Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da Uninove |
Texto Completo: | http://bibliotecatede.uninove.br/handle/tede/3321 |
Resumo: | The relationship between pre-eclampsia (PE) and vitamin D deficiency, two important public health problems, is increasingly under discussion. It is not known which of these clinical conditions arises first. There is evidence that one intensifies the other, especially because proteinuria, a consistent finding and factor to classify PE, can be ameliorated by vitamin D replacement. At the same time, it is possible that vitamin D activation is impaired in proteinuria, once the vitamin D-activating tubules would be losing their endocytic ability. The present study aimed to verify the relationship between vitamin D deficiency, proteinuria and loss of the tubular endocytic apparatus, in pregnant women with PE. In a first phase, 159 patient charts were surveyed between 2012 and 2013 by the obstetrics service of a public tertiary hospital in the northern region of the city of São Paulo, in order to characterize the population to be studied, as well as to evaluate the incidence of PE in two seasons, summer and winter. In a second phase, 38 patients attended by the same medical service and included in a case-control study were selected. Of these 38 patients, 12 normotensive patients constituted the Control group, 16 constituted the PE group (pre-eclamptic without proteinuria) and 10 constituted the PEP group (pre-eclamptic with proteinuria). Blood, plasma, and urine were collected for the following analyzes: proteinuria, albuminuria, 25-hydroxyvitamin D (25-VitD) and cubilin (tubular endocytic tracer marker). In addition, the expression of 10 components of the tubular endocytic apparatus was analyzed in the blood of control patients and PEP (transcriptome) patients. Of the more relevant results, we observed that the 25-VitD deficiency was highly incident in the analyzed population and was not different between the groups. The PEP group presented greater loss of cubilin in the urine and of the ten components of the tubular endocytic apparatus analyzed, six presented significantly decreased expression. The present study demonstrates the 25-VitD deficiency in a population of pregnant women in the northern part of the city of São Paulo and demonstrates that preeclamptic patients with proteinuria excrete more cubilin and lose the expression of components of the tubular endocytic apparatus, pointing to a Possible mechanism by which vitamin D deficiency can be aggravated in PE. |
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Dellê, Humbertohttp://lattes.cnpq.br/7435662740477057Dellê, Humbertohttp://lattes.cnpq.br/7435662740477057Daher, Silviahttp://lattes.cnpq.br/5938358901097469Camacho, Cléber Pintohttp://lattes.cnpq.br/1832800364435894http://lattes.cnpq.br/8515896300232738Albejante, Maria Clara2024-04-09T12:45:21Z2016-05-18Albejante, Maria Clara. Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia. 2016. 62 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo.http://bibliotecatede.uninove.br/handle/tede/3321The relationship between pre-eclampsia (PE) and vitamin D deficiency, two important public health problems, is increasingly under discussion. It is not known which of these clinical conditions arises first. There is evidence that one intensifies the other, especially because proteinuria, a consistent finding and factor to classify PE, can be ameliorated by vitamin D replacement. At the same time, it is possible that vitamin D activation is impaired in proteinuria, once the vitamin D-activating tubules would be losing their endocytic ability. The present study aimed to verify the relationship between vitamin D deficiency, proteinuria and loss of the tubular endocytic apparatus, in pregnant women with PE. In a first phase, 159 patient charts were surveyed between 2012 and 2013 by the obstetrics service of a public tertiary hospital in the northern region of the city of São Paulo, in order to characterize the population to be studied, as well as to evaluate the incidence of PE in two seasons, summer and winter. In a second phase, 38 patients attended by the same medical service and included in a case-control study were selected. Of these 38 patients, 12 normotensive patients constituted the Control group, 16 constituted the PE group (pre-eclamptic without proteinuria) and 10 constituted the PEP group (pre-eclamptic with proteinuria). Blood, plasma, and urine were collected for the following analyzes: proteinuria, albuminuria, 25-hydroxyvitamin D (25-VitD) and cubilin (tubular endocytic tracer marker). In addition, the expression of 10 components of the tubular endocytic apparatus was analyzed in the blood of control patients and PEP (transcriptome) patients. Of the more relevant results, we observed that the 25-VitD deficiency was highly incident in the analyzed population and was not different between the groups. The PEP group presented greater loss of cubilin in the urine and of the ten components of the tubular endocytic apparatus analyzed, six presented significantly decreased expression. The present study demonstrates the 25-VitD deficiency in a