53 results on '"Helcio Rodrigues"'
Search Results
2. HLA-A*31 como marcador de suscetibilidade genetica em sepse
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Fabiano Pinheiro da Silva, Germano Preuhs Filho, Eduardo Finger, Hermes Vieira Barbeiro, Fernando Godinho Zampieri, Alessandra Carvalho Goulart, Francisco Torggler Filho, Nicolas Panajotopoulos, Irineu Tadeu Velasco, Jorge Kalil, Heraldo Possolo de Souza, Luiz Monteiro da Cruz Neto, and Helcio Rodrigues
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Sepse ,Antigenos HLA-A ,Inflamacao ,Marcadores geneticos ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objetivo: Haplótipos do HLA têm sido associados a muitas doenças autoimunes, mas não foi descrita qualquer associação na sepse. O objetivo desse estudo é investigar o sistema HLA como um possível marcador de suscetibilidade genética à sepse. Métodos: Estudo prospectivo de coorte, incluindo pacientes admitidos em unidade de terapia intensiva e controles-saudáveis obtidos em lista de doadores de transplante renal. Foram excluídos pacientes abaixo dos 18 anos de idade, gestantes ou HIV positivos, pacientes com doença maligna metastática ou sob quimioterapia, pacientes com hepatopatia avançada, com condições de fim de vida. O DNA foi extraído de sangue total, e a haplotipagem de HLA foi realizada com a tecnologia MiliPlex®. Resultados: Foram incluídos 1.121 pacientes (1.078 doadores de rim, 20 pacientes com sepse grave e 23 pacientes admitidos por choque séptico) entre outubro de 2010 e outubro de 2012. Os participantes positivos para HLA-A*31 tiveram risco aumentado de desenvolver sepse (OR: 2,36 IC95%: 1,26-5,35). Não foi identificada outra associação significativa, quando considerado como nível de significância o valor de p
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- 2013
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3. The impact of pretransplant donor-specific antibodies on graft outcome in renal transplantation: a six-year follow-up study
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Elias David-Neto, Patricia Soares Souza, Nicolas Panajotopoulos, Helcio Rodrigues, Carlucci Gualberto Ventura, Daisa Silva Ribeiro David, Francine Brambate Carvalhinho Lemos, Fabiana Agena, William Carlos Nahas, Jorge Elias Kalil, and Maria Cristina Ribeiro Castro
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Renal Transplantation ,Donor-Specific Antibodies ,Solid-Phase Assay ,Luminex ,DSA ,Medicine (General) ,R5-920 - Abstract
OBJECTIVE: The significance of pretransplant, donor-specific antibodies on long-term patient outcomes is a subject of debate. This study evaluated the impact and the presence or absence of donor-specific antibodies after kidney transplantation on short- and long-term graft outcomes. METHODS: We analyzed the frequency and dynamics of pretransplant donor-specific antibodies following renal transplantation from a randomized trial that was conducted from 2002 to 2004 and correlated these findings with patient outcomes through 2009. Transplants were performed against a complement-dependent T- and B-negative crossmatch. Pre- and posttransplant sera were available from 94 of the 118 patients (80%). Antibodies were detected using a solid-phase (LuminexH), single-bead assay, and all tests were performed simultaneously. RESULTS: Sixteen patients exhibited pretransplant donor-specific antibodies, but only 3 of these patients (19%) developed antibody-mediated rejection and 2 of them experienced early graft losses. Excluding these 2 losses, 6 of 14 patients exhibited donor-specific antibodies at the final follow-up exam, whereas 8 of these patients (57%) exhibited complete clearance of the donor-specific antibodies. Five other patients developed ''de novo'' posttransplant donor-specific antibodies. Death-censored graft survival was similar in patients with pretransplant donor-specific and non-donor-specific antibodies after a mean follow-up period of 70 months. CONCLUSION: Pretransplant donor-specific antibodies with a negative complement-dependent cytotoxicity crossmatch are associated with a risk for the development of antibody-mediated rejection, although survival rates are similar when patients transpose the first months after receiving the graft. Our data also suggest that early posttransplant donor-specific antibody monitoring should increase knowledge of antibody dynamics and their impact on long-term graft outcome.
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- 2012
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4. Correction: The Absence of CYP3A5*3 Is a Protective Factor to Anticonvulsants Hypersensitivity Reactions: A Case-Control Study in Brazilian Subjects.
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Luciana Kase Tanno, Daniel Shikanai Kerr, Bernardo dos Santos, Leda Leme Talib, Célia Yamaguti, Helcio Rodrigues, Wagner Farid Gattaz, and Jorge Kalil
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Medicine ,Science - Published
- 2015
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5. The Absence of CYP3A5*3 Is a Protective Factor to Anticonvulsants Hypersensitivity Reactions: A Case-Control Study in Brazilian Subjects.
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Luciana Kase Tanno, Daniel Shikanai Kerr, Bernardo dos Santos, Leda Leme Talib, Célia Yamaguti, Helcio Rodrigues, Wagner Farid Gattaz, and Jorge Kalil
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Medicine ,Science - Abstract
Although aromatic anticonvulsants are usually well tolerated, they can cause cutaneous adverse drug reactions in up to 10% of patients. The clinical manifestations of the antiepileptics-induced hypersensitivity reactions (AHR) vary from mild skin rashes to severe cutaneous drug adverse reactions which are related to high mortality and significant morbidity. Genetic polymorphisms in cytochrome P450 genes are associated with altered enzymatic activity and may contribute to the risk of AHR. Here we present a case-control study in which we genotyped SNPs of CYP2C19, 2C9 and 3A5 of 55 individuals with varying severities of AHR, 83 tolerant, and 366 healthy control subjects from São Paulo, Brazil. Clinical characterization was based on standardized scoring systems and drug patch test. All in vivo investigation followed the ENDA (European Network of Drug Allergy) recommendations. Genotype was determined by real time PCR using peripheral blood DNA as a template. Of all 504 subjects, 65% were females, 45% self-identified as Afro-American, 38% as Caucasian and 17% as having non-African mixed ascendancy. Amongst 55 subjects with AHR, 44 had severe cutaneous drug adverse reactions. Of the 46 drug patch tests performed, 29 (63%) were positive. We found a strong association between the absence of CYP3A5*3 and tolerant subjects when compared to AHR (p = 0.0002, OR = 5.28 [CI95% 2.09-14.84]). None of our groups presented positive association with CYP2C19 and 2C9 polymorphisms, however, both SNPs contributed to separation of cases and tolerants in a Classification and Regression Tree. Our findings indicate that drug metabolism genes can contribute in the tolerability of antiepileptics. CYP3A5*3 is the most prevalent CYP3A5 allele associated with reduced enzymatic function. The current study provides evidence that normal CYP3A5 activity might be a protective factor to aromatic antiepileptics-induced hypersensitivity reactions in Brazilian subjects.
