Navegando por Palavras-chave "cistatina"
Agora exibindo 1 - 4 de 4
Resultados por página
Opções de Ordenação
- ItemSomente MetadadadosAvaliação da função renal em idosos(Universidade Federal de São Paulo (UNIFESP), 2014-07-30) Duque, Gisane Cavalcanti [UNIFESP]; Kirsztajn, Gianna Mastroianni Kirsztajn [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introdução: Com o envelhecimento populacional, houve simultaneamente um aumento da prevalência de doenças crônicas, entre elas a Doença Renal Crônica (DRC). Estudos direcionados ao diagnóstico de DRC na população idosa são muito importantes diante das particularidades fisiológicas desta população. Definir métodos de estimar a Taxa de Filtração Glomerular (TFG) que sejam adequados para esse perfil de pacientes é essencial para prevenção e tratamento precoce, evitando comprometimento da qualidade de vida e perda da funcionalidade. Objetivo: Procuramos determinar a presença de DRC utilizando urinálise e estimativas da TFG na população idosa a partir de diferentes equações baseadas em cistatina C e creatinina séricas. MATERIAL E Métodos: Em um estudo transversal, foram avaliados 105 pacientes com idade maior ou igual a 60 anos, divididos em dois grupos: idoso (menos de 80 anos) e muito idoso (maior ou igual a 80 anos). A TFG foi calculada usando as equações de Cockcroft-Gault, MDRD, CKD EPI creatinina, CKD EPI cistatina, CKD EPI creatinina-cistatina e Larsson. Resultados: A urinálise foi avaliada em 43 pacientes, sendo que em 30, os resultados estavam dentro da normalidade, 6 apresentaram hematúria, 5 proteinúria e 2, as duas alterações concomitantemente. Os valores da creatinina e cistatina C séricas variaram de 0,58 a 1,39 (média 0,88) e 0,48 a 1,84 (média 1,08) no grupo idoso e 0,61 a 1,72 (média 1,01) e 0,58 a 1,89 (média 1,23) no grupo muito idoso, respectivamente. Em análise multivariada, no grupo idoso, a creatinina se correlacionou bem com a equação do CKD EPI creatinina; e a cistatina C com a equação do CKD EPI cistatina e a equação de Larsson. No grupo muito idoso, a creatinina se correlacionou bem com a equação do CKD EPI creatinina-cistatina e CKD EPI cistatina; e a cistatina, com a equação de CKD EPI cistatina. No que se refere à detecção de DRC, usando as diferentes equações para estimar a TFG, foi encontrada TFG < 60 ml/min em 12,4 a 26,7% dos indivíduos no grupo idoso e 13,3 a 30,5% no grupo muito idoso. Conclusão: De acordo com nosso estudo, a equação do CKD EPI apresentou melhor performance na população idosa, especialmente a equação de CKD EPI cistatina. Além disso, a CKD EPI creatinina também parece ser apropriada para uso na prática clínica. Estudos mais abrangentes são necessários para confirmar nossos achados.
- ItemSomente MetadadadosAvaliação de alterações urinárias e função renal em gestantes portadoras de hipertensão arterial crônica(Universidade Federal de São Paulo (UNIFESP), 2016-06-30) Silva Junior, Guilherme Santos da [UNIFESP]; Kirsztajn, Gianna Mastroianni Kirsztajn [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Abnormal renal function in pregnant women with chronic hypertension is related to an increased frequency of superimposed preeclampsia. In the evaluation of such patients markers of glomerular filtration rate, as serum cystatin C and creatinine, can be used for early diagnosis of chronic kidney disease. The detection of proteinuria is also important and has implications in clinical management and in the pregnancy outcome. OBJECTIVE: 1. To describe the epidemiological profile of pregnant women with chronic hypertension; 2. To evaluate urinary abnormalities (by urinalysis) and renal function (by serum determination of creatinine and cystatin C, and formulas for estimation of glomerular filtration rate (eGFR); 3. To evaluate the pregnancy outcome in cases of chronic hypertension. METHODS: In this study 103 pregnant women with chronic hypertension were enrolled (blood pressure over 140x90 mmHg, detected previously to pregnancy or until the 20th week), followed in the Outpatient Service of Pre-Natal of the Department of Obstetrics, by the Nephritis Group, in the UNIFESP-EPM, from January-2008 to June-2013, that were submitted to clinical and laboratorial assessments. The following tests were collected: serum creatinine (102) and cystatin C (102), urinalysis (97) and protein/creatinine ratio (97) in a random urine sample (PCR). The control group was composed by 22 healthy pregnant women. It was also performed a data collection after each delivery related to the characteristics of the delivery and the newborn. RESULTS: Pregnant women were 21 to 45 years-old (mean age: 34 yrs). In the first visit with the Nephritis Group, gestational age was 8 to 38 weeks. As concerned to color/race, 57.3% were brown, 26.2% white and 16.5% black; 12.6% were primigravida, 64.1% had multiple pregnancies (? a 3) and the remainder were in the 2nd pregnancy. Previous preeclampsia-eclampsia were reported in 21.3% and nephropathy in 7.8% of the cases. Systemic hypertension was diagnosed only in the present pregnancy in 14.9% of them. When they knew the time since hypertension diagnosis, it was observed that 84.1% had hypertension for ? 