6 results on '"Amâncio RT"'
Search Results
2. Sepsis induces brain mitochondrial dysfunction.
- Author
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d'Avila JCP, Santiago APS, Amâncio RT, Galina A, Oliveira MF, and Bozza FA
- Published
- 2008
- Full Text
- View/download PDF
3. Sepsis is a major determinant of outcome in critically ill HIV/AIDS patients.
- Author
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Japiassú AM, Amâncio RT, Mesquita EC, Medeiros DM, Bernal HB, Nunes EP, Luz PM, Grinsztejn B, and Bozza FA
- Subjects
- AIDS-Related Opportunistic Infections complications, AIDS-Related Opportunistic Infections mortality, Acquired Immunodeficiency Syndrome microbiology, Acquired Immunodeficiency Syndrome mortality, Adult, Chi-Square Distribution, Critical Illness mortality, Female, HIV Infections microbiology, HIV Infections mortality, Hospital Mortality, Humans, Intensive Care Units statistics & numerical data, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Sepsis complications, Shock, Septic complications, Shock, Septic mortality, Survival Analysis, Treatment Outcome, Acquired Immunodeficiency Syndrome complications, HIV Infections complications, Sepsis mortality
- Abstract
Introduction: New challenges have arisen for the management of critically ill HIV/AIDS patients. Severe sepsis has emerged as a common cause of intensive care unit (ICU) admission for those living with HIV/AIDS. Contrastingly, HIV/AIDS patients have been systematically excluded from sepsis studies, limiting the understanding of the impact of sepsis in this population. We prospectively followed up critically ill HIV/AIDS patients to evaluate the main risk factors for hospital mortality and the impact of severe sepsis on the short- and long-term survival., Methods: All consecutive HIV-infected patients admitted to the ICU of an infectious diseases research center, from June 2006 to May 2008, were included. Severity of illness, time since AIDS diagnosis, CD4 cell count, antiretroviral treatment, incidence of severe sepsis, and organ dysfunctions were registered. The 28-day, hospital, and 6-month outcomes were obtained for all patients. Cox proportional hazards regression analysis measured the effect of potential factors on 28-day and 6-month mortality., Results: During the 2-year study period, 88 HIV/AIDS critically ill patients were admitted to the ICU. Seventy percent of patients had opportunist infections, median CD4 count was 75 cells/mm3, and 45% were receiving antiretroviral therapy. Location on a ward before ICU admission, cardiovascular and respiratory dysfunctions on the first day after admission, and the presence of severe sepsis/septic shock were associated with reduced 28-day and 6-month survival on a univariate analysis. After a multivariate analysis, severe sepsis determined the highest hazard ratio (HR) for 28-day (adjusted HR, 3.13; 95% CI, 1.21-8.07) and 6-month (adjusted HR, 3.35; 95% CI, 1.42-7.86) mortality. Severe sepsis occurred in 44 (50%) patients, mainly because of lower respiratory tract infections. The survival of septic and nonseptic patients was significantly different at 28-day and 6-month follow-up times (log-rank and Peto test, P < 0.001)., Conclusions: Severe sepsis has emerged as a major cause of admission and mortality for hospitalized HIV/AIDS patients, significantly affecting short- and longer-term survival of critically ill HIV/AIDS patients.
- Published
- 2010
- Full Text
- View/download PDF
4. Increased susceptibility to septic and endotoxic shock in monocyte chemoattractant protein 1/cc chemokine ligand 2-deficient mice correlates with reduced interleukin 10 and enhanced macrophage migration inhibitory factor production.
- Author
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Gomes RN, Figueiredo RT, Bozza FA, Pacheco P, Amâncio RT, Laranjeira AP, Castro-Faria-Neto HC, Bozza PT, and Bozza MT
- Subjects
- Animals, Cecum surgery, Chemokine CCL2 genetics, Disease Models, Animal, Female, Genetic Predisposition to Disease, Intramolecular Oxidoreductases, Leukocytes pathology, Ligation, Lipopolysaccharides, Male, Mice, Mice, Mutant Strains, Peritonitis genetics, Peritonitis metabolism, Peritonitis microbiology, Shock, Septic mortality, Systemic Inflammatory Response Syndrome genetics, Systemic Inflammatory Response Syndrome metabolism, Chemokine CCL2 metabolism, Interleukin-10 metabolism, Macrophage Migration-Inhibitory Factors metabolism, Shock, Septic genetics, Shock, Septic metabolism
- Abstract
The chemokine monocyte chemoattractant protein 1/CC chemokine ligand 2 (MCP-1/CCL2) is a potent chemoattractant of mononuclear cells and a regulatory mediator involved in a variety of inflammatory diseases. In the present study, we demonstrate that mcp-1/ccl2-deficient mice are more susceptible to systemic inflammatory response syndrome induced by lipopolysaccharide and to polymicrobial sepsis induced by cecum ligation and puncture (CLP) when compared with wild-type mice. Interestingly, in the CLP model, mcp-1/ccl2-deficient mice efficiently cleared the bacteria despite an impaired recruitment of leukocytes, especially mononuclear cells. The increased lethality rate in these models correlates with an impaired production of interleukin (IL) 10 in vivo. Furthermore, macrophages from mcp-1/ccl2-deficient mice activated with lipopolysaccharide also produced lower amounts of IL-10 and similar tumor necrosis factor compared with wild-type mice. We observed a drastic increase in the amounts of macrophage migration inhibitory factor at 6 and 24 h after CLP in mcp-1/ccl2-deficient mice. These results indicate that endogenous MCP-1/CCL2 positively regulates IL-10 but negatively controls macrophage migration inhibitory factor during peritoneal sepsis, thus suggesting an important immunomodulatory role for MCP-1/CCL2 in controlling the balance between proinflammatory and anti-inflammatory factors in sepsis.