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- 2015
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6. 423.4: Raising the Potential of Transplantation With a KPD Collaborative Program
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Juliana Bastos, David JB Machado, Gustavo F Ferreira, Thais Freesz, Helcio Rodrigues, Renata P Souza, Raquel Moreira, Alexandre A Pires, Vinicius S Colares, Camila M Assunção, and Elias David-Neto
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Transplantation - Published
- 2022
7. HLA-C*17, DQB1*03:01, DQA1*01:03 and DQA1*05:05 Alleles Associated to Bullous Pemphigoid in Brazilian Population
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Jorge Kalil, Claudia B. Rosales, Julio M. Gil, Luiz Ubirajara Sennes, Helcio Rodrigues, Ivan Dieb Miziara, and Azis Arruda Chagury
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Pemphigoid ,Dermatology ,Human leukocyte antigen ,030207 dermatology & venereal diseases ,03 medical and health sciences ,HLA-C ,0302 clinical medicine ,Genetic predisposition ,Medicine ,Typing ,HLA antigens ,Allele ,skin and connective tissue diseases ,ANTÍGENOS HLA ,business.industry ,medicine.disease ,HLA-A ,Polymerase chain reaction ,bullous ,Genes ,Immunology ,MHC class I ,MHC class II ,Original Article ,Bullous pemphigoid ,business ,030215 immunology - Abstract
Background Bullous pemphigoid (BP) is an autoimmune disease with bullous vesicles and an incidence of 0.2 to 1.4 per 100,000 inhabitants. Many studies have been published demonstrating the association of pemphigoid with HLA class II system alleles in different populations, however there are no data on the BP, one of the most heterogeneous in the world. Objective To typify HLA alleles in Brazilians with Bullous pemphigoid. Methods The study group included 17 Brazilian patients with a confirmed diagnosis of BP from a hospital in Sao Paulo city, southeast Brazil. DNA was extracted from peripheral blood using Qiagen kits and HLA A, B, C, DR and DQ typing was performed using polymerase chain reaction. The control group was composed of a database of 297 deceased donors from the city of Sao Paulo. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA class I (A, B and C) and class II (DRB1, DQB1 and DQA1). Results Our findings show that alleles HLA C*17, DQB1*03:01, DQA1*01:03 and DQA1*05:05 are associated with the onset of the disease in the Brazilian population, with relative risks of 8.31 (2.46 to 28.16), 3.76 (1.81 to 7.79), 3.57 (1.53 to 8.33), and 4.02 (1.87 to 8.64), respectively (p
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- 2017
8. Homologous transplantation with fresh frozen bone for dental implant placement can induce HLA sensitization: a preliminary study
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Marcelo Henrique Napimoga, Victor Angelo Martins Montalli, André Antonio Pelegrine, Marcelo Teixeira, Helcio Rodrigues, and Paulo Eduardo de Lacerda
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medicine.medical_specialty ,medicine.medical_treatment ,Bone Screws ,Biomedical Engineering ,Dentistry ,Osseointegration ,HLA Sensitization ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,HLA Antigens ,medicine ,Homologous chromosome ,Humans ,Transplantation, Homologous ,Dental implant ,Bone regeneration ,Homologous transplantation ,Sensitization ,Dental Implants ,Titanium ,030222 orthopedics ,Transplantation ,Bone Transplantation ,business.industry ,030206 dentistry ,Cell Biology ,Surgery ,medicine.anatomical_structure ,Orthopedic surgery ,Tomography, X-Ray Computed ,business - Abstract
It has been related in orthopedic surgeries the HLA sensitization. Thus, we evaluate if the use of fresh-frozen homologous bone (FFHB) for dental implant placement induce anti-HLA sensitization. Six patients were treated with FFHB corticocancellous block grafts. After 6 months, bone biopsies were harvested during implant placement to allow histomorphometric analysis. Vital mineralized tissue (VMT), non-vital mineralized tissue (NVMT) and non-mineralized tissue (NMT) were quantified histomorphometrically. Peripheral blood was collected from the patients before FFHB placement and 6 months after the surgery for anti-HLA analysis. The histomorphometric analysis showed the presence of VMT, NVMT and NMT in 45.56 ± 15.72 %, 14.16 ± 13.39 % and 40.29 ± 12.60 %, respectively. The baseline and 6 months postoperative CTs revealed bone thickness in the order of 5.66 ± 0.67 mm and 8.71 ± 1.52 mm (3.05 ± 1.39 mm). The anti-HLA analysis revealed that two of the six patients (33.3 %) became sensitized, however this was not associated with any FFHB incorporation loss (p > 0.05). A total of 24 implants were placed all of which were osseointegrated after 6 months. Although FFHB-related HLA sensitization does not appear to affect bone incorporation when treating insufficient bone thickness for implant placement, further follow-up is required to determine whether there is an association between HLA sensitization and long-term graft survival.
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- 2016
9. A case-control study of HLA alleles in Brazilian patients with Melkersson-Rosenthal syndrome
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Claudia B. Rosales, Helcio Rodrigues, Neusa Yuriko Sakai Valente, Giovanna Piacenza Florezi, Marcello Menta Simonsen Nico, Silvia Vanessa Lourenço, N. Panajotopoulos, and Camila Fátima Biancardi Gavioli
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Patients ,Genes, MHC Class II ,Genes, MHC Class I ,Human leukocyte antigen ,Gastroenterology ,Inflammatory bowel disease ,Major Histocompatibility Complex ,Young Adult ,Crohn Disease ,Melkersson–Rosenthal syndrome ,Internal medicine ,Genetics ,medicine ,HLA-DQ beta-Chains ,Humans ,Genetic Predisposition to Disease ,Granulomatosis, Orofacial ,Child ,HLA-DRB1 ,Alleles ,Genetics (clinical) ,Aged ,Crohn's disease ,Melkersson-Rosenthal Syndrome ,business.industry ,Infant ,General Medicine ,Middle Aged ,Inflammatory Bowel Diseases ,medicine.disease ,Facial paralysis ,HLA-A ,Case-Control Studies ,Child, Preschool ,Female ,Orofacial granulomatosis ,business ,Brazil ,HLA-DRB1 Chains - Abstract
Melkersson-Rosenthal syndrome (MRS) is a neuromucocutaneous disease that manifests by the triad of recurrent orofacial edema (frequently as cheilitis granulomatosa), relapsing facial paralysis and plicated tongue. The cause of MRS remains unknown, but genetic predisposal and a relationship with inflammatory bowel disease are suspected. The objective of this research was to compare the frequency of class I and II HLA alleles in patients with a confirmed diagnosis of MRS with those of a healthy control group. We conduct a case-control study and typed of HLA A, B, C, DR, and DQ using molecular techniques. The study included 36 patients with MRS and 297 patients in the control group. There was an increase in the expression of HLA A*02 (p = 0.0269; OR: 1,79 [1,045-2,973]), HLA DRB1*11 (p 0,0001; OR: 4,009 [2,214-7,277]), HLA DRB1*13 (not statistically significant) and HLA DQB1*03 (p = 0,0177; OR: 1,829 [1,122-2,978]) and low levels of HLA A*01 (p = 0.0046; OR: 0,097 [0,009-0,538]), HLA DRB1*04 (p = 0.0274; OR: 0,228 [0,053-0,844]), HLA DRB1*07 (p = 0,0091; OR: 0,183 [0,043-0,670]) and HLA DQB1*02 (p = 0.0051; OR: 0,312 [0,143-0,721]) in MRS patients compared with the control group. Crohn disease (CD) patients had disparate genetic profiles versus those with MRS. This single-institution study had a small cohort, because this disease is rare. Conclusions: There is a genetic predisposition toward MRS, involving associated and protective genes.
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- 2020
10. 3ª Diretriz Brasileira de Transplante Cardíaco
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Juliano Gasparetto, Sandrigo Mangini, Mônica Samuel Avila, Silvia Moreira Ayub Ferreira, João Manoel Rossi Neto, Maria da Consolação Vieira Moreira, Helcio Rodrigues, Alexandre Siciliano Colafranceschi, Carlos Fernando Ramos Lavagnoli, Fernando Antibas Atik, Fabiana G. Marcondes-Braga, Luis Fernando Bernal da Costa Seguro, Fernando Augusto Marinho dos Santos Figueira, Livia Adams Goldraich, Fábio Antônio Gaiotto, Flávio de Souza Brito, Dirceu R. Almeida, Marcelo Botelho Ulhoa Junior, Germano Emilio Conceição Souza, Lidia Zytynski Moura, I.W. Campos, Rodrigo Moreno Dias Carneiro, Fernando Bacal, Cláudio Léo Gelape, José Leudo Xavier Júnior, Luiz Alberto Benvenuti, Tânia Mara Varejão Strabelli, João David de Souza Neto, and Luis Eduardo Paim Rohde
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lcsh:Diseases of the circulatory (Cardiovascular) system ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,lcsh:RC666-701 ,business.industry ,MEDLINE ,Medicine ,Evidence-based medicine ,030204 cardiovascular system & hematology ,030230 surgery ,Cardiology and Cardiovascular Medicine ,business - Published
- 2018
11. The Kinetics of Anti-HLA Antibodies in the First Year after Kidney Transplantation: In Whom and When Should They Be Monitored?
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Helcio Rodrigues, Elias David-Neto, N. Panajotopoulos, Erick A. Barbosa, Gabriella Maciel, Renata T M P de Souza, Daísa S. David, Patrícia Jorge Soalheiro de Souza, Maria Cristina Ribeiro de Castro, Fabiana Agena, and Flávio Jota de Paula
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medicine.medical_specialty ,biology ,Article Subject ,business.industry ,030232 urology & nephrology ,lcsh:Surgery ,lcsh:RD1-811 ,030230 surgery ,medicine.disease ,Gastroenterology ,Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Antigen ,Internal medicine ,medicine ,biology.protein ,Hla antibodies ,Antibody ,Prospective cohort study ,business ,Kidney transplantation ,Research Article - Abstract
The impact of the kinetics of the anti-HLA antibodies after KTx on the occurrence of acute rejection as well as the better time-point to monitor anti-HLA Abs after transplantation is not completely defined. This prospective study followed 150 patients over 12 months after transplantation. Serum IgG anti-HLA Abs were detected by single antigen beads after typing donors and recipients for loci A, B, C, DR, and DQ. Before KTx, 89 patients did not present anti-HLA Abs and 2% developed “de novo” Abs during the 1st year, 39 patients were sensitized without DSAs, and 13% developed DSA after surgery; all of them presented ABMR. Sensitized patients presented higher acute rejection rates (36.4% versus 13.5%, p<0.001), although 60% of the patients did not present ABMR. Patients, in whom DSA-MFI decreased during the first two weeks after surgery, did not develop ABMR. Those who sustained their levels presented a rate of 22% of ABMR. 85% of patients developed ABMR when MFIs increased early after transplantation (which occurred in 30% of the DSA positive patients). In the ABMR group, we observed an iDSA-MFI sharp drop on the fourth day and then an increase between the 7th and 14th POD, which suggests DSA should be monitored at this moment in sensitized patients for better ABMR prediction.
