Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença

Detalhes bibliográficos
Autor(a) principal: Horimoto, Alex Magno Coelho
Data de Publicação: 2015
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFMS
Texto Completo: https://repositorio.ufms.br/handle/123456789/2260
Resumo: Introduction: Systemic sclerosis (SSc) is an autoimmune disease of the connective tissue characterized by the triad of vascular injury, autoimmunity (cellular and humoral) and tissue fibrosis. The observation that type V collagen (COLV) is a hidden molecule between heterotypic fibers and deposition occurs with abnormal morphology of this collagen in the skin of SSc patients, strongly suggests that the COLV is an important character in triggering autoimmunity, since could elicit a specific response (COLV and anti COLV) with immune complex formation and deposition in the vascular endothelium, leading to vascular damage which would allow the influx of cells from innate immunity, causing release of proteolytic enzymes that degrade heterotypical collagen fibers with exposure of more COLV and perpetuation of the disease Objectives: To evaluate the socio demographic, clinical and laboratory characteristics of 60 SSc patients from de Department of Rheumatology of the University Hospital Maria Aparecida Pedrossian of FMUFMS and correlate the presence of anti COL V with clinical and laboratory aspects of the disease. Methods: We selected 60 patients with ES who agreed to participate in the study during the period from January to December 2013. During the initial interview were collected socio demographic data and clinical examination, in addition to serum anti COL V and specific antibodies ES, correlating the type of autoantibody with the clinical and laboratory manifestations found. Results: All patients evaluated ES met the new criteria of the 2013 ACR/ EULAR diagnostic pathology, were mostly female (98.3%) and the limited form of the disease (43.3%) with a mean age of 51 years-old white followed by brown, with initial manifestation of Raynaud's phenomenon before diagnosis, the mean disease duration of 9 years and skin score modified Rodnan average of 13.08. Regarding personal history, most stated that being a smoker (76.7%), diabetes mellitus was observed in 15% and cancer in 1.7% of patients with SSc. The main clinical manifestations observed in each organ system of the patients were: skin thickening in the hands (78.3%), Raynaud's phenomenon (100%), arthritis (33.3%), esophageal involvement (71.7%), interstitial lung disease (45%), pulmonary hypertension (19.4%) and scleroderma renal crisis (1.7%). The most significant laboratory abnormalities were: elevation of inflammatory markers in 41.7% of patients (ESR and CRP), elevation of CPK (15%), decrease in complement factors C3 and C4 (3.3%), antinuclear antibody (95%) anti centromere (41.7%), antibody against DNA topoisomerase 1 (26.7%), anti RNA polymerase III (11.7%), anti Ul RNP (16.7%) and anti Ro (SSA) in 11.7% of patients. The anti COLV positivity for the same. was detected in 8.3% of patients with SSc and showed a significant statistical correlation with disease activity and with scleroderma renal crisis, and tendency to association with pulmonary arterial hypertension; however, did not correlate with the severity index of disease or any other clinical manifestations, nor with any of the three specific antibodies ES studied. Conclusions: The anti COLV correlated significantly with disease activity and is probably related to the early injury of endothelium-basal membrane complex, being a good indicator of need for treatment in patients with