population of pregnant women in the northern part of the city of São Paulo and demonstrates that preeclamptic patients with proteinuria excrete more cubilin and lose the expression of components of the tubular endocytic apparatus, pointing to a Possible mechanism by which vitamin D deficiency can be aggravated in PE.Está cada vez mais em discussão a relação entre pré-eclâmpsia (PE) e deficiência de vitamina D, dois problemas importantes de saúde pública. Não se sabe ao certo qual das condições clínicas surge primeiro. Há indícios de que uma intensifica a outra, especialmente porque a proteinúria, achado consistente e classificador da PE, pode ser amenizada pela reposição de vitamina D. Ao mesmo tempo, é possível que a ativação da vitamina D esteja prejudicada na situação de proteinúria, onde os túbulos ativadores da vitamina D estariam perdendo sua habilidade endocítica. O presente estudo teve como objetivo central verificar a relação entre deficiência de vitamina D, proteinúria e perda do aparelho endocítico tubular, em gestantes com PE. Em uma primeira fase, foram levantados 159 prontuários de pacientes atendidas entre 2012 e 2013 pelo serviço de obstetrícia de um hospital público terciário da região norte da cidade de São Paulo, a fim de caracterizar a população a ser estudada, bem como avaliar a incidência de PE em duas épocas do ano, verão e inverno. Em uma segunda fase, foram selecionadas 38 pacientes atendidas pelo mesmo serviço médico e incluídas em um estudo caso-controle. Destas 38 pacientes, 12 normotensas constituíram o grupo Controle, 16 constituíram o grupo PE (pré-eclâmpticas sem proteinúria) e 10 constituíram o grupo PEP (pré-eclâmpticas com proteinúria). O sangue, plasma e urina foram coletados para as seguintes análises: proteinúria, albuminúria, 25-hidroxivitamina D (25-VitD) e cubilina (marcador de aparelho endocítico tubular). Além disso, a expressão de 10 componentes do aparelho endocítico tubular foi analisada no sangue de pacientes controle e pacientes PEP (transcriptoma). Dos resultados mais relevantes, observamos que a deficiência de 25-VitD foi altamente incidente na população analisada e não foi diferente entre os grupos. O grupo PEP apresentou maior perda de cubilina na urina e dos dez componentes do aparelho endocítico tubular analisados, seis apresentaram expressão significativamente diminuída. O presente estudo demonstra a deficiência de 25-VitD em uma população de gestantes da zona norte da cidade de São Paulo e demonstra que as pacientes pré-eclâmpticas com proteinúria excretam mais cubilina e perdem a expressão de componentes do aparelho endocítico tubular, apontando para um possível mecanismo pelo qual a deficiência de vitamina D pode ser agravada na PE.Submitted by Nadir Basilio (nadirsb@uninove.br) on 2024-04-09T12:45:21Z No. of bitstreams: 1 Maria Clara Albejante.pdf: 947056 bytes, checksum: 991fecd40ffdb43a290480f89ac62de7 (MD5)Made available in DSpace on 2024-04-09T12:45:21Z (GMT). No. of bitstreams: 1 Maria Clara Albejante.pdf: 947056 bytes, checksum: 991fecd40ffdb43a290480f89ac62de7 (MD5) Previous issue date: 2016-05-18application/pdfporUniversidade Nove de JulhoPrograma de Mestrado em MedicinaUNINOVEBrasilSaúdeproteinúriahipertensãopré-eclâmpsiavitamina Dlesão tubular renalexpressão gênicaproteinuriahypertensionpreeclampsiavitamindtubular injurygene expressionCIENCIAS DA SAUDEImpacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsiaImpact of the proteinuria on the endocytic tubular apparatus in pre-eclampsia patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis8765449414823306929600info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da Uninoveinstname:Universidade Nove de Julho (UNINOVE)instacron:UNINOVEORIGINALMaria Clara Albejante.pdfMaria Clara Albejante.pdfapplication/pdf947056http://localhost:8080/tede/bitstream/tede/3321/2/Maria+Clara+Albejante.pdf991fecd40ffdb43a290480f89ac62de7MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82165http://localhost:8080/tede/bitstream/tede/3321/1/license.txtbd3efa91386c1718a7f26a329fdcb468MD51tede/33212024-04-09 09:45:21.984oai:localhost: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Biblioteca Digital de Teses e Dissertaçõeshttp://bibliotecatede.uninove.br/PRIhttp://bibliotecatede.uninove.br/oai/requestbibliotecatede@uninove.br||bibliotecatede@uninove.bropendoar:2024-04-09T12:45:21Biblioteca Digital de Teses e Dissertações da Uninove - Universidade Nove de Julho (UNINOVE)false |
dc.title.por.fl_str_mv |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
dc.title.alternative.eng.fl_str_mv |
Impact of the proteinuria on the endocytic tubular apparatus in pre-eclampsia patients |
title |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
spellingShingle |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia Albejante, Maria Clara proteinúria hipertensão pré-eclâmpsia vitamina D lesão tubular renal expressão gênica proteinuria hypertension preeclampsia vitamind tubular injury gene expression CIENCIAS DA SAUDE |
title_short |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
title_full |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
title_fullStr |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