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- 2018
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12. High rate of clinical recurrence in patients with Vogt–Koyanagi–Harada disease treated with early high-dose corticosteroids
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Jorge Kalil, Viviane Mayumi Sakata, Helcio Rodrigues, Joyce Hisae Yamamoto, Carlos Eduardo Hirata, Maria Lucia C. Marin, Felipe T. da Silva, and Rogério A. Costa
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Adult ,Male ,Vogt–Koyanagi–Harada disease ,medicine.medical_specialty ,Adolescent ,Disease ,Methylprednisolone ,Polymerase Chain Reaction ,Retina ,Young Adult ,Cellular and Molecular Neuroscience ,Recurrence ,Prednisone ,medicine ,Humans ,Fluorescein Angiography ,Young adult ,Child ,Glucocorticoids ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Uveomeningoencephalitic Syndrome ,Middle Aged ,Prognosis ,Fluorescein angiography ,medicine.disease ,Fibrosis ,Dermatology ,eye diseases ,Sensory Systems ,Surgery ,Ophthalmology ,Pulse Therapy, Drug ,Chronic Disease ,Female ,business ,Brazil ,HLA-DRB1 Chains ,medicine.drug - Abstract
To analyse the rate of clinical recurrences in Brazilian patients with Vogt-Koyanagi-Harada (VKH) disease after early high-dose corticosteroid treatment.Retrospective study including patients treated with early high-dose corticosteroids (prednisone, 1-1.5 mg/kg/day, or 3-day 1 g methylprednisolone pulsetherapy) within 1 month from disease onset followed by slow taper (at least 6 months). Patients with a minimum 12-month follow-up were subdivided based on the presence of disease recurrence or persistence after 6 months from initial presentation into: acute-resolved (AR, no recurrences), chronic-recurrent (CR), and chronic-recurrent with subretinal fibrosis (SRF). Recurrences were defined as the presence of clinical and/or fluorescein angiography findings.Twenty-nine patients (58 eyes) with a median follow-up of 65 months were included. Six (21 %), 11 (38 %) and 12 (41 %) patients were allocated to AR, CR, and SRF groups respectively. Though having received treatment within 1 month of onset, median time to initial treatment differed among groups (11, 15, and 25 days, in AR, CR, and SRF groups respectively). Intensity of immunosuppression, cataract development, and longer time to achieve logMAR visual acuity ≤0.8 differed significantly among the groups, being more severe in SRF group. HLA-DRB1*0405 allele followed the same trend, though not reaching significance (0.5 in AR group, 0.6 in CR, and 0.8 in SRF).VKH disease in Brazilian patients evolved to chronic-recurrent disease in 79 % of cases; 38 % developed subretinal fibrosis, in spite of similar initial treatment regimens. Time to initiate treatment influenced outcomes.
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- 2015
13. Asma alérgica e não alérgica apresentam diferentes características fenotípicas e genotípicas
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Helcio Rodrigues, Pedro Giavina-Bianchi, Rosana Câmara Agondi, Priscila Takejima, Marcelo Vivolo Aun, and Jorge Kalil
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General Earth and Planetary Sciences ,General Environmental Science - Published
- 2017
14. Dynamics of anti-human leukocyte antigen antibodies after renal transplantation and their impact on graft outcome
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Helcio Rodrigues, D. S. R. David, Jorge Kalil, Elias David-Neto, C. Ronda, Nicolas Panajotopolous, Patrícia Soares de Souza, Maria Cristina Ribeiro de Castro, W. C. Nahas, and Fabiana Agena
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Kidney transplant ,Graft function ,Gastroenterology ,Antibodies ,Cohort Studies ,HLA Antigens ,Internal medicine ,medicine ,Humans ,Kidney transplantation ,Transplantation ,biology ,business.industry ,Incidence (epidemiology) ,Graft Survival ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Treatment Outcome ,surgical procedures, operative ,Immunology ,biology.protein ,Kidney Failure, Chronic ,Female ,Graft survival ,Antibody ,business - Abstract
The purpose of this study was to sequentially monitor anti-HLA antibodies and correlate the results with antibody-mediated rejection (AMR), graft survival (GS), and graft function (GF). We collected sera from 111 kidney transplant recipients on transplant days 0, 7, 14, 30, 60, 90, 180, and 360 and analyzed PRA levels by ELISA. DSAs were analyzed by single-antigen beads in rejecting kidneys. At pre-transplant, 79.3% of the patients were non-sensitized (PRA = 0%) and 20.7% were sensitized (PRA > 1%). After transplant, patients were grouped by PRA profile: no anti-HLA antibodies pre- or post-transplant (group HLApre-/post-; n = 80); de novo anti-HLA antibodies post-transplant (group HLApre-/post+; n = 8); sensitized pre-transplant/increased PRA post-transplant (group HLApre+/post↑; n = 9); and sensitized pre-transplant/decreased PRA post-transplant (group HLApre+/post↓; n = 14). De novo anti-HLA antibodies were detected at 7-180 d. In sensitized patients, PRA levels changed within the first 30 d post-transplant. Incidence of AMR was higher in HLApre-/post+ and HLApre+/post↑ than in HLApre-/post-, and HLApre+/post↓ (p
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- 2014
15. HLA-A*31 as a marker of genetic susceptibility to sepsis
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Jorge Kalil, Hermes Vieira Barbeiro, Eduardo Finger, Helcio Rodrigues, Alessandra C. Goulart, Luiz Monteiro da Cruz Neto, Heraldo Possolo de Souza, Fabiano Pinheiro da Silva, Francisco Torggler Filho, N. Panajotopoulos, Germano Preuhs Filho, Fernando G. Zampieri, and Irineu Tadeu Velasco
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medicine.medical_specialty ,Human leukocyte antigen ,Critical Care and Intensive Care Medicine ,law.invention ,Sepsis ,Cohort Studies ,Liver disease ,law ,Internal medicine ,medicine ,Genetic predisposition ,Humans ,Genetic Predisposition to Disease ,Prospective Studies ,Prospective cohort study ,Inflammation ,HLA-A Antigens ,business.industry ,Septic shock ,General Medicine ,medicine.disease ,Intensive care unit ,Shock, Septic ,Intensive Care Units ,Haplotypes ,Immunology ,Genetic markers ,Original Article ,business ,Biomarkers ,Cohort study - Abstract
Objective: The HLA haplotype has been associated with many autoimmune diseases, but no associations have been described in sepsis. This study aims to investigate the HLA system as a possible marker of genetic sepsis susceptibility. Methods: This is a prospective cohort study including patients admitted to an intensive care unit and healthy controls from a list of renal transplant donors. Patients with less 18 years of age; pregnant or HIV positive patients; those with metastatic malignancies or receiving chemotherapy; or with advanced liver disease; or with end-of-life conditions were excluded. The DNA was extracted from the whole blood and HLA haplotypes determined using MiliPlex® technology. Results: From October 2010 to October 2012, 1,121 patients were included (1,078 kidney donors, 20 patients admitted with severe sepsis and 23 with septic shock). HLA-A*31 positive subjects had increased risk of developing sepsis (OR 2.36, 95%CI 1.26-5.35). Considering a p value
- Published
- 2013
16. Study of the association between human leukocyte antigens (HLA) and pemphigus vulgaris in Brazilian patients
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Julio M. Gil, Azis Arruda Chagury, Jorge Kalil, Luiz Ubirajara Sennes, Claudia B. Rosales, Helcio Rodrigues, Raimar Weber, and Ivan Dieb Miziara
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musculoskeletal diseases ,Adult ,Male ,Linkage disequilibrium ,Dermatology ,Human leukocyte antigen ,HLA-C Antigens ,HLA-DQ alpha-Chains ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Gene Frequency ,immune system diseases ,HLA Antigens ,HLA-DR ,Medicine ,HLA-DQ beta-Chains ,Humans ,Genetic Predisposition to Disease ,skin and connective tissue diseases ,HLA-DRB1 ,Alleles ,HLA-DQB1 ,business.industry ,Pemphigus vulgaris ,Middle Aged ,medicine.disease ,HLA-B ,HLA-A ,Haplotypes ,HLA-B Antigens ,Immunology ,Female ,business ,Brazil ,Pemphigus ,030215 immunology ,HLA-DRB1 Chains - Abstract
Background Pemphigus vulgaris is a mucocutaneous blistering autoimmune disease that manifests as painful blisters or erosions on the skin and/or mucosal surfaces. IgG autoantibodies target desmoglein, playing a major role in disease pathogenesis. Genetic predisposal to pemphigus vulgaris, especially the HLA DR and DQ alleles, has been known since the 1980s. The unique constitution of the Brazilian population favors exploratory genetic studies. Methods The study group included 51 patients with a confirmed diagnosis of pemphigus vulgaris from a tertiary hospital in Sao Paulo city, Sao Paulo, southeast Brazil. DNA was extracted from peripheral blood, and HLA A, B, C, DR, and DQ typing was performed. The control group was composed of a database of 297 deceased donors from the city of Sao Paulo typed with the same method. The statistical significance level was adjusted using the Bonferroni correction depending on the phenotypic frequencies evaluated for HLA A, HLA B, HLA C, HLA DRB1, DQA1, and HLA DQB1. Results The alleles HLA-B*57, HLA-C*15, HLA-DRB1*04:02, HLA-DRB1*08:04, HLA-DRB1*14:01, DQA1*03:01, DQB1*03:02, and DQB1*05:03 were associated with susceptibility. Alleles HLA DRB1*04:02 and HLA-DRB1*14:01 and their respective haplotypes DRB1*04-DQA1*03:01-DQB1*03:02, and DRB1*14-DQA1*01:01-DQB1*05:03 conferred a risk of the disease. Conclusions The DRB1*04:02 and DQB1*05:03 alleles are associated with pemphigus vulgaris in our study as well as in various populations. The association with HLA-DRB1*08:04 in our study was confirmed to be specific to this allele and not to linkage disequilibrium to any adjacent gene. The association between HLA-B*57 and pemphigus vulgaris is reported for the first time in the present study.