10 yrs and 15.9% > 10 yrs. PCR in random urine sample (Ref: < or = 0.30g/g) was elevated in 5.2% of the patients, range: 0,0 - 6,4g/g. Serum creatinine levels range was 0.36 to 2.8 mg/dL; 19.6% of the values were elevated. Serum cystatin range was 0.54 to 3.14 mg/L; 14.7% of the values were elevated. By the Cockcroft-Gault formula (n=102), eGFR range was 24.1 -368.8 mL/min (mean: 203.7), MDRD (n=102), 16 -211 mL/min (mean: 145.12), CKD-EPI creatinine (n=102), 18-179 mL/min (mean: 134.38), CKD-EPI cystatin C (n=101),15-157 mL/min (mean: 96.28), CKD-EPI creatinine-cystatin C (n=100), 15-168 mL/min (mean: 115.13). By the Cockcroft-Gault, MDRD and CKD-EPI creatinine, it was observed eGFR < 60 mL/min in 1.9 % of the patients, by CKD-EPI cystatin C, in 8.9 % and by CKD-EPI creatinin-cystatin C, in 3% of them. In the assessment of pregnancy characteristics of patients and their newborn (compared with the frequencies of the cases with CKD-EPI cystatin C < 60 ml/min/1.73 m2), it was observed: 20.5% (33.3%) of preterm birth < 37 weeks, 17.5% (22.2%) of birth weight < 2500g and 17.5% (22.2%) of small for gestational age (SGA); superimposed preeclampsia-eclampsia occurred in 24.7% (22.2%) of the cases. CONCLUSIONS: Due to the relevance of superimposed preeclampsia-eclampsia and chronic hypertension that increase the risk of maternal and fetal morbimortality, it is extremely important the early detection of proteinuria (in this study detected in 5.2%) and abnormal renal function (1.9 to 8.9%, according to the eGFR formula applied; increased levels of serum creatinine in 19.6% and cystatin C in 14.7% of the cases), for decision making and close follow-up. Proteinuria screening and determinations of serum creatinine and cystatin C are able to identify risk groups. The results suggest also that the formulas CKD-EPI and MDRD can eventually have applicability in the assessment of deficit of renal function in pregnant women, nevertheless more studies with this specific purpose are still necessary. At last, it was also shown a high frequency of preterm birth or with < 2500g at birth or small for gestational age, as well as of superimposed preeclampsia-eclampsia (24.7%) in pregnant women with chronic hypertension.
- ItemAcesso aberto (Open Access)BmCistatina, Inibidor de cisteinoproteases presente em corpo gorduroso de carrapato Boophilus microplus: Clonagem, expressão, purificação e caracterização(Universidade Federal de São Paulo (UNIFESP), 2006-12-31) Lima, Cássia Arantes de [UNIFESP]; Nader, Helena Bonciani [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The tick economic importance is directly related to its blood feeding behavior. Among the species that belong to the Ixodidae family the Boophilus microplus tick has great importance in veterinary medicine. It is an ectoparasite responsible for disease transmissions such as: the babesiosis and fever of cattle. The tick control has been done by using acaricides, however alternative methods as the immunological control have been investigated. The protease inhibitors have an important role in the proteolysis regulation of endogenous or exogenous enzymes from all organisms. The protease inhibitors present in hematophagous animals are important molecules in the control of innumerous proteases involved in the host’s hemostatic and immune systems. The present work describes the characterization of a recombinant cysteine protease inhibitor, Bmcystatin from the fat body of B. microplus. The complete nucleotide sequence of the Bmcystatin (298 pb) was obtained by random sequencing of clones from a fat body cDNA library. The recombinant protein was produced using the E. coli BL21 SI expression vector pET26b. The Bmcystatin expression was induced with 0.3 M NaCl and the soluble protein extracted by French press. The Bmcystatin purification was performed by affinity chromatography on Ni-NTA agarose resin followed by ionic exchange chromatography on HiTrap Q column. Purified Bmcystatin presented molecular mass of 11 kDa and high inhibitory activity for cathepsin L with Ki value of 0.1 nM. The Bmcystatin amino acid sequence presented 70% similarity to an Ixodes scapularis tick cystatin. The expression analysis of Bmcystatin by semiquantitive RT-PCR showed DNA band amplification only in the fat body cDNA preparation. On the other hand, the protein recognition by anti-Bmcystatin antibody was observed in the fat body and salivary gland extracts of B. microplus by Western blot. In conclusion, this work generated the following tools for future studies: the anti-Bmcystatin antibody and the complete nucleotide sequence of Bmcystatin gene, which will be important to confirm Bmcystatin localization in B. microplus, and it will allow us to use the RNA interference methodology for functional studies, respectively.
- ItemSomente MetadadadosEstudo molecular e funcional de um inibidor de cisteínoproteases identificado no genoma do mosquito aedes aegypti(Universidade Federal de São Paulo (UNIFESP), 2013-11-27) Oliveira, Felipe Araujo de Alcantara [UNIFESP]; Tanaka, Aparecida Sadae Tanaka [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: Caracterizar um inibidor de protease da família das cistatinas no mosquito Aedes aegypti, abordando parâmetros bioquímicos e verificar seus possível papel na infecção do mosquito com vírus da DENV. Métodos: A proteína foi expressa em E. colí para a produção de anticorpos, afim de confirmar a presença da proteína nativa, e para a realização de testes enzirnáticos. Reações de cadeia da polimerase quantitativos (qPCRs) foram realizadas afim de verificar quais tecidos o transcrito está expresso e sua modulação com a infecção por DENV. Resultados: A proteína pertence à família das estefinas (125B) e inibe diversas cisteinopeptases como as cathepsias humanas B, L1, L2, S e a papaína. O anticorpo produzido apresentou afinidade por uma proteína de tamanho similar ao esperado. A cistatina se encontrada majoritariamente no intestino e a quantidade de transcritos apresenta redução durante a infecção.