DANIELA SOUZA FARIAS ITAO

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Projetos de Pesquisa
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LIM/22 - Laboratório de Patolologia Cardiovascular, Hospital das Clínicas, Faculdade de Medicina

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  • article 16 Citação(ões) na Scopus
    Macrophage Polarization in the Perivascular Fat Was Associated With Coronary Atherosclerosis
    (2022) FARIAS-ITAO, Daniela Souza; PASQUALUCCI, Carlos Augusto; ANDRADE, Renato Araujo de; SILVA, Luiz Fernando Ferraz da; YAHAGI-ESTEVAM, Maristella; LAGE, Silvia Helena Gelas; LEITE, Renata Elaine Paraizo; CAMPO, Alexandre Brincalepe; SUEMOTO, Claudia Kimie
    Background Inflammation of the perivascular adipose tissue (PvAT) may be related to atherosclerosis; however, the association of polarized macrophages in the pericoronary PvAT with measurements of atherosclerosis components in humans has not been fully investigated. Methods and Results Coronary arteries were dissected with surrounding PvAT. We evaluated the percentage of arterial obstruction, intima-media thickness, fibrous cap thickness, plaque components, and the number of vasa vasorum. The number of proinflammatory (M1) and anti-inflammatory (M2) macrophages in the periplaque and control PvAT were evaluated using immunohistochemistry. Regression models adjusted for sociodemographic and clinical variables were used. In 319 segments from 82 individuals, we found a correlation of the M1/M2 macrophage density ratio with an increase in arterial obstruction (P=0.02) and lipid content (P=0.01), and a decrease in smooth muscle cells (P=0.02). M1 and the ratio of M1/M2 macrophages were associated with an increased risk of thrombosis (P=0.03). In plaques with thrombosis, M1 macrophages were correlated with a decrease in fibrous cap thickness (P=0.006), an increase in lipid content (P=0.008), and the number of vasa vasorum in the adventitia layer (P=0.001). M2 macrophages were correlated with increased arterial obstruction (P=0.01), calcification (P=0.02), necrosis (P=0.03) only in plaques without thrombosis, and decrease of the number of vasa vasorum in plaques with thrombosis (P=0.003). Conclusions M1 macrophages in the periplaque PvAT were associated with a higher risk of coronary thrombosis and were correlated with histological components of plaque progression and destabilization. M2 macrophages were correlated with plaque size, calcification, necrotic content, and a decrease in the number of vasa vasorum in the adventitia layer.
  • article 125 Citação(ões) na Scopus
    Very low levels of education and cognitive reserve A clinicopathologic study
    (2013) FARFEL, Jose Marcelo; NITRINI, Ricardo; SUEMOTO, Claudia Kimie; GRINBERG, Lea Tenenholz; FERRETTI, Renata Eloah Lucena; LEITE, Renata Elaine Paraizo; TAMPELLINI, Edilaine; LIMA, Luzia; FARIAS, Daniela Souza; NEVES, Ricardo Caires; RODRIGUEZ, Roberta Diehl; MENEZES, Paulo Rossi; FREGNI, Felipe; BENNETT, David A.; PASQUALUCCI, Carlos Augusto; JACOB FILHO, Wilson
    Objective: We conducted a clinicopathologic study in a large population with very low levels of education to determine whether very few years of education could contribute to cognitive reserve and modify the relation of neuropathologic indices to dementia. Methods: In this cross-sectional study, we included 675 individuals 50 years of age or older from the Brazilian Aging Brain Study Group. Cognitive abilities were evaluated through a structured interview with an informant at the time of autopsy, including the Clinical Dementia Rating (CDR) scale. Neuropathologic examinations were performed using immunohistochemistry and following internationally accepted criteria. Multivariate linear regression models were conducted to determine whether the association between cognitive abilities (measured by CDR sum of boxes) and years of education was independent of sociodemographic variables and neuropathologic indices, including neuritic plaques, neurofibrillary tangles, lacunar infarctions, small-vessel disease, and Lewy bodies. In addition, interaction models were used to examine whether education modified the relation between neuropathologic indices and cognition. Results: Mean education was 3.9 +/- 3.5 years. Formal education was associated with a lower CDR sum of boxes (beta = -0.197; 95% confidence interval -0.343, -0.052; p = 0.008), after adjustment for sociodemographic variables and neuropathologic indices. Furthermore, education modified the relationship of lacunar infarcts with cognitive abilities (p = 0.04). Conclusions: Even a few years of formal education contributes to cognitive reserve.