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spelling 2015-05-11T15:34:00Z2021-09-30T19:57:40Z2015https://repositorio.ufms.br/handle/123456789/2260Introduction: Systemic sclerosis (SSc) is an autoimmune disease of the connective tissue characterized by the triad of vascular injury, autoimmunity (cellular and humoral) and tissue fibrosis. The observation that type V collagen (COLV) is a hidden molecule between heterotypic fibers and deposition occurs with abnormal morphology of this collagen in the skin of SSc patients, strongly suggests that the COLV is an important character in triggering autoimmunity, since could elicit a specific response (COLV and anti COLV) with immune complex formation and deposition in the vascular endothelium, leading to vascular damage which would allow the influx of cells from innate immunity, causing release of proteolytic enzymes that degrade heterotypical collagen fibers with exposure of more COLV and perpetuation of the disease Objectives: To evaluate the socio demographic, clinical and laboratory characteristics of 60 SSc patients from de Department of Rheumatology of the University Hospital Maria Aparecida Pedrossian of FMUFMS and correlate the presence of anti COL V with clinical and laboratory aspects of the disease. Methods: We selected 60 patients with ES who agreed to participate in the study during the period from January to December 2013. During the initial interview were collected socio demographic data and clinical examination, in addition to serum anti COL V and specific antibodies ES, correlating the type of autoantibody with the clinical and laboratory manifestations found. Results: All patients evaluated ES met the new criteria of the 2013 ACR/ EULAR diagnostic pathology, were mostly female (98.3%) and the limited form of the disease (43.3%) with a mean age of 51 years-old white followed by brown, with initial manifestation of Raynaud's phenomenon before diagnosis, the mean disease duration of 9 years and skin score modified Rodnan average of 13.08. Regarding personal history, most stated that being a smoker (76.7%), diabetes mellitus was observed in 15% and cancer in 1.7% of patients with SSc. The main clinical manifestations observed in each organ system of the patients were: skin thickening in the hands (78.3%), Raynaud's phenomenon (100%), arthritis (33.3%), esophageal involvement (71.7%), interstitial lung disease (45%), pulmonary hypertension (19.4%) and scleroderma renal crisis (1.7%). The most significant laboratory abnormalities were: elevation of inflammatory markers in 41.7% of patients (ESR and CRP), elevation of CPK (15%), decrease in complement factors C3 and C4 (3.3%), antinuclear antibody (95%) anti centromere (41.7%), antibody against DNA topoisomerase 1 (26.7%), anti RNA polymerase III (11.7%), anti Ul RNP (16.7%) and anti Ro (SSA) in 11.7% of patients. The anti COLV positivity for the same. was detected in 8.3% of patients with SSc and showed a significant statistical correlation with disease activity and with scleroderma renal crisis, and tendency to association with pulmonary arterial hypertension; however, did not correlate with the severity index of disease or any other clinical manifestations, nor with any of the three specific antibodies ES studied. Conclusions: The anti COLV correlated significantly with disease activity and is probably related to the early injury of endothelium-basal membrane complex, being a good indicator of need for treatment in patients withIntrodução: A esclerose sistêmica (ES) é uma enfermidade do tecido conjuntivo de caráter autoimune caracterizada pela triade de injúria vascular, autoimunidade (celular e humoral) e fibrose tecidual. A observação de que o colágeno V (COLV) é uma molécula oculta entre as fibras heterotípicas e que ocorre deposição deste colágeno com morfologia anomala no tecido cutâneo de pacientes com ES, sugere fortemente que o COLV seja um personagem importante no desencadeamento de autoimunidade, já que poderia suscitar uma resposta especifica (COLV e anti COLV), com formação de imunocomplexos e deposição dos mesmos no endotelio vascular, acarretando dano vascular o que permitiria o influxo de células da imunidade inata, ocasionando liberação de enzimas proteoliticas que degradariam as fibras heterotipicas de colágeno, com exposição de mais COLV e perpetuação da enfermidade. Objetivos: Avaliar as características sócio demográficas, clinicas e laboratoriais de 60 pacientes com ES do Serviço de Reumatologia do Hospital Universitário Maria Aparecida Pedrossian da FMUFMS e correlacionar a presença do anti COL V com aspectos clínicos e laboratoriais da enfermidade. Métodos: Foram selecionados 60 pacientes com diagnóstico de ES que concordaram em participar da pesquisa durante o periodo de Janeiro a Dezembro de 2013. Durante a entrevista