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- 2016
17. Allergic and Nonallergic Asthma Have Distinct Phenotypic and Genotypic Features
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Jorge Kalil, Helcio Rodrigues, Pedro Giavina-Bianchi, Marcelo Vivolo Aun, Rosana Câmara Agondi, and Priscila Takejima
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0301 basic medicine ,Adult ,Male ,Genotype ,Immunology ,Human leukocyte antigen ,Disease ,Immunoglobulin E ,LEUCÓCITOS ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,HLA Antigens ,Immunology and Allergy ,Medicine ,Humans ,Alleles ,Asthma ,Aged ,biology ,business.industry ,Haplotype ,Anti-Inflammatory Agents, Non-Steroidal ,General Medicine ,Atopic dermatitis ,Middle Aged ,medicine.disease ,Phenotype ,respiratory tract diseases ,030104 developmental biology ,030228 respiratory system ,biology.protein ,Female ,business ,Brazil - Abstract
Background: Identification of asthma phenotypes enables a better understanding and management of this heterogeneous disease. Studies have reported associations between human leukocyte antigens (HLA) and asthma in different populations, but the results have been inconclusive and they have rarely considered the distinct disease phenotypes. Our objective was to characterize allergic and nonallergic asthma phenotypes and evaluate possible associations with the HLA system. Methods: A total of 109 patients with asthma were prospectively followed during 2 years. They were divided into 2 groups, i.e., allergic and nonallergic asthma, according to their clinical history and skin prick test and serum-specific immunoglobulin E (IgE) results. The control group comprised 297 deceased donors of solid organs. Patients' features and HLA class I and II genotypes were assessed and compared. Results: This study showed different features between asthma phenotypes. Nonallergic patients were older at the onset of asthma symptoms and had a higher rate of intolerance to nonsteroidal anti-inflammatory drugs. Allergic patients had higher total serum IgE levels, reported atopic dermatitis and rhinoconjunctivitis more frequently, and, unexpectedly, had a greater disease severity. New associations between the HLA genotypes and allergic and nonallergic asthma were identified. The HLA-B*42, HLA-C*17, HLA-DPA1*03, and HLA-DPB1*105 genotypes were associated with allergic asthma and the HLA-B*48 genotype with the nonallergic phenotype. The presence of the haplotype HLA-DPA1*03 DQA*05 was associated with allergic asthma, and the presence of HLA-DPA1*03 and the absence of HLA-DQA*05 with nonallergic asthma. Conclusions: Allergic and nonallergic asthma have distinct phenotypic and genotypic features. New associations between asthma phenotypes and HLA class I and II were identified.
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- 2016
18. C4d staining in post-reperfusion renal biopsy is not useful for the early detection of antibody-mediated rejection when CDC crossmatching is negative
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Fernando Saito, A.C. Piovesan, Helcio Rodrigues, Patrícia de Almeida Rodrigues Silva e Souza, Ioannis M. Antonopoulos, Giordano F. Ginani, Elias David-Neto, Hideki Kanashiro, D. S. R. David, William C. Nahas, Renato Falci, and Maria Cristina Ribeiro de Castro
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Adult ,Cytotoxicity, Immunologic ,Graft Rejection ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Biopsy ,Kidney ,Immunofluorescence ,Peritubular capillaries ,Isoantibodies ,Complement C4b ,medicine ,Humans ,Prospective Studies ,Kidney surgery ,Transplantation ,medicine.diagnostic_test ,business.industry ,Histocompatibility Testing ,Middle Aged ,Kidney Transplantation ,Peptide Fragments ,Complement-dependent cytotoxicity ,medicine.anatomical_structure ,Nephrology ,Reperfusion ,Female ,Kidney Diseases ,Renal biopsy ,business - Abstract
Background Sensitized patients (pts) may develop acute antibody-mediated rejection (AMR) due to preformed donor-specific antibodies, undetected by pre-transplant complement-dependent cytotoxicity (CDC) crossmatch (XM). We hypothesized that C4d staining in 1-h post-reperfusion biopsies (1-h Bx) could detect early complement activation in the renal allograft due to preformed donor-specific antibodies. Methods To test this hypothesis, renal transplants (n = 229) performed between June 2005 and December 2007 were entered into a prospective study of 1-h Bx and stained for C4d by immunofluorescence. Transplants were performed against a negative T-cell CDC-XM with the exception of three cases with a positive B-cell XM. Results All 229 1-h Bx stained negative for C4d. Fourteen pts (6%) developed AMR. None of the 14 protocol 1-h Bx stained positive for C4d in peritubular capillaries (PTC). However, all indication biopsies-that diagnosed AMR-performed at a median of 8 days after transplantation stained for C4d in PTC. Conclusions These data show that C4d staining in 1-h Bx is, in general, not useful for the early detection of AMR when CDC-XM is negative.
- Published
- 2010
19. ANTICORPOS NÃO-HLA REATIVOS CONTRA AS CÉLULAS ENDOTELIAIS PODEM ESTAR ENVOLVIDOS NA PERDA PRECOCE DO ENXERTO RENAL
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N. Panajotopoulos, Maria Cristina Ribeiro de Castro, Denis Glotz, Jorge Kalil, Helcio Rodrigues, Ianhez Le, C. Viggiani, Elias David-Neto, William C. Nahas, C. Ronda, and D. S. R. David
- Subjects
medicine.diagnostic_test ,biology ,business.industry ,Negativity effect ,Immune monitoring ,medicine.disease ,Flow cytometry ,Transplant rejection ,Hybridoma cell ,Antigen ,Immunology ,medicine ,biology.protein ,Antibody ,business - Abstract
Há crescente evidência de que os anticorpos direcionados contra antígenos não-HLA presentes em células endoteliais estão associados à rejeição ao enxerto. Objetivos: 1. Verificar a presença de anticorpos anti-célula endotelial (AACE) nos eluatos de rins nefrectomizados após rejeição mediada por anticorpos não anti-HLA; 2. Verificar a possibilidade de detectar AACE em soros coletados no pré-transplante e antes da rejeição; 3. Verificar o potencial efeito inibitório da IVIG in vitro sobre os AACE. Métodos: Soros (absorvidos com pool de plaquetas) e eluatos provenientes de 12 aloenxertos renais foram testados por citometria de fluxo contra a linhagem EAHy.926 (hibridoma de célula epitelial com célula endotelial). Eluatos positivos foram testados com ou sem adição de imunoglobulina polivalente intravenosa (IVIg). Resultados: A ausência de anticorpos anti-HLA contra o doador foi verificada antes do transplante, da rejeição e antes e depois da transplantectomia, através de provas cruzadas utilizando a técnica de citotoxicidade dependente de complemento (CDC) com e sem anti-globulina humana. Em nove eluatos foram detectados anticorpos reativos contra a linhagem. Em 7/9 casos a marcação de C4d foi negativa. Tais anticorpos não foram detectados no soro pré-transplante. Contudo, 2/4 soros pré-rejeição foram positivos para AACE, e um foi considerado positivo fraco. Em 9 casos, a adição de IVIg resultou em forte diminuição na ligação dos AACE. Conclusões: Os AACE parecem estar envolvidos no processo de rejeição humoral. A detecção de tais anticorpos no soro pré-rejeição abre a possibilidade de um monitoramento imune. A utilização de IVIg para bloqueio da ligação desses anticorpos com a célula-alvo pode funcionar como uma possível terapia na rejeição humoral causada por AACE.