  • article 5 Citação(ões) na Scopus
    Association between adiposity and systemic atherosclerosis: a protocol of a cross-sectional autopsy study
    (2016) NISHIZAWA, Aline; SUEMOTO, Claudia Kimie; FARIAS, Daniela Souza; CAMPOS, Fernanda Marinho; SILVA, Karen Cristina Souza da; CUELHO, Anderson; LEITE, Renata Elaine Paraizo; FERRETTI-REBUSTINI, Renata Eloah de Lucena; GRINBERG, Lea Tenenholz; FARFEL, Jose Marcelo; JACOB-FILHO, Wilson; PASQUALUCCI, Carlos Augusto
    Introduction: Adiposity has been associated with atherosclerosis in clinical studies. However, few autopsy studies have investigated this association, and they had only examined the coronary artery disease. Moreover, most studies had small sample sizes and were limited to middle-aged or young adults. Our aim is to investigate the association between adiposity and systemic atherosclerosis in an autopsy study. Methods and analysis: A sample of 240 deceased with 30 years or more will be evaluated. The sample size was calculated using the lowest correlation coefficient found in previous studies (r=0.109), assuming a power of 90% and alpha=0.05. We will collect information about sociodemographics, frequency of previous contact of the deceased's next of kin and cardiovascular risk factors. We will measure neck, waist and hip circumferences, weight, height and abdominal subcutaneous tissue thickness, and then we will calculate the body mass index, waist-to-hip ratio, waist-to-height ratio and body shape index. We will also weigh the pericardial and abdominal visceral fat, the heart, and we will measure the left ventricular wall thickness. We will evaluate the presence of myocardial infarction, the degree of atherosclerosis in the aorta, carotid, coronary and cerebral arteries and plaque composition in carotid, coronary and cerebral arteries. For each individual, we will fix arterial and adipose tissue samples in 10% formalin and freeze another adipose tissue sample at -80 degrees C for future studies. Ethics and dissemination: Ethical approval was granted by the Ethics Committee of University of Sao Paulo Medical School, Brazil. Results will be submitted for publication in a peer-reviewed journal.
  • article
    Perivascular Adipose Tissue Inflammation and Coronary Artery Disease: An Autopsy Study Protocol
    (2016) FARIAS-ITAO, Daniela Souza; PASQUALUCCI, Carlos Augusto; NISHIZAWA, Aline; SILVA, Luiz Fernando Ferraz; CAMPOS, Fernanda Marinho; SILVA, Karen Cristina Souza da; LEITE, Renata Elaine Paraizo; GRINBERG, Lea Tenenholz; FERRETTI-REBUSTINI, Renata Eloah Lucena; JACOB FILHO, Wilson; SUEMOTO, Claudia Kimie
    Background: Perivascular adipose tissue (PAT) inflammation may have a role in coronary artery disease (CAD) pathophysiology. However, most evidence has come from samples obtained during surgical procedures that may imply in some limitations. Moreover, the role of B lymphocytes and inflammation in PAT that is adjacent to unstable atheroma plaques has not been investigated in humans using morphometric measurements. Objective: The objective of this study is to investigate the inflammation in PAT, subcutaneous, and perirenal adipose tissues (SAT and PrAT) among chronic CAD, acute CAD, and control groups in an autopsy study. Methods: Heart, SAT, and PrAT samples are collected from autopsied subjects in a general autopsy service, with the written informed consent of the next-of-kin (NOK). Sociodemographic and clinical data are obtained from a semistructure interview with the NOK. Coronary arteries are dissected and PAT are removed. Sections with the greatest arterial obstruction or unstable plaques, and the local with absence of atherosclerosis in all coronary arteries are sampled. PAT are represented adjacent to these fragments. Adipose tissues are fixed in 4% buffered paraformaldehyde solution and analyzed immunohistochemically for macrophages (CD68), macrophage polarization (CD11c for proinflammatory and CD206 for anti-inflammatory), B lymphocytes (CD20), and T lymphocytes (CD3). Slides will be scanned, and inflammatory cells will be quantified in 20 random fields. Participants will be categorized in CAD groups, after morphometric measurement of arterial obstruction and plaque composition analysis in accordance with American Heart Association classification. Three study groups will be investigated: acute CAD (at least one unstable plaque); chronic CAD (>= 50% arterial obstruction); and controls (< 50% arterial obstruction). Inflammatory cells in PAT, SAT, and PrAT will be counted and compared between groups using multivariate linear regression, adjusted for age, body mass index, hypertension, diabetes, alcohol use, and smoking. Results: We present the methods of our study that was developed from 2 pilots. Currently, data collection and tissue processing are ongoing. Data collection, histology and immunochemistry procedures, and quantification of all inflammatory cells are expected to be concluded within 1 year. Conclusions: This study will contribute for the understanding of the mechanisms of CAD pathophysiology because it will help to clarify the role of inflammation both in chronic and acute CAD.
