual performance or any period of the sexual response cycle, and polycystic ovary syndrome (PCOS) affects self-image with repercussions on sexuality. Aim: To evaluate sexual dysfunction in women with PCOS. Methods: A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The primary databases MEDLINE, EMBASE, Cochrane, and Lilacs were accessed using specific terms. There was no constraint against year of publication. The meta-analysis was conducted with RevMan program version 5.3. Main Outcome Measure: We evaluated the relationship between sexual dysfunction and PCOS. Results: The systematic review encompassed 19 studies. The analysis indicated that 11 specific and 6 general instruments were used to measure the sexual function in PCOS women. Of these, the Female Sexual Function Index scale was used most frequently. All studies assessed different aspects of sexual performance in PCOS women, and no difference was found in between women with PCOS and control subjects. Clinical Implications: Although there were disparities regarding ethnicity, culture, religion, and economy among studies, the available evidence failed to prove a significant link between PCOS and sexual dysfunction. Strength & Limitations: This systematic review addressed a multidimensional theme with many variables and with a wide diversity of measurement tools. Studies were small, and populations were not homogeneous. Conclusion: Despite potential risk of bias, such as inhomogeneity of study population, sexual function of both PCOS patients and women with regular menstrual cycles might, in general, be similar.
bookPart Síndrome dos ovários policísticos(2013) JúNIOR, José Maria Soares; MACIEL, Gustavo Arantes Rosa; SIMõES, Ricardo dos Santos; BARACAT, Maria Cândida Pinheiro; BARACAT, Edmund Chada- Nutritional and dietary aspects in polycystic ovary syndrome: insights into the biology of nutritional interventions(2020) NEVES, Luisa Pinheiro Pimenta; MARCONDES, Rodrigo Rodrigues; MAFFAZIOLI, Giovana De Nardo; SIMOES, Ricardo Santos; MACIEL, Gustavo Arantes Rosa; JR, Jose Maria Soares; BARACAT, Edmund ChadaPolycystic Ovary Syndrome (PCOS) is a complex endocrine disorder, which affects 5-17% of reproductive age women and is often associated with obesity and metabolic impairment. Common treatment strategies are based on exercise, diet and nutrient supplementation since PCOS is often linked with obesity and metabolic impairment. Studies have recommended that nutrition is a key factor in the health maintenance of women with PCOS, however, little is known about the subject in the context of such a disease. This narrative review aims to identify dietary and nutritional aspects of PCOS and discuss the role of nutrients in management of polycystic ovary syndrome in view of clinical trials.