inicial foram coletados dados sócio demográficos e exame clinico, além da dosagem sérica de anti COL V e anticorpos específicos para ES, correlacionando o tipo de autoanticorpo com as manifestações clínicas e laboratoriais encontradas. Resultados: Todos os pacientes com ES avaliados preenchiam os novos critérios do ACR/EULAR para diagnóstico da patologia, eram principalmente do sexo feminino (98,3%) e da forma limitada da doença (43,3%), com idade média de 51 anos, cor branca seguida pela parda, com manifestação inicial de fenômeno de Raynaud antes do diagnóstico, tempo de duração da doença médio de 9 anos e escore cutâneo modificado de Rodnan médio de 13,08. Em relação aos antecedentes pessoais, a maioria declarou não ser tabagista (76,7%) e observou-se diabetes mellitus em 15% e câncer em 1,7% dos pacientes com ES. As principais manifestações clínicas observadas em cada sistema orgânico dos pacientes foram: espessamento cutâneo nas mãos (78,3%), fenômeno de Raynaud (100%), artrite (33,3%), acometimento de esôfago (71,7%), doença intersticial pulmonar (45%), hipertensão arterial pulmonar (19,4%) e crise renal esclerodérmica (1,7%). As alterações laboratoriais mais significativas foram: elevação de provas inflamatórias em 41,7% dos pacientes (VHS e PCR), elevação de CPK (15%), queda dos fatores do complemento C3 e C4 (3,3%), anticorpo antinuclear (95%), anti centromero (41,7%), anticorpo anti DNA topoisomerase 1 (26,7%), anti RNA polimerase III (11,7%), anti Ul RNP (16,7%) e anti Ro (SSA) em 11,7% dos pacientes. O anti COLV foi detectado em 8,3% dos pacientes com ES e apresentou importante correlação estatistica com a atividade da doença e com crise renal esclerodérmica, além de tendência à associação com hipertensão arterial pulmonar, no entanto, não se correlacionou com o indice de gravidade da doença ou qualquer outra manifestação clínica, nem com qualquer um dos três anticorpos específicos da ES estudados. Conclusões: O anti COLV se correlacionou de forma significativa com a atividade da doença e está provavelmente relacionado com a lesão precoce do complexo endotélio-membrana basal, sendo um bom indicador de necessidade de tratamento naqueles pacientes com positividade para o mesmo.porEscleroderma SistêmicoAnticorposAutoanticorposAnticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doençainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisCosta, Izaías Pereira daYoshinari, Natalino HajimeHorimoto, Alex Magno Coelhoinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMSinstname:Universidade Federal de Mato Grosso do Sul (UFMS)instacron:UFMSTHUMBNAILAlex Magno Coelho Horimoto.pdf.jpgAlex Magno Coelho Horimoto.pdf.jpgGenerated Thumbnailimage/jpeg1186https://repositorio.ufms.br/bitstream/123456789/2260/4/Alex%20Magno%20Coelho%20Horimoto.pdf.jpg2aa9d9d1bf330e5cafa5742538cf5817MD54ORIGINALAlex Magno Coelho Horimoto.pdfAlex Magno Coelho Horimoto.pdfapplication/pdf9238705https://repositorio.ufms.br/bitstream/123456789/2260/1/Alex%20Magno%20Coelho%20Horimoto.pdff40b54ae4db9dc680f87042fe710dc1cMD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.ufms.br/bitstream/123456789/2260/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52TEXTAlex Magno Coelho Horimoto.pdf.txtAlex Magno Coelho Horimoto.pdf.txtExtracted texttext/plain0https://repositorio.ufms.br/bitstream/123456789/2260/3/Alex%20Magno%20Coelho%20Horimoto.pdf.txtd41d8cd98f00b204e9800998ecf8427eMD53123456789/22602024-08-20 09:03:19.823oai:repositorio.ufms.br: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Repositório InstitucionalPUBhttps://repositorio.ufms.br/oai/requestri.prograd@ufms.bropendoar:21242024-08-20T13:03:19Repositório Institucional da UFMS - Universidade Federal de Mato Grosso do Sul (UFMS)false
dc.title.pt_BR.fl_str_mv Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
title Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
spellingShingle Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
Horimoto, Alex Magno Coelho
Escleroderma Sistêmico
Anticorpos
Autoanticorpos
title_short Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
title_full Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
title_fullStr Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