- Published
- 2008
20. The Absence of CYP3A5*3 Is a Protective Factor to Anticonvulsants Hypersensitivity Reactions: A Case-Control Study in Brazilian Subjects
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Jorge Kalil, Célia Yamaguti, Wagner F. Gattaz, Daniel S. Kerr, Leda Leme Talib, Luciana Kase Tanno, Helcio Rodrigues, and Bernardo dos Santos
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Adult ,Male ,Adolescent ,Genotype ,Drug allergy ,lcsh:Medicine ,Single-nucleotide polymorphism ,CYP2C19 ,Pharmacology ,Polymorphism, Single Nucleotide ,Drug Hypersensitivity ,Young Adult ,Medicine ,Cytochrome P-450 CYP3A ,Humans ,CYP3A5 ,lcsh:Science ,Cytochrome P-450 CYP2C9 ,Multidisciplinary ,business.industry ,lcsh:R ,Case-control study ,Correction ,Middle Aged ,medicine.disease ,Cytochrome P-450 CYP2C19 ,Tolerability ,Case-Control Studies ,Immunology ,lcsh:Q ,Anticonvulsants ,Female ,business ,Drug metabolism ,Brazil ,Research Article - Abstract
Although aromatic anticonvulsants are usually well tolerated, they can cause cutaneous adverse drug reactions in up to 10% of patients. The clinical manifestations of the antiepileptics-induced hypersensitivity reactions (AHR) vary from mild skin rashes to severe cutaneous drug adverse reactions which are related to high mortality and significant morbidity. Genetic polymorphisms in cytochrome P450 genes are associated with altered enzymatic activity and may contribute to the risk of AHR. Here we present a case-control study in which we genotyped SNPs of CYP2C19, 2C9 and 3A5 of 55 individuals with varying severities of AHR, 83 tolerant, and 366 healthy control subjects from Sao Paulo, Brazil. Clinical characterization was based on standardized scoring systems and drug patch test. All in vivo investigation followed the ENDA (European Network of Drug Allergy) recommendations. Genotype was determined by real time PCR using peripheral blood DNA as a template. Of all 504 subjects, 65% were females, 45% self-identified as Afro-American, 38% as Caucasian and 17% as having non-African mixed ascendancy. Amongst 55 subjects with AHR, 44 had severe cutaneous drug adverse reactions. Of the 46 drug patch tests performed, 29 (63%) were positive. We found a strong association between the absence of CYP3A5*3 and tolerant subjects when compared to AHR (p = 0.0002, OR = 5.28 [CI95% 2.09–14.84]). None of our groups presented positive association with CYP2C19 and 2C9 polymorphisms, however, both SNPs contributed to separation of cases and tolerants in a Classification and Regression Tree. Our findings indicate that drug metabolism genes can contribute in the tolerability of antiepileptics. CYP3A5*3 is the most prevalent CYP3A5 allele associated with reduced enzymatic function. The current study provides evidence that normal CYP3A5 activity might be a protective factor to aromatic antiepileptics-induced hypersensitivity reactions in Brazilian subjects.
- Published
- 2015
21. HLA-A*31 as a marker of genetic susceptibility to sepsis
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Fabiano Pinheiro da Silva, Germano Preuhs Filho, Eduardo Finger, Hermes Vieira Barbeiro, Fernando Godinho Zampieri, Alessandra Carvalho Goulart, Francisco Torggler Filho, Nicolas Panajotopoulos, Irineu Tadeu Velasco, Jorge Kalil, Heraldo Possolo de Souza, Luiz Monteiro da Cruz Neto, and Helcio Rodrigues
- Subjects
Inflammation ,Inflamacao ,Antigenos HLA-A ,Sepsis ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Marcadores geneticos ,Genetic markers ,Sepse ,HLA-A antigens ,lcsh:RC86-88.9 - Abstract
Objetivo: Haplótipos do HLA têm sido associados a muitas doenças autoimunes, mas não foi descrita qualquer associação na sepse. O objetivo desse estudo é investigar o sistema HLA como um possível marcador de suscetibilidade genética à sepse. Métodos: Estudo prospectivo de coorte, incluindo pacientes admitidos em unidade de terapia intensiva e controles-saudáveis obtidos em lista de doadores de transplante renal. Foram excluídos pacientes abaixo dos 18 anos de idade, gestantes ou HIV positivos, pacientes com doença maligna metastática ou sob quimioterapia, pacientes com hepatopatia avançada, com condições de fim de vida. O DNA foi extraído de sangue total, e a haplotipagem de HLA foi realizada com a tecnologia MiliPlex®. Resultados: Foram incluídos 1.121 pacientes (1.078 doadores de rim, 20 pacientes com sepse grave e 23 pacientes admitidos por choque séptico) entre outubro de 2010 e outubro de 2012. Os participantes positivos para HLA-A*31 tiveram risco aumentado de desenvolver sepse (OR: 2,36 IC95%: 1,26-5,35). Não foi identificada outra associação significativa, quando considerado como nível de significância o valor de p
- Published
- 2013
22. New Associations Between HLA Genotypes and Asthma Phenotypes
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Helcio Rodrigues, Marcelo Vivolo Aun, Priscila Takejima, Pedro Giavina-Bianchi, Jorge Kalil, and Rosana Câmara Agondi
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Asthma phenotypes ,Immunology ,Genotype ,Immunology and Allergy ,Human leukocyte antigen ,Biology - Published
- 2016
23. Non-human leukocyte antigen antibodies reactive with endothelial cells could be involved in early loss of renal allografts
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Elias David-Neto, Jorge Kalil, C. Viggiani, Ianhez Le, Denis Glotz, Suzete C. Ferreira, Maria Cristina Ribeiro de Castro, Helcio Rodrigues, William C. Nahas, N. Panajotopoulos, C. Ronda, Susan C. P. Borba, and S.R. David Daisa
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Graft Rejection ,Pathology ,medicine.medical_specialty ,Anti-nuclear antibody ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Antibodies ,Cell Line ,Antigen ,medicine ,Humans ,Transplantation, Homologous ,Transplantation ,Kidney ,biology ,business.industry ,Histocompatibility Testing ,Histocompatibility Antigens Class I ,Panel reactive antibody ,SISTEMA IMUNE ,Endothelial Cells ,Immunoglobulins, Intravenous ,Cytotoxicity Tests, Immunologic ,Flow Cytometry ,Kidney Transplantation ,Immunity, Humoral ,Endothelial stem cell ,medicine.anatomical_structure ,Treatment Outcome ,Immunology ,biology.protein ,Surgery ,Antibody ,business ,Brazil - Abstract
Preformed donor-specific human leukocyte antigen (HLA) antibodies have been associated with allograft dysfunction and failure. However, recipients of HLA-identical kidneys can develop acute humoral rejection, implicating putative pathogenic antibodies that are directed against non-HLA antigens. We investigated the presence of endothelial cell-reactive antibodies in 11 patients who experienced early loss of their transplanted kidneys owing to humoral rejection and 1 loss from renal venal thrombosis. We examined the potential efficacy of intravenous immunoglobulin to block the binding of these antibodies, as previously suggested for anti-HLA antibodies.
- Published
- 2011
24. HLA-DRB1*04:02, DRB1*08:04 and DRB1*14 alleles associated to pemphigus vulgaris in southeastern Brazilian population
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Ivan Dieb Miziara, Francisco Antonio Monteiro, Jorge Kalil, G. Preuhs-Filho, Raimar Weber, and Helcio Rodrigues
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Immunology ,Oligonucleotides ,Human leukocyte antigen ,Biology ,Polymerase Chain Reaction ,Biochemistry ,Cohort Studies ,Bone Marrow ,HLA Antigens ,Genetics ,medicine ,Humans ,Immunology and Allergy ,False Positive Reactions ,Prospective Studies ,Allele ,Fluorescent Antibody Technique, Indirect ,Alleles ,Models, Statistical ,Hla drb1 04 ,Haplotype ,Pemphigus vulgaris ,General Medicine ,medicine.disease ,Pemphigus ,Haplotypes ,Case-Control Studies ,BRASIL ,Brazilian population ,Brazil ,HLA-DRB1 Chains - Published
- 2011
25. Influence of single-nucleotide polymorphisms on C-reactive protein levels in chronic kidney disease before and after kidney transplantation
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Anói Castro Cordeiro, L M. Pereira, Jorge Kalil, João Egidio Romão, Helcio Rodrigues, Rajendranath Ramasawmy, Elias David-Neto, Ianhez Le, Susan C. P. Borba, Roberto Pecoits-Filho, Hugo Abensur, and I. de Castro
- Subjects
Adult ,Male ,medicine.medical_specialty ,Genotype ,Single-nucleotide polymorphism ,Polymorphism, Single Nucleotide ,Internal medicine ,Cadaver ,Medicine ,Humans ,Allele ,Promoter Regions, Genetic ,Kidney transplantation ,DNA Primers ,Transplantation ,Kidney ,Polymorphism, Genetic ,biology ,business.industry ,C-reactive protein ,Acute-phase protein ,Genetic Variation ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Tissue Donors ,Endocrinology ,medicine.anatomical_structure ,C-Reactive Protein ,biology.protein ,Kidney Failure, Chronic ,Surgery ,Female ,business ,Kidney disease ,Follow-Up Studies - Abstract
Introduction. We sought to evaluate 2 single-nucleotide polymorphisms (SNPs) in the C-reactive protein (CRP) gene promoter region for their effects on CRP levels in chronic kidney disease (CKD) patients before and after a successful kidney transplantation. Methods. Fifty CKD patients were evaluated before and at the first and second years after the graft. Two SNPs were studied, a bi-allelic (GiA) at the 409 and a tri-allelic (CiTiA) variation at the 390 position in the CRP gene. Results. All patients presented the 409GG genotype. At the 390 position, the “A” allele was not found; there were 15 “CC” patients, 11 “TT” patients, and 24 “CT” patients. CRP levels were different among patients with various genotypes (P .019). Also the presence of the allele “T” was sufficient to determine differences in CRP levels both in pretransplantation (P .045) and at 1 year posttransplantation (P .011), but not at the second year (P .448). Conclusion. SNPs at the 390 position of the CRP gene promoter region influence CRP basal levels in such a way that the “C” allele correlated with the lowest and the “T” with the highest. We did not observe this influence in our patients at the second year posttransplantation.
