Browsing by Author "Lima, Bruno"
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- Associação de genes HLA e não HLA com a suscetibilidade para a sarcoidose na população portuguesa do nortePublication . Alves, Helena; Lima, Bruno; Morais, António
- Cytokine gene polymorphisms in Pigeon Breeder's Disease expressionPublication . Freitas, Cláudia; Lima, Bruno; Martins, Natália; Melo, Natália; Mota, Patrícia; Novais-Bastos, Hélder; Alves, Helena; Sokhatska, Oksana; Delgado, Luís; Morais, AntónioBackground: Exaggerated immunological response to repeated inhalation of organic or chemical dusts may lead to Hypersensitivity Pneumonitis among sensitized individuals. Only a few exposed individuals became ill and disease expression pattern is highly variable which suggest that genetic factors may play a role. Aim: To investigate interferon (IFN)-γ, tumour necrosis factor (TNF)-α, interleukin (IL)-6, transforming growth factor (TGF)-ß, and IL-10 gene polymorphisms in a cohort of pigeon breeder's disease (PBD) patients in comparison with exposed but healthy controls and the association with different patterns of disease. Methods: We evaluated 40 PBD patients and 70 exposed controls. IFN-γ, TNF-α, IL-6, TGF-ß, and IL-10 polymorphisms were determined by polymerase chain reaction-sequence specific primer amplification. Results: Polymorphism analysis of IFN-γ, TNF-α, IL-6, TGF-ß, and IL-10 genotypes and allele frequencies showed no differences between patients and controls. IFN-γ T/T genotype frequency was increased among patients with chronic presentation (RR=2.33, p=0.047) compared with those with acute/subacute presentation. Also, chronic presenting patients had an increased frequency of IFN-γ T allele (50% vs 22.5%, RR=1.76, p=0.011). No differences were found in TNF-α, IL-6, TGF-ß, and IL-10 genotypes neither allelic frequencies between both groups of patients. IL-6 C/C genotype was more frequent in patients who showed chronic evolution (RR=2.54, p=0.017), when comparing with patients with disease resolution. Conclusion: IFN-γ T/T and the IL-6 C/C genotypes seem to play a role in HP expression due to avian exposure, as their frequencies are increased in chronic presentations or in those with chronic evolution one year after the initial diagnosis, respectively. (Sarcoidosis Vasc Diffuse Lung Dis 2020; 37 (3): e2020004).
- Interleukine-6 promoter polymorphism -174g/C association with chronic nephropathy of the graft: a meta-analysisPublication . Lima, Bruno; Mendes, Miguel; Alves, HelenaDespite being the subject of several independent studies, the relationship between Interleukine-6 (IL-6) polymorphisms and kidney graft outcome continue to be plagued by contradictory conclusions. In this meta-analysis we collect all the relevant studies to further clarify the association of IL-6 genotypes and Chronic Nephropathy of the Graft (CNG). Relevant published data was retrieved through Medline with references to kidney transplant outcome and IL-6 polymorphisms. Odds ratios (OR) with 95% confidence intervals (CI) were used to assess the strength of the association. Z test was used to determine the significance of the pooled OR. Statistical heterogeneity was measured using the Q statistic. A total of 6 studies, including 474 transplanted patients with CNG and 731 transplanted patients as control group with stable graft function, were collected. The distribution of IL-6 polymorphims was evaluated and no heterogeneity was observed among individual estimates. Original data was combined using the fixed-effects model. For the total population, we found that G/G and G/C IL-6 genotypes were less common in the CNG group than in the control group with an OR of 0.61, (95 % CI=0.42–0.87), and p=0.006, which shows a protective association of IL-6 high producers genotypes in the CNG group. IL-6 is both a major proinflammatory cytokine and an important anti-inflammatory mediator, these complex actions would yield variable effects on atherosclerosis and cardiovascular risk profile in kidney transplant recipients. Our comprehensive meta-analysis indicated that there is sufficient evidence to demonstrate an association between the IL-6 polymorphisms and CNG after kidney transplantation.
