Browsing by Author "Faria, Maria Sameiro"
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- Administração profiláctica de plasma no síndrome hemolítico urémico atípico recorrentePublication . Almeida, Marta Pinto; Faria, Maria Sameiro; Mota, Conceição; Costa, Teresa; Costa, Elísio; Barbot, José; Costa, Elísio; Pereira, ElóiO síndrome hemolítico urémico (SHU) define- se pela ocorrência simultânea de anemia hemolítica microangiopática, trombocitopenia e insuficiência renal aguda. A forma atípica de SHU, ou SHU não associado à toxina shiga like(SHU-não-Stx), ocorre em 10% dos casos na criança e apresenta prognóstico reservado. Os autores apresentam um caso clínico de uma criança com idade actual de cinco anos e oito meses com SHU atípico esporádico, de aparecimento precoce, aos quatro meses de vida, com carácter multirecidivante (seis recidivas). O doseamento sérico do factor H do complemento, a análise molecular dos genes do factor H (SCR 20 — sequenciação, os 19 restantes SCRs e o promotor —SSCP), e da membrane cofactor protein (SCR 1-4, e os 14 exões), a determinação da actividade de ADAMTS 13 e a pesquisa de inibidores foram normais. A biópsia renal revelou lesões glomerulares difusas com tumefecção das células endoteliais e redução dos lúmens capilares. O estudo ultraestrutural evidenciou extensa duplicação das membranas basais das ansas capilares e ausência de depósitos imunes. A doente apresentou boa resposta ao tratamento profiláctico com plasma, efectuado com intervalos de 3 semanas, com ausência de novas recaídas durante os períodos em que efectuou profilaxia (duração total de profilaxia: dois anos e sete meses). Conclui-se que esta forma de tratamento profiláctico se revelou, neste caso, e até à data, segura e eficaz na prevenção das recorrências, pelo que deve ser tida em consideração no tratamento de casos de SHU com perfil recidivante.
- Band 3 as a marker of erythrocyte changes in chronic renal failurePublication . Costa, Elísio; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, Alfredo; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, Alice
- Fibrinolytic in chronic renal failure patients under haemodialysis and its retionship to recombinant human erythrpoietin resistancePublication . Costa, Elísio; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, António; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, Alice
- Haemorheological changes during recombinante human erythropoietin therapy in a rat model of renal failure induced by partial nephrectomyPublication . Costa, Elísio; Reis, Flávio; Rocha-Pereira, Petronila; Baptista, Sofia; Dias, André; Rocha, Susana; Castro, Elisabeth; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, Alfredo; Lemos, Edite Teixeira de; Parada, Belmiro; Figueiredo, Arnaldo; Quintanilha, Alexandre; Teixeira, Frederico; Belo, Luís; Santos-Silva, AliceThe aim of this work was to study the effect of recombinant human erythropoietin (rhEPO) the rapy on haemorheological parameters, by using a rat model of chronic renal failure (CRF) induced by partial (3/4) nephrectomy. The study used adult male Wistar rats and was performed in three groups: a control one (n=6) and in two groups with induced chronic renal failure (n=9), being one of them submitted to rhEPO the rapy (n=4). Blood samples from the control group were collected at the beginning and at the end of the experimental procedure and from CRF rats at 3, 5, 8, 12 and 15 weeks after surgical partial nephrectomy. Haemorheology and renal function were evaluated. Three weeks after the 3/4 nephrectomy, a statistically significant increase in serum urea and creatinine concentrations were found. This increase in renal function markers remained high along the 12 weeks of experimental procedure. Comparing with controls, rhEPO treated rat have showed a statistically significant progressive increase in haemoglobin (Hb), haematocrit (Ht), red blood cells (RBC) count, mean cell volume (MCV), mean cell Hb (MCH) and red cell distribution width (RDW), showing at 12 weeks an inverse change, though still presenting significant higher values; a decrease in platelet counts, during the first 9 weeks of rhEPO therapy. When comparing haemorheological data from non-treated CRF and controls, we found only a trend to increased MCV and MCH values and a decrease in reticulocyte count. Comparing the two groups of CRF rats, we found that rhEPO treated rats presented significantly higher values in RBC, Hb, Ht and RDW. In both groups of CRF rats, at five weeks, there was a decrease in their values, showing at the end a significantly lower value when compared to controls. No consistent alterations were found in white blood cells in CRF rats, with or without rhEPO therapy. Partial nephrectomy seems to be a suitable methodology to induce CRF in rats and to study erythropoiesis biology. The rhEPO therapy is associated with an increased erythropoietic stimulation and a decrease in platelet count.
- Higher fibrinolytic and inflammatory markers are associated with central venous catheters use in chronic kidney disease patients under haemodialysisPublication . Costa, Elísio; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Reis, Flávio; Teixeira, Frederico; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, Alfredo; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, Alice
- Inflammation, T-Cell phenotype, and inflammatory cytokines in chronic kidney disease patients under hemodialysis and its relationship to resistance to recombinant human erythropoietin therapyPublication . Costa, Elísio; Lima, Margarida; Alves, João Moura; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, Alfredo; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, AliceBackground Resistance to recombinant human erythropoietin (rhEPO) occurs in some chronic kidney disease (CKD) patients, which may be due to enhanced systemic inflammatory response and to the erythropoiesis-suppressing effect of pro-inflammatory cytokines, some of which are produced by T cells. Aim of study The aim of this study was to investigate the relationship between resistance to rhEPO therapy in hemodialysis CKD patients and inflammatory markers [Creactive protein (CRP), soluble interleukin (IL)-2 receptor(sIL2R), and serum albumin levels], blood cell counts, Tcell phenotype, cytokine production by T cells, and serum cytokine levels. Materials and Methods We studied 50 hemodialysis CKD patients, 25 responders and 25 nonresponders to rhEPO, and compared them to each other and with 25 healthy controls. When compared to controls, CKD patients showed increased serum levels of CRP, IL-6, and sIL2R and a T-cell lymphopenia, due to decreased numbers of both CD4+ and CD8+ T cells. T cells from CKD patients had an immunophenotype compatible with chronic T-cell stimulation as shown by the increased percentage of CD28−, CD57+, HLA-DR+, CD28−HLA-DR+, and CD57+ HLA-DR+ T cells and produce higher levels of IL-2, INF-γ, and TNF-α after short-term in vitro stimulation, although Th1 cytokines were not detectable in serum. Statistically significant differences were found between responders and nonresponders to rhEPO therapy for total lymphocyte and CD4+ T-lymphocyte counts, albumin (lower in nonresponders) and CRP (higher in nonresponders) levels. Conclusion CKD patients under hemodialysis present with raised inflammatory markers and decrease of total lymphocyte and CD4+ T-lymphocyte counts when compared with controls. Some of those markers are even further enhanced in nonresponders to rhEPO therapy patients, but resistance to this therapy cannot be justified by a Th1 polarized T-cell response.
- Neuthrophil activation markers in chronic renal failure patients under haemodialysis and recombinant human erythropoietinPublication . Costa, Elísio; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Miranda, Vasco; Faria, Maria Sameiro; Loureiro, António; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, Alice
- T-cell phenotype and inflammation in chronic kidney disease patients under haemodialysis and its relationship to resistance to rhEPO therapyPublication . Faria, Maria Sameiro; Costa, Elísio; Lima, Margarida; Moura-Alves, João; Rocha, Susana; Rocha-Pereira, Petronila; Castro, Elisabeth; Miranda, Vasco; Loureiro, Alfredo; Quintanilha, Alexandre; Belo, Luís; Santos-Silva, Alice