- Published
- 2006
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- View/download PDF
5. Exogenous platelet-activating factor acetylhydrolase reduces mortality in mice with systemic inflammatory response syndrome and sepsis.
- Author
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Gomes RN, Bozza FA, Amâncio RT, Japiassú AM, Vianna RC, Larangeira AP, Gouvêa JM, Bastos MS, Zimmerman GA, Stafforini DM, Prescott SM, Bozza PT, and Castro-Faria-Neto HC
- Subjects
- Animals, Anti-Bacterial Agents administration & dosage, Cytokines blood, Disease Models, Animal, Drug Therapy, Combination, Female, Humans, Male, Mice, Middle Aged, Systemic Inflammatory Response Syndrome blood, 1-Alkyl-2-acetylglycerophosphocholine Esterase administration & dosage, Platelet Activating Factor antagonists & inhibitors, Systemic Inflammatory Response Syndrome drug therapy
- Abstract
Current evidence indicates that dysregulation of the host inflammatory response to infectious agents is central to the mortality of patients with sepsis and in those with systemic inflammatory response syndrome. Strategies to block inflammatory mediators, often with complicated outcomes, are currently being investigated as new adjuvant therapies for sepsis. Here, we determined if administration of recombinant platelet-activating factor (rPAF)-acetylhydrolase (rPAF-AH), an enzyme that inactivates PAF and PAF-like lipids, protects mice from inflammatory injury and death after administration of lipopolysaccharide (LPS) or cecal ligation and puncture (CLP). Administration of rPAF-AH increased plasma PAF-AH activity and reduced mortality in both models. Treatment with rPAF-AH increased peritoneal fluid levels of monocyte chemoattractant protein 1/CCL-2 and decreased interleukin 6 and migration inhibitory factor levels after LPS administration or CLP. Administration of a broad-spectrum antibiotic together with rPAF-AH was more protective than single treatment with either of these agents. The combined treatment was associated with reduced interleukin 6 levels in mice subjected to CLP. We observed acute decreases in plasma PAF-AH activity in mice subjected to CLP or challenged with LPS and in human patients with sepsis. We conclude that alterations in the endogenous PAF-AH contribute to the pathophysiology of sepsis and that administration of exogenous rPAF-AH reduces inflammatory injury and mortality in models relevant to the clinical syndrome. Variations in endogenous PAF-AH activity may potentially account for variable responses to exogenous rPAF-AH in previous clinical trials. Serial measurements of plasma PAF-AH activity in murine models demonstrate dynamic regulation of the endogenous enzyme, potentially explaining the variations in human subjects.
- Published
- 2006
- Full Text
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6. Antibiotic treatment in a murine model of sepsis: impact on cytokines and endotoxin release.
- Author
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Vianna RC, Gomes RN, Bozza FA, Amâncio RT, Bozza PT, David CM, and Castro-Faria-Neto HC
- Subjects
- Animals, Anti-Infective Agents therapeutic use, Cecum injuries, Cecum pathology, Ciprofloxacin therapeutic use, Clindamycin therapeutic use, Colony-Forming Units Assay, Disease Models, Animal, Enzyme-Linked Immunosorbent Assay, Female, Gram-Negative Bacteria metabolism, Imipenem therapeutic use, Inflammation, Interleukin-10 biosynthesis, Interleukin-6 biosynthesis, Leukocytes metabolism, Lipopolysaccharides metabolism, Male, Mice, Time Factors, Tumor Necrosis Factor-alpha biosynthesis, Anti-Bacterial Agents therapeutic use, Cytokines metabolism, Endotoxins metabolism, Sepsis drug therapy
- Abstract
Experimental and clinical studies in sepsis indicate that antibiotic therapy may induce the release of endotoxin (LPS) from the outer membrane of gram-negative bacteria and therefore may affect the physiologic response and survival. The aim of this study was to evaluate if antibiotics commonly used to treat secondary peritonitis are capable of changing survival rates, proinflammatory and anti-inflammatory cytokine concentrations, and the release of endotoxin in a murine model of sepsis. Sepsis was induced by cecal ligation and puncture (CLP) in Swiss mice using an 18-gauge needle. The animals received injections of saline solution or imipenem or a combination of ciprofloxacin plus clindamycin every 8 h for 3 days. Antibiotic treatment induced an increase in survival rate and decreased plasma and peritoneal fluid levels of TNF-alpha and IL-6 at 6 and 24 h after CLP as compared with saline-treated animals. Antibiotic-treated animals also showed an early (6 h) decrease and a late (24 h) increase in IL-10 concentration in the peritoneal fluid. LPS concentrations were elevated in all groups, but imipenem-treated animals showed higher levels (2.2 EU/mL) than ciprofloxacin plus clindamycin (1.3 EU/mL) and saline-treated (1.5 EU/mL) groups. We conclude that antibiotic-induced endotoxin release is not a major determinant in the inflammatory response and prognosis in murine models of sepsis.
- Published
- 2004
- Full Text
- View/download PDF
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