- Published
- 2008
26. Identification of novel consensus CD4 T-cell epitopes from clade B HIV-1 whole genome that are frequently recognized by HIV-1 infected patients
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Jorge Kalil, Sandra Lúcia de Moraes, Juergen Hammer, Edecio Cunha-Neto, John Sidney, Luiz Augusto Marcondes Fonseca, Helcio Rodrigues, Aluísio Augusto Cotrim Segurado, Adriana Coutinho-Silva, Alessandro Sette, Simone G. Fonseca, Esper G. Kallas, Universidade de São Paulo (USP), Hoffmann La Roche Inc, Universidade Federal de São Paulo (UNIFESP), and La Jolla Inst Allergy & Immunol
- Subjects
Adult ,CD4-Positive T-Lymphocytes ,Male ,In silico ,Immunology ,Enzyme-Linked Immunosorbent Assay ,HIV Infections ,Human leukocyte antigen ,Genome, Viral ,Biology ,Genome ,Peripheral blood mononuclear cell ,Epitope ,HLA binding ,Epitopes ,Interferon-gamma ,Viral Proteins ,vaccine ,Consensus Sequence ,Consensus sequence ,Immunology and Allergy ,Humans ,CD4+T cell epitopes ,Aged ,Genetics ,ELISPOT ,HLA-DR Antigens ,Middle Aged ,Virology ,CD4 Lymphocyte Count ,Infectious Diseases ,conserved ,consensus ,HIV-1 ,Leukocytes, Mononuclear ,Female ,Peptides ,CD8 ,Algorithms - Abstract
Objective: To identify promiscuous and potentially protective human CD4 T-cell epitopes in most conserved regions within the protein-coding genome of HIV-1 clade B consensus sequence.Design: We used the TEPITOPE algorithm to screen the most conserved regions of the whole genome of the HIV-1 subtype B consensus sequence to identify promiscuous human CD4 T-cell epitopes in HIV-1. the actual promiscuity of HLA binding of the 18 selected peptides was assessed by binding assays to nine prevalent HLA-DR molecules. Synthetic peptides were tested with interferon-gamma ELISPOT assays on peripheral blood mononuclear cells (PBMC) from 38 HIV-1 infected patients and eight uninfected controls.Results: Most peptides bound to multiple HLA-DR molecules. PBMC from 91% of chronically HIV-1 infected patients recognized at least one of the promiscuous peptides, while none of the healthy controls recognized peptides. All 18 peptides were recognized, and each peptide was recognized by at least 18% of patients; 44% of the patients recognized five or more peptides. This response was not associated to particular HLA-DR alleles. Similar responses were obtained in CD8 T-cell-depleted PBMC.Conclusion: in silico prediction of promiscuous epitopes led to the identification of naturally immunodominant CD4 T-cell epitopes recognized by PBMC from a significant proportion of a genetically heterogeneous patient population exposed to HIV-1. This combination of CD4 T-cell epitopes-11 of them not described before-may have the potential for inclusion in a vaccine against HIV-1, allowing the immunization of genetically distinct populations. (c) 2006 Lippincott Williams & Wilkins. Univ São Paulo, Sch Med, Heart Inst Incor, Immunol Lab, BR-05403000 São Paulo, Brazil Univ São Paulo, Sch Med, Div Clin Immunol & Allergy, Dept Med, BR-05403000 São Paulo, Brazil Univ São Paulo, Sch Med, Dept Infect Dis, BR-05403000 São Paulo, Brazil Univ São Paulo, Inst Trop Med, BR-05403000 São Paulo, Brazil Hoffmann La Roche Inc, Dept Genom & Informat Sci, Nutley, NJ 07110 USA Universidade Federal de São Paulo, Div Infect & Parasit Dis, São Paulo, Brazil La Jolla Inst Allergy & Immunol, San Diego, CA USA Universidade Federal de São Paulo, Div Infect & Parasit Dis, São Paulo, Brazil Web of Science
- Published
- 2006
27. Desensitization using IVIG alone for living-donor kidney transplant: impact on donor-specific antibodies
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Luiz Roberto de Sousa Ulisses, Jenaine Oliveira Paixão, Fabiana Agena, Patrícia Soares de Souza, Flávio J Paula, Gislene Bezerra, Hélcio Rodrigues, Nicolas Panajotopolous, Elias David-Neto, and Maria Cristina Ribeiro de Castro
- Subjects
Antibodies ,HLA Antigens ,Living Donors ,Graft Rejection ,Histocompatibility Testing ,Kidney Transplantation ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Introduction: Sensitization to human leukocyte antigen is a barrier to. Few data have been published on desensitization using polyvalent human intravenous immunoglobulin (IVIG) alone. Methods: We retrospectively reviewed the of 45 patients with a positive complement-dependent cytotoxicity crossmatch (CDCXM) or flow cytometry crossmatch (FCXM) against living donors from January 2003 to December 2014. Of these, 12 were excluded. Patients received monthly IVIG infusions (2 g/kg) only until they had a negative T-cell and B-cell FCXM. Results: During the 33 patients, 22 (66.7%) underwent living donor kidney transplantation, 7 (21.2%) received a deceased donor graft, and 4 (12.1%) did not undergo transplantation. The median class I and II panel reactive antibodies for these patients were 80.5% (range 61%-95%) and 83.0% (range 42%-94%), respectively. Patients (81.8%) had a positive T-cell and/or B-cell CDCXM and 4 (18.2%) had a positive T-cell and/or B-cell FCXM. Patients underwent transplantation after a median of 6 (range 3-16). The median donor-specific antibody mean fluorescence intensity sum was 5057 (range 2246-11,691) before and 1389 (range 934-2492) after desensitization (p = 0.0001). Mean patient follow-up time after transplantation was 60.5 (SD, 36.8) months. Nine patients (45.0%). Death-censored graft survival at 1, 3, and 5 years after transplant was 86.4, 86.4, and 79.2%, respectively and patient survival was 95.5, 95.5, and 83.7%, respectively. Conclusions: Desensitization using IVIG alone is an effective strategy, allowing successful transplantation in 87.9% of these highly sensitized patients.
- Published
- 2022
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28. Pre- and Posttransplant Monitoring of Alloantibodies by Complement-Dependent Cytotoxicity and Luminex Methodologies in Liver Transplantation
- Author
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Jorge Kalil, Maria Cristina Ribeiro de Castro, N. Panajotopoulos, Francisco Antonio Monteiro, Helcio Rodrigues, Sérgio Mies, M. Paredes, and P. Massarolo
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Cytotoxicity, Immunologic ,Graft Rejection ,Graft dysfunction ,Time Factors ,T-Lymphocytes ,medicine.medical_treatment ,Human leukocyte antigen ,Liver transplantation ,Fluorescence ,Microsphere ,HLA Antigens ,Isoantibodies ,Monitoring, Immunologic ,Predictive Value of Tests ,medicine ,Humans ,Cytotoxicity ,Complement Activation ,ANTICORPOS ,B-Lymphocytes ,Transplantation ,biology ,business.industry ,Histocompatibility Testing ,Cytotoxicity Tests, Immunologic ,equipment and supplies ,Complement-dependent cytotoxicity ,Liver Transplantation ,respiratory tract diseases ,Treatment Outcome ,Histocompatibility ,Immunology ,biology.protein ,Surgery ,Antibody ,business ,Antibody screening ,Biomarkers - Abstract
Background This study evaluated the influence of circulating anti-HLA antibodies on outcomes of 97 liver allografts from deceased donors. Methods Human leukocyte antigen (HLA) antibody screening was performed by both complement-dependent cytotoxicity (CDC) and multiparameter Luminex microsphere-based assays (Luminex assay). Results The agreements between T- and B- cell CDC and Luminex assays were 67% and 77% for pre- and posttransplant specimens, respectively. Graft dysfunction was not associated with either positive pretransplant CDC or Luminex panel-reactive antibody (PRA) values. Likewise, positive posttransplant T- or B- cell CDC PRA values were not associated with graft dysfunction. In contrast, posttransplant Luminex PRA values were significantly higher among patients with graft dysfunction compared with subjects with good outcomes ( P = .017). Conclusion Posttransplant monitoring of HLA antibodies with Luminex methodology allowed identification of patients at high-risk for poor graft outcomes.
