Banca de QUALIFICAÇÃO: LUCAS JOSE SA DA FONSECA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : LUCAS JOSE SA DA FONSECA
DATE: 28/11/2022
TIME: 13:30
LOCAL: Via "Google meeting"
TITLE:

IMPACT OF COEXISTING METABOLIC SYNDROME ON SISTEMIC OXIDATIVE STATUS AND DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

KEY WORDS:

Keywords: Rheumatoid Arthritis; Metabolic Syndrome; early diagnosis; Oxidative Stress; Lipid Peroxidation.

PAGES: 170
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

Introduction: rheumatoid arthritis (RA) is a systemic autoimmune disease with joint compromise of destructive pattern. Oxidative stress, a condition in which the balance between oxidants and antioxidants is lost, favoring cellular and molecular damage, is envolved in the inflammatory mechanisms of RA. Individuals with RA are at increased cardiovascular risk, being more prone to present metabolic syndrome (MetS), a condition in which cardiometabolic risk factors are combined, with a marked systemic inflammatory component. In this multifactorial context, the intersection points among RA, oxidative stress and MetS are still yet to be determined. Aim: to study clinical and laboratory parameters and those from redox status in patients with RA compared to controls with and without MetS, searching for adjuvant biomarkers in the assessment of systemic inflammatory status and of disease activity, presenting a structured protocol for screening MetS in patients with RA. Methodology: 26 controls with no known comorbidities and 45 individuals with RA were selected from the local community and from the Rheumatology outpatient facility in the Professor Alberto Antunes Teaching Hospital, Federal University of Alagoas, respectively. Diagnosis of RA was established according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR, 2010) classification criteria, and the diagnosis of MetS, based on those defined by the its harmonized version, 2009. After clinical assessment, patients underwent peripheral venous blood sample collection for general biochemical analyses and for the markers of oxidative stress (the enzymes superoxide dismutase, SOD; catalase, CAT; arginase, and the levels of serum lipid peroxidation by using the TBARS method). Results: the majority of volunteers was represented by females on both groups, without significant differences for anthropometric parameters and blood pressure values. Increased levels of HDL cholesterol and alkaline phosphatase were found in RA group compared to the controls, with no significant differences for the remaining biochemical parameters assessed. Serum lipid peroxidation evidenced elevated levels of malondialdehyde (MDA) in RA patients compared to the controls, and during subgroup analysis, coexisting MetS implied higher concentrations of MDA in RA individuals, a fact not observed when MetS was found in the control group. The analyses of antioxidant enzymes SOD and CAT did not show significant differences between groups, either in erythrocytes or in plasma samples, with similar observations for the arginase activity. Conclusion: despite the use of pharmacological therapy with antioxidant effects as part of the treatment of RA, the oxidative imbalance was evident in those patients, being worsened by coexisting MetS, contributing to the exacerbation of the pro-inflammatory millieu observed in the presence of RA. MetS screening after RA diagnosis is made is crucial for early intervention on cardiovascular risk factors and for better joint and cardiovascular outcomes in its carriers, possibly being easen by a structured protocol initiated before the rheumatologist consultation.

 

 

BANKING MEMBERS:
Presidente - 1545496 - LUIZA ANTAS RABELO
Externo(a) ao Programa - 1791653 - FLAVIO TELES DE FARIAS FILHO
Externo(a) ao Programa - 1120995 - SANDRA MARY LIMA VASCONCELOS
Externo(a) ao Programa - 058.526.204-75 - VALERIA NUNES DE SOUZA - UFPE