title_full_unstemmed Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
title_sort Anticorpo anti-colágeno tipo V em pacientes portadores de esclerose sistêmica: correlação com outros autoanticorpos específicos, critérios de gravidade e de atividade da doença
author Horimoto, Alex Magno Coelho
author_facet Horimoto, Alex Magno Coelho
author_role author
dc.contributor.advisor1.fl_str_mv Costa, Izaías Pereira da
dc.contributor.advisor2.fl_str_mv Yoshinari, Natalino Hajime
dc.contributor.author.fl_str_mv Horimoto, Alex Magno Coelho
contributor_str_mv Costa, Izaías Pereira da
Yoshinari, Natalino Hajime
dc.subject.por.fl_str_mv Escleroderma Sistêmico
Anticorpos
Autoanticorpos
topic Escleroderma Sistêmico
Anticorpos
Autoanticorpos
description Introduction: Systemic sclerosis (SSc) is an autoimmune disease of the connective tissue characterized by the triad of vascular injury, autoimmunity (cellular and humoral) and tissue fibrosis. The observation that type V collagen (COLV) is a hidden molecule between heterotypic fibers and deposition occurs with abnormal morphology of this collagen in the skin of SSc patients, strongly suggests that the COLV is an important character in triggering autoimmunity, since could elicit a specific response (COLV and anti COLV) with immune complex formation and deposition in the vascular endothelium, leading to vascular damage which would allow the influx of cells from innate immunity, causing release of proteolytic enzymes that degrade heterotypical collagen fibers with exposure of more COLV and perpetuation of the disease Objectives: To evaluate the socio demographic, clinical and laboratory characteristics of 60 SSc patients from de Department of Rheumatology of the University Hospital Maria Aparecida Pedrossian of FMUFMS and correlate the presence of anti COL V with clinical and laboratory aspects of the disease. Methods: We selected 60 patients with ES who agreed to participate in the study during the period from January to December 2013. During the initial interview were collected socio demographic data and clinical examination, in addition to serum anti COL V and specific antibodies ES, correlating the type of autoantibody with the clinical and laboratory manifestations found. Results: All patients evaluated ES met the new criteria of the 2013 ACR/ EULAR diagnostic pathology, were mostly female (98.3%) and the limited form of the disease (43.3%) with a mean age of 51 years-old white followed by brown, with initial manifestation of Raynaud's phenomenon before diagnosis, the mean disease duration of 9 years and skin score modified Rodnan average of 13.08. Regarding personal history, most stated that being a smoker (76.7%), diabetes mellitus was observed in 15% and cancer in 1.7% of patients with SSc. The main clinical manifestations observed in each organ system of the patients were: skin thickening in the hands (78.3%), Raynaud's phenomenon (100%), arthritis (33.3%), esophageal involvement (71.7%), interstitial lung disease (45%), pulmonary hypertension (19.4%) and scleroderma renal crisis (1.7%). The most significant laboratory abnormalities were: elevation of inflammatory markers in 41.7% of patients (ESR and CRP), elevation of CPK (15%), decrease in complement factors C3 and C4 (3.3%), antinuclear antibody (95%) anti centromere (41.7%), antibody against DNA topoisomerase 1 (26.7%), anti RNA polymerase III (11.7%), anti Ul RNP (16.7%) and anti Ro (SSA) in 11.7% of patients. The anti COLV positivity for the same. was detected in 8.3% of patients with SSc and showed a significant statistical correlation with disease activity and with scleroderma renal crisis, and tendency to association with pulmonary arterial hypertension; however, did not correlate with the severity index of disease or any other clinical manifestations, nor with any of the three specific antibodies ES studied. Conclusions: The anti COLV correlated significantly with disease activity and is probably related to the early injury of endothelium-basal membrane complex, being a good indicator of need for treatment in patients with
publishDate 2015
dc.date.accessioned.fl_str_mv 2015-05-11T15:34:00Z
dc.date.issued.fl_str_mv 2015
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