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- 2012
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29. Monitoring of soluble HLA class I in liver transplant recipients: correlation with transplant-related complications
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Jorge Kalil, Sérgio Mies, P. Massarolo, Francisco Antonio Monteiro, Helcio Rodrigues, N. Panajotopoulos, Silvano Raia, and C. Viggiani
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Adult ,Graft Rejection ,Male ,Transplantation ,Adolescent ,business.industry ,Histocompatibility Antigens Class I ,Middle Aged ,Bioinformatics ,Class (biology) ,Sensitivity and Specificity ,Liver Transplantation ,Text mining ,Soluble hla ,Postoperative Complications ,Immunology ,Medicine ,Humans ,Surgery ,Female ,business ,Complication - Published
- 2002
30. Polymorfism Of CYP2C9 And 3A5 and carbamazepine hypersensitivity reactions in Brazilian subjects
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Daniel S. Kerr, Jorge Kalil, Helcio Rodrigues, Luciana Kase Tanno, Wagner F. Gattaz, Leda Leme Talib, and Bernardo dos Santos
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Drug ,Pulmonary and Respiratory Medicine ,education.field_of_study ,Allergy ,business.industry ,media_common.quotation_subject ,Population ,Drug allergy ,Immunology ,Patch test ,medicine.disease ,Poster Presentation ,Medicine ,SNP ,Immunology and Allergy ,Allele ,business ,education ,CYP2C9 ,media_common - Abstract
Background The cytochrome P450 2C9 and 3A5 enzymes are predominantly found in the human liver, and have important functions in the metabolism of antiepileptics. Genetic polymorphisms in these genes are associated with altered enzymatic activities and may give rise to the risk of drug hypersensitivity. Therefore, we analyze the association between CBZ hypersensitivity reactions (CHR) and polymorphisms of CYP2C9 and 3A5 in a population of Sao Paulo, Brazil. Methods Case-control study in which we genotyped the SNP of CYP2C9 (rs1057910, rs1799853) and 3A5 (rs776746) of samples obtained from 52 subjects with varying severities CHR, 82 tolerants, and 366 control subjects, all from Sao Paulo, Brazil. According to the alleles presente, each subject was classified as normal, decrease or increased funcion for the enzyme. The phenotype was evaluated based on standardized scoring systems using an adapted ENDA (European Network of Drug Allergy) questionnaire, medical records and on the clinical follow-up. The patch test with the culprit drug was performed according the ENDA recommendations.
- Published
- 2014
31. The Kinetics of HLA Antibodies After Kidney Transplantation - the Impact On Acute Rejection and Graft Loss
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Elias David-Neto, P. S. Souza, D. S. R. David, Fabiana Agena, Willian Nahas, Erick A. Barbosa, N. Panajotopoulos, Helcio Rodrigues, G. Maciel, Ribeiro M. de Castro, and Renata T M P de Souza
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Transplantation ,business.industry ,Kinetics ,Immunology ,Medicine ,Hla antibodies ,business ,Graft loss ,medicine.disease ,Kidney transplantation - Published
- 2014
32. Clinical significance of donor-specific alloantibodies in liver transplant recipients
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Jorge Kalil, Sérgio Mies, Silvano Raia, Helcio Rodrigues, C. Viggiani, P. Massarolo, Regina Maria Cubero Leitão, G. Preuhs, Francisco Antonio Monteiro, and N. Panajotopoulos
- Subjects
Adult ,Graft Rejection ,Male ,Lymphocyte ,Text mining ,Immune system ,Isoantibodies ,medicine ,Ethnicity ,Humans ,Clinical significance ,Retrospective Studies ,Transplantation ,biology ,business.industry ,Histocompatibility Testing ,Graft Survival ,Tissue Donors ,Liver Transplantation ,Survival Rate ,medicine.anatomical_structure ,Treatment Outcome ,Immunoglobulin M ,Immunoglobulin G ,Immunology ,biology.protein ,Surgery ,Female ,Antibody ,business - Published
- 1999
33. Relevance of positive B-cell crossmatch in renal transplantation with living donors
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Helcio Rodrigues, Ianhez Le, C. Viggiani, Claudia B. Rosales, Jorge Kalil, and N. Panajotopoulos
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Reoperation ,Transplantation ,Kidney ,B-Lymphocytes ,B cell crossmatch ,Time Factors ,business.industry ,Histocompatibility Testing ,Graft Survival ,Living donor ,Kidney Transplantation ,Hyperimmunization ,medicine.anatomical_structure ,Treatment Outcome ,Immunoglobulin M ,Immunoglobulin G ,Immunology ,Living Donors ,Medicine ,Humans ,Surgery ,business ,Retrospective Studies - Published
- 1999
34. CLINICAL IMPLICATIONS OF THE MONITORING OF ANTI-HLA ANTIBODIES AFTER KIDNEY TRANSPLANTATION
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Maria Cristina Ribeiro de Castro, Fabiana Agena, Helcio Rodrigues, D. S. R. David, Jorge Kalil, P. S. Souza, C. Ronda, N. Panajotopoulos, Elias David-Neto, and Ianhez Le
- Subjects
Nephrology ,Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,Immunology ,medicine ,Hla antibodies ,medicine.disease ,business ,Artificial kidney ,Kidney transplantation - Published
- 2008
35. NON-HLA ANTIBODIES REACTIVE WITH ENDOTHELIAL CELLS COULD BE INVOLVED IN EARLY LOSS OF RENAL ALLOGRAFTS
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Maria Cristina Ribeiro de Castro, Jorge Kalil, Helcio Rodrigues, D. S. R. David, N. Panajotopoulos, C. Viggiani, E Ianhez, Suzete C. Ferreira, Denis Glotz, and C. Ronda
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Transplantation ,Vasculogenesis ,business.industry ,Non hla antibodies ,Immunology ,Medicine ,business - Published
- 2008
36. Identification of patients at high risk of graft loss by pre- and posttransplant monitoring of anti-HLA class I IgG antibodies by enzyme-linked immunosorbent assay
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Helcio Rodrigues, Roland Buelow, Francisco Antonio Monteiro, Jorge Kalil, and Carlos Mineiro
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Allosensitization ,medicine.medical_treatment ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Gastroenterology ,Risk Factors ,Internal medicine ,medicine ,Humans ,Risk factor ,Dialysis ,Retrospective Studies ,Transplantation ,Kidney ,biology ,business.industry ,Graft Survival ,Histocompatibility Antigens Class I ,Panel reactive antibody ,Kidney Transplantation ,medicine.anatomical_structure ,Immunoglobulin G ,Immunology ,biology.protein ,Female ,Antibody ,business - Abstract
Identification of risk factors influencing graft survival may lead to the development of models to predict graft outcome. Such models may provide guidance for immunosuppressive therapy, measure posttransplantation outcome, and eventually improve graft survival in high-risk patients. A major risk factor influencing graft survival is allosensitization. However, due to the lack of standardization of lymphocytotoxicity assays, the detection of alloantibodies utilizing this current methodology may not correlate with posttransplant events. Recently, a novel standardized enzyme-linked immunosorbent assay (ELISA) for the detection of anti-HLA class I IgG antibodies was developed. To evaluate the predictive value of this diagnostic test, a retrospective analysis of 124 renal allograft recipients with an 18-month follow-up time was performed. A highly significant (P=0.01) correlation between pre-transplant ELISA panel reactive antibody (PRA) results and graft loss was observed. Patients with pre-transplant ELISA PRA of >10% had a three times higher risk of graft loss compared with patients who tested negative. No such correlation was observed with complement-dependent cytotoxicity results independent of the reduction of IgM antibodies with dithiothreitol. Similarly, a highly significant correlation of ELISA results with the occurrence of early graft dysfunction was observed. Almost all patients (88%) with a pretransplant ELISA PRA of >50% required posttransplant dialysis, compared with 45% of patients with a pretransplant ELISA PRA of 10-50% and 27% of patients with a pretransplant ELISA PRA of
- Published
- 1997
37. Pretransplant and posttransplant monitoring of anti-HLA class I IgG1 antibodies by ELISA identifies patients at high risk of graft loss
- Author
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Jorge Kalil, Helcio Rodrigues, Francisco Antonio Monteiro, Carlos Mineiro, and F.J. de Paula
- Subjects
Cytotoxicity, Immunologic ,Graft Rejection ,Time Factors ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Graft loss ,Immunoglobulin E ,Isoantibodies ,Predictive Value of Tests ,Medicine ,Treatment Failure ,Monitoring, Physiologic ,Retrospective Studies ,Transplantation ,Kidney ,Analysis of Variance ,biology ,business.industry ,Graft Survival ,Histocompatibility Antigens Class I ,Kidney Transplantation ,medicine.anatomical_structure ,Immunoglobulin G ,Immunology ,biology.protein ,Surgery ,Antibody ,business ,Follow-Up Studies - Published
- 1997
38. Non-HLA (Megalin?) Antibodies in Kidney Transplantation
- Author
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L. V. Rizzo, Helcio Rodrigues, Susan C. P. Borba, Jorge Kalil, N. Panajotopoulos, Elias David-Neto, R. Giordano, Maria Cristina Ribeiro de Castro, Willian Nahas, and C. Ronda
- Subjects
Transplantation ,biology ,business.industry ,Immunology ,biology.protein ,Medicine ,Human leukocyte antigen ,Antibody ,business ,medicine.disease ,Kidney transplantation - Published
- 2012
39. POST-TRANSPLANT HLA ANTIBODIES DETECTED BY LUMINEX DONOR-SPECIFIC CROSSMATCH CORRELATE WITH POOR LIVER GRAFT OUTCOME
- Author
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Sérgio Mies, Francisco Antonio Monteiro, P. Massarolo, J. E. Kalil-Filho, M. Paredes, and Helcio Rodrigues
- Subjects
Liver graft ,Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,Medicine ,Hla antibodies ,business ,Gastroenterology ,Post transplant - Published
- 2010
40. IS POSTTX DSA (DONOR-SPECIFIC ANTIBODIES), IN PATIENTS WHO SURVIVE THE FIRST 6 MONTHS, DELETERIOUS TO THE LONG-TERM? OUTCOME? A FIVE-YEAR ANALYSIS
- Author
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R. Rocha, Helcio Rodrigues, F. Lemos, Carlucci Gualberto Ventura, G. Preuhs, J. E. Kalil-Filho, P. S. Souza, K. M. Takaki, N. Panajotopoulos, L. M. Fadel, Elias David-Neto, Maria Cristina Ribeiro de Castro, W. C. Nahas, and Fabiana Agena
- Subjects
Transplantation ,Pediatrics ,medicine.medical_specialty ,business.industry ,Donor specific antibodies ,Medicine ,In patient ,business ,Outcome (game theory) ,Term (time) - Published