  • article 15 Citação(ões) na Scopus
    Association between diabetes and causes of dementia: Evidence from a clinicopathological study
    (2017) MATIOLI, Maria Niures Pimentel dos Santos; SUEMOTO, Claudia Kimie; RODRIGUEZ, Roberta Diehl; FARIAS, Daniela Souza; SILVA, Magnólia Moreira da; LEITE, Renata Elaine Paraizo; FERRETTI-REBUSTINI, Renata Eloah Lucena; PASQUALUCCI, Carlos Augusto; JACOB FILHO, Wilson; GRINBERG, Lea Tenenholz; NITRINI, Ricardo
    ABSTRACT. Background: Diabetes mellitus is a risk factor for dementia, especially for vascular dementia (VaD), but there is no consensus on diabetes as a risk factor for Alzheimer's disease (AD) and other causes of dementia. Objective: To explore the association between diabetes and the neuropathological etiology of dementia in a large autopsy study. Methods: Data were collected from the participants of the Brain Bank of the Brazilian Aging Brain Study Group between 2004 and 2015. Diagnosis of diabetes was reported by the deceased's next-of-kin. Clinical dementia was established when CDR ≥ 1 and IQCODE > 3.41. Dementia etiology was determined by neuropathological examination using immunohistochemistry. The association of diabetes with odds of dementia was investigated using multivariate logistic regression. Results: We included 1,037 subjects and diabetes was present in 279 participants (27%). The prevalence of dementia diagnosis was similar in diabetics (29%) and non-diabetics (27%). We found no association between diabetes and dementia (OR = 1.22; 95%CI = 0.81-1.82; p = 0.34) on the multivariate analysis. AD was the main cause of dementia in both groups, while VaD was the second-most-frequent cause in diabetics. Other mixed dementia was the second-most-common cause of dementia and more frequent among non-diabetics (p = 0.03). Conclusion: Diabetes was not associated with dementia in this large clinicopathological study.
  • article 57 Citação(ões) na Scopus
    Diabetes is Not Associated with Alzheimer's Disease Neuropathology
    (2017) MATIOLI, Maria Niures Pimentel dos Santos; SUEMOTO, Claudia Kimie; RODRIGUEZ, Roberta Diehl; FARIAS, Daniela Souza; SILVA, Magnolia Moreira da; LEITE, Renata Elaine Paraizo; FERRETTI-REBUSTINI, Renata Eloah Lucena; FARFEL, Jose Marcelo; PASQUALUCCI, Carlos Augusto; JACOB FILHO, Wilson; ARVANITAKIS, Zoe; NASLAYSKY, Michel Satya; ZATZ, Mayana; GRINBERG, Lea Tenenholz; NITRINI, Ricardo
    Background: Previous evidence linking diabetes to Alzheimer's disease (AD) neuropathology is mixed and scant data are available from low-and middle-income countries. Objective: To investigate the association between diabetes and AD neuropathology in a large autopsy study of older Brazilian adults. Methods: In this cross-sectional study, diabetes was defined by diagnosis during life or use of antidiabetic medication. A standardized neuropathological examination was performed using immunohistochemistry. The associations of diabetes with Consortium to Establish and Registry for Alzheimer Disease (CERAD) scores for neuritic plaques and Braak-Braak (BB) scores for neurofibrillary tangles were investigated using multivariable ordinal logistic regression. We investigated effect modification of education, race, and APOE on these associations. Results: Among 1,037 subjects (mean age = 74.4 +/- 11.5 y; mean education = 4.0 +/- 3.7 y; 48% male, 61% White), diabetes was present in 279 subjects. Diabetes was not associated with BB (OR = 1.12, 95% CI = 0.81-1.54, p = 0.48) or with CERAD (OR = 0.97, 95% CI = 0.68-1.38, p = 0.86) scores on analyses adjusted for sociodemographic and clinical variables. We observed effect modification by the APOE allele epsilon 4 on the association between diabetes mellitus and BB scores. Conclusion: No evidence of an association between diabetes and AD neuropathology was found in a large sample of Brazilians; however, certain subgroups, such as APOE allele epsilon 4 carriers, had higher odds of accumulation of neurofibrillary tangles.