title_full_unstemmed |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
title_sort |
Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia |
author |
Albejante, Maria Clara |
author_facet |
Albejante, Maria Clara |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Dellê, Humberto |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7435662740477057 |
dc.contributor.referee1.fl_str_mv |
Dellê, Humberto |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/7435662740477057 |
dc.contributor.referee2.fl_str_mv |
Daher, Silvia |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/5938358901097469 |
dc.contributor.referee3.fl_str_mv |
Camacho, Cléber Pinto |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/1832800364435894 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8515896300232738 |
dc.contributor.author.fl_str_mv |
Albejante, Maria Clara |
contributor_str_mv |
Dellê, Humberto Dellê, Humberto Daher, Silvia Camacho, Cléber Pinto |
dc.subject.por.fl_str_mv |
proteinúria hipertensão pré-eclâmpsia vitamina D lesão tubular renal expressão gênica |
topic |
proteinúria hipertensão pré-eclâmpsia vitamina D lesão tubular renal expressão gênica proteinuria hypertension preeclampsia vitamind tubular injury gene expression CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
proteinuria hypertension preeclampsia vitamind tubular injury gene expression |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
The relationship between pre-eclampsia (PE) and vitamin D deficiency, two important public health problems, is increasingly under discussion. It is not known which of these clinical conditions arises first. There is evidence that one intensifies the other, especially because proteinuria, a consistent finding and factor to classify PE, can be ameliorated by vitamin D replacement. At the same time, it is possible that vitamin D activation is impaired in proteinuria, once the vitamin D-activating tubules would be losing their endocytic ability. The present study aimed to verify the relationship between vitamin D deficiency, proteinuria and loss of the tubular endocytic apparatus, in pregnant women with PE. In a first phase, 159 patient charts were surveyed between 2012 and 2013 by the obstetrics service of a public tertiary hospital in the northern region of the city of São Paulo, in order to characterize the population to be studied, as well as to evaluate the incidence of PE in two seasons, summer and winter. In a second phase, 38 patients attended by the same medical service and included in a case-control study were selected. Of these 38 patients, 12 normotensive patients constituted the Control group, 16 constituted the PE group (pre-eclamptic without proteinuria) and 10 constituted the PEP group (pre-eclamptic with proteinuria). Blood, plasma, and urine were collected for the following analyzes: proteinuria, albuminuria, 25-hydroxyvitamin D (25-VitD) and cubilin (tubular endocytic tracer marker). In addition, the expression of 10 components of the tubular endocytic apparatus was analyzed in the blood of control patients and PEP (transcriptome) patients. Of the more relevant results, we observed that the 25-VitD deficiency was highly incident in the analyzed population and was not different between the groups. The PEP group presented greater loss of cubilin in the urine and of the ten components of the tubular endocytic apparatus analyzed, six presented significantly decreased expression. The present study demonstrates the 25-VitD deficiency in a population of pregnant women in the northern part of the city of São Paulo and demonstrates that preeclamptic patients with proteinuria excrete more cubilin and lose the expression of components of the tubular endocytic apparatus, pointing to a Possible mechanism by which vitamin D deficiency can be aggravated in PE. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-05-18 |
dc.date.accessioned.fl_str_mv |
2024-04-09T12:45:21Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Albejante, Maria Clara. Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia. 2016. 62 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
dc.identifier.uri.fl_str_mv |
http://bibliotecatede.uninove.br/handle/tede/3321 |
identifier_str_mv |
Albejante, Maria Clara. Impacto da proteinúria sobre o aparelho endocítico tubular em pacientes com pré-eclâmpsia. 2016. 62 f. Dissertação( Programa de Mestrado em Medicina) - Universidade Nove de Julho, São Paulo. |
url |
http://bibliotecatede.uninove.br/handle/tede/3321 |
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por |
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por |
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8765449414823306929 |
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600 |
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openAccess |
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UNINOVE |
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Brasil |
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Saúde |
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Universidade Nove de Julho |
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