- 2010
41. IS PRE-TRANSPLANT DSA ALWAYS DELETERIOUS TO THE RENAL ALLOGRAFT?
- Author
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Helcio Rodrigues, G. Preuhs, R. Rocha, F. Lemos, K. M. Takaki, N. Panajotopoulos, Carlucci Gualberto Ventura, Maria Cristina Ribeiro de Castro, W. C. Nahas, Fabiana Agena, P. S. Souza, L. M. Fadel, Elias David-Neto, and D. S. R. David
- Subjects
Transplantation ,medicine.medical_specialty ,business.industry ,Urology ,Renal allograft ,Medicine ,business - Published
- 2010
42. Clinical significance of skin crossmatch in kidney transplantation
- Author
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R.A. Silva, Z.N.P. Oliveira, Jorge Kalil, N. Panajotopoulos, Ianhez Le, Helcio Rodrigues, W. C. Nahas, and L.M.I. Fukumori
- Subjects
Pathology ,medicine.medical_specialty ,T-Lymphocytes ,Immunofluorescence ,Bioinformatics ,Sensitivity and Specificity ,Text mining ,medicine ,Humans ,Clinical significance ,Treatment Failure ,Selection (genetic algorithm) ,Kidney transplantation ,Skin ,B-Lymphocytes ,Transplantation ,Kidney ,medicine.diagnostic_test ,business.industry ,Histocompatibility Testing ,medicine.disease ,Kidney Transplantation ,Predictive factor ,Treatment Outcome ,medicine.anatomical_structure ,Surgery ,business - Published
- 1999
43. RENAL TRANSPLANTATION USING LIVING DONORS WITH A POSITIVE CROSSMATCH: CAN WE PREDICT EFFICACY OF DESENSITIZATION WITH IVIG BY AN 'IN VITRO' TEST?
- Author
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N. Panajotopoulos, Ianhez Le, C. Viggiani, C. Ronda, R Maciel, J Kalil Filho, L Mp Araújo, Willian Nahas, Denis Glotz, Helcio Rodrigues, M Cr Castro, and Elias David-Neto
- Subjects
Transplantation ,In vitro test ,business.industry ,medicine.medical_treatment ,Immunology ,medicine ,business ,Positive crossmatch ,Desensitization (medicine) - Published
- 2004
44. Influence of pretransplant allosensitization in cardiac transplant outcome
- Author
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Francisco Antonio Monteiro, Jorge Kalil, N. Stolf, Alfredo Inácio Fiorelli, C. Viggiani, and Helcio Rodrigues
- Subjects
Graft Rejection ,Male ,Oncology ,medicine.medical_specialty ,Allosensitization ,T-Lymphocytes ,Outcome (game theory) ,Text mining ,Isoantibodies ,Monitoring, Immunologic ,Internal medicine ,Ethnicity ,medicine ,Humans ,Retrospective Studies ,Transplantation ,business.industry ,Histocompatibility Testing ,Graft Survival ,Survival Analysis ,Surgery ,Predictive factor ,Treatment Outcome ,Immunoglobulin G ,Heart Transplantation ,Female ,business - Published
- 1999
45. Crossmatch testing of organ donors and recipients by cross-stat elisa: Clinical relevance of test results
- Author
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Francisco Antonio Monteiro, Jorge Kalil, and Helcio Rodrigues
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Internal medicine ,Immunology ,medicine ,Immunology and Allergy ,Clinical significance ,General Medicine ,business ,stat ,Test (assessment) - Published
- 1996
46. Allospecific IgM: Clinical significance in first grafts and regrafts
- Author
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N. Panajotopoulos, Maria Lucia C. Marin, Jorge Kalil, Helcio Rodrigues, C. Viggiani, E. Sabbaga, F.J. Paula, and Luiz Estevam Ianhez
- Subjects
business.industry ,Immunology ,Immunology and Allergy ,Medicine ,Clinical significance ,General Medicine ,business - Published
- 1994
47. A new technique to increase sensitivity of microlymphocytotoxicity test using polyethylene glycol
- Author
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Jorge Kalil, N. Panajotopoulos, C. Viggiani, K. Portugal, A.B. Khoury, Helcio Rodrigues, and A. Lima
- Subjects
chemistry.chemical_compound ,Materials science ,Chromatography ,chemistry ,Immunology ,Immunology and Allergy ,General Medicine ,Sensitivity (control systems) ,Polyethylene glycol - Published
- 1994
48. Relevance of positive B-cell crossmatch in renal transplantation
- Author
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F.J. Paula, Helcio Rodrigues, C. Viggiani, N. Panajotopoulos, Luiz Estevam Ianhez, Maria Lucia C. Marin, E. Sabbaga, and Jorge Kalil
- Subjects
Oncology ,Transplantation ,medicine.medical_specialty ,B cell crossmatch ,business.industry ,Internal medicine ,Immunology ,medicine ,Immunology and Allergy ,General Medicine ,Session (computer science) ,business - Published
- 1994
49. The Kinetics of Anti-HLA Antibodies in the First Year after Kidney Transplantation: In Whom and When Should They Be Monitored?
- Author
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Maria Cristina Ribeiro de Castro, Erick A. Barbosa, Renata P. Souza, Fabiana Agena, Patrícia S. de Souza, Gabriella Maciel, Hélcio Rodrigues, Nicolas Panajotopoulos, Daísa S. David, Flávio J. de Paula, and Elias David-Neto
- Subjects
Surgery ,RD1-811 - Abstract
The impact of the kinetics of the anti-HLA antibodies after KTx on the occurrence of acute rejection as well as the better time-point to monitor anti-HLA Abs after transplantation is not completely defined. This prospective study followed 150 patients over 12 months after transplantation. Serum IgG anti-HLA Abs were detected by single antigen beads after typing donors and recipients for loci A, B, C, DR, and DQ. Before KTx, 89 patients did not present anti-HLA Abs and 2% developed “de novo” Abs during the 1st year, 39 patients were sensitized without DSAs, and 13% developed DSA after surgery; all of them presented ABMR. Sensitized patients presented higher acute rejection rates (36.4% versus 13.5%, p
- Published
- 2018
- Full Text
- View/download PDF
50. Monitoring of IgG anti-HLA class I by PRA-STAT and graft outcome
- Author
-
Francisco Antonio Monteiro, Carlos Mineiro, Jorge Kalil, and Helcio Rodrigues
- Subjects
business.industry ,Immunology ,Immunology and Allergy ,Medicine ,General Medicine ,Human leukocyte antigen ,business ,Outcome (game theory) ,Class (biology) ,stat
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