  • article 29 Citação(ões) na Scopus
    B Lymphocytes and Macrophages in the Perivascular Adipose Tissue Are Associated With Coronary Atherosclerosis: An Autopsy Study
    (2019) FARIAS-ITAO, Daniela Souza; PASQUALUCCI, Carlos Augusto; NISHIZAWA, Aline; SILVA, Luiz Fernando Ferraz da; CAMPOS, Fernanda Marinho; BITTENCOURT, Marcio Sommer; SILVA, Karen Cristina Souza da; LEITE, Renata Elaine Paraizo; GRINBERG, Lea Tenenholz; FERRETTI-REBUSTINI, Renata Eloah de Lucena; JACOB-FILHO, Wilson; SUEMOTO, Claudia Kimie
    Background Macrophages and T lymphocytes in the perivascular adipose tissue (PvAT) were previously linked to coronary artery disease. However, the role of these cells and B lymphocytes in the human PvAT adjacent to unstable atherosclerotic plaques has not been investigated. Moreover, previous studies were inconclusive on whether PvAT inflammation was restricted to the surroundings of the atheroma plaque. Methods and Results Coronary arteries were freshly dissected with the surrounding PvAT. Atherosclerotic plaques were classified according to the internationally accepted anatomopathological criteria. Immune cells in the PvAT were detected using immunohistochemistry and then quantified. We used linear and logistic regressions with robust standard errors, adjusted for possible confounding factors. In 246 atherosclerotic plaques (205 stable and 41 unstable plaques) from 82 participants (mean age=69.0 +/- 14.4 years; 50% men), the percentage of arterial obstruction was positively correlated with the densities of CD68(+) macrophages (P=0.003) and CD20(+) B lymphocytes (P=0.03) in the periplaque PvAT. The number of cells was greater in the periplaque PvAT than in the distal PvAT (macrophages, P<0.001; B lymphocytes, P=0.04). In addition, the density of macrophages in the periplaque PvAT was greater in the presence of unstable plaques (P=0.03) and was also greater near unstable plaques than in the distal PvAT (P=0.001). CD3(+) T lymphocytes were not associated with percentage of obstruction and stable/unstable plaque composition. Conclusions The density of CD20(+) B lymphocytes and CD68(+) macrophages in periplaque PvAT was increased with plaque size, and the CD68(+) macrophages were greater near unstable atherosclerotic plaques than near stable lesions. This inflammation was more intense in the periplaque PvAT than in the PvAT distal to the atherosclerotic plaques.
  • article 1 Citação(ões) na Scopus
    Severe Dementia Predicts Weight Loss by the Time of Death
    (2021) CICILIATI, Aline Maria M.; ADRIAZOLA, Izabela Ono; FARIAS-ITAO, Daniela Souza; PASQUALUCCI, Carlos Augusto; LEITE, Renata Elaine Paraizo; NITRINI, Ricardo; GRINBERG, Lea T.; JACOB-FILHO, Wilson; SUEMOTO, Claudia Kimie
    Background: Body mass index (BMI) in midlife is associated with dementia. However, the association between BMI and late-life obesity is controversial. Few studies have investigated the association between BMI and cognitive performance near the time of death using data from autopsy examination. We aimed to investigate the association between BMI and dementia in deceased individuals who underwent a full-body autopsy examination. Methods: Weight and height were measured before the autopsy exam. Cognitive function before death was investigated using the Clinical Dementia Rating (CDR) scale. The cross-sectional association between BMI and dementia was investigated using linear regression models adjusted for sociodemographic and clinical variables. Results: We included 1,090 individuals (mean age 69.5 +/- 13.5 years old, 46% women). Most participants (56%) had a normal BMI (18.5-24.9 kg/m(2)), and the prevalence of dementia was 16%. Twenty-four percent of the sample had cancer, including 76 cases diagnosed only by the autopsy examination. Moderate and severe dementia were associated with lower BMI compared with participants with normal cognition in fully adjusted models (moderate: beta = -1.92, 95% CI = -3.77 to -0.06, p = 0.042; severe: beta = -2.91, 95% CI = -3.97 to -1.86, p < 0.001). Conclusion: BMI was associated with moderate and severe dementia in late life, but we did not find associations of BMI with less advanced dementia stages.