- Interleukine-6 promoter polymorphism -174G/C is not associated with acute rejection episodes after kidney transplantation: a meta-analysisPublication . Lima, Bruno; Mendes, Miguel; Alves, HelenaProinflammatory and anti-inflammatory cytokines play key roles in immunologic phenomena leading to Acute Rejection Episodes (ARE) after kidney transplantation which are responsible for kidney graft loss. In particular, interleukin-6 (IL-6), regulates the immune response by acting on various cells including differentiation and maturation of B and T cells or macrophages. This investigation seek to summarize current knowledge on the clinical impact on ARE of IL-6 -174G/C polymorphisms. Relevant published data was retrieved through Medline pertaining to kidney transplant outcome and IL-6 polymorphisms. Odds ratios (OR) with 95 % confidence intervals (CI) were used to assess the strength of the association. Z test was used to determine the significance of the pooled OR. Statistical heterogeneity was measured using the Q statistic. The effect of heterogeneity was quantified using the I2-statistic. A total of 16 studies, including 672 ARE transplanted cases and 1290 transplanted controls without rejection episodes, were collected in this meta-analysis. For high vs. low IL-6 genotypes, no heterogeneity (Q =12.07, p=0.67, I2 =0.0%) was observed among individual estimates, and original data was combined using the fixed-effects model. For the total population, we found no association between G/G and G/C IL-6 genotypes with ARE, we obtained an effect summary OR=1.14, with a 95 % CI=0.84-1.55, and p=0.4. In conclusion, in recipients with a high producer (G/G and G/C) genotype of IL-6, the -174G/C polymorphism is not associated with acute rejection of renal allograft.
- Seeking transparency on allocation of kidneys from deceased donorsPublication . Lima, Bruno; Mendes, Miguel; Alves, HelenaKidney transplantation is the preferred treatment for many end stage renal disease patients; however, the small number of organs for transplantation does not allow all patients to have access to this scarce resource. An allocation system for deceased donor kidneys should be anchored to transparent policies and rules. It should take into account the relationship between supply and demand, hence seeking a balance between the higher net benefit of survival that can be provided by a particular organ and the transplant candidates’ waiting time (as well as the probability of being transplanted).
- Transplant Open Registry InitiativePublication . Lima, Bruno; Henriques, Teresa; Reis, Filipe; Alves, HelenaHealth data science aims to extract knowledge from data allowing better decision-making, using multidisciplinary approaches from fields such as computation, statistics, epidemiology, and several medical knowledge domains. We live in the ‘big data’ era, with a growing availability of health data, in volume, variety, and velocity, also for tasks such as kidney transplantation. Hereby, secondary use of this health data must be encouraged to improve patient care planning, disease research, and policymaking around transplantation. This article presents the Transplant Open Registry (TxOR) website where some health data science applications on kidney transplantation are available. With it, we try to answer, some of the remaining questions on kidney transplantation in Portugal, with a new approach.
- Why badly treat what you can well prevent?Publication . Alves, M. Helena; Langford Santos, Helena; Lima, BrunoTransplantation is one of the medical activities with more expectation of success. For patients with end stage renal disease, kidney transplantation provides a better quality of life compared with those on dialysis, even for those with advanced age or co-morbidities. Greater access to food since the Second World War, high exposure to chemical and toxic, associated with changes in lifestyles, increased diabetes, hypertension, obesity, cardiovascular disease, chronic renal failure and transplantation demands. The dream of replacing damaged parts in the human body materialized with the transplants, but the hope in transplantation reached much higher levels than the actual results deserve. The transplant was used as flags of technical and scientific differentiation and success. Nonetheless transplantation was faced with shortage of organs and increased demand. The claim to the right to treatment quickly was confused and understood as the right to transplantation.