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Traditional and Non-Traditional Risk Factors Involved with Endothelial Dysfunction and Arterial Stiffness in Autoimmune Rheumatic Diseases

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第3期9卷 85-100页

作者： rafael giovani misse Isabela Bruna Pires Borges Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil

Autoimmune rheumatic diseases (ARDs) have been closely associated with accelerated plaque progression and the development of atherosclerosis, which lead to high morbidity and mortality rates for cardiovascular diseases. Endothelial dysfunction and arterial stiffness are greatly evidenced in several studies in the early phase of atherosclerosis. In ARDs, endothelial dysfunction and arterial stiffness are related to traditional and non-traditional risk factors. To date, no studies have clearly analyzed the main parameter involved in endothelial dysfunction and arterial stiffness. In this context, the present narrative review’s purpose was to describe the main factor in endothelial dysfunction and arterial stiffness in different ARDs. Endothelial dysfunction and arterial stiffness are related to traditional risk factors (i.e., hypertension, diabetes, dyslipidemia, metabolic syndrome, sedentary behavior) and non-traditional risk factors (linked to the immune mechanisms involved in these diseases). Moreover, in the present study, these associations were systemically analyzed in ankylosing spondylitis, antiphospholipid syndrome, rheumatoid arthritis, psoriatic arthritis, systemic autoimmune myopathies, systemic lupus erythematosus and systemic sclerosis. The present review shows that the relationship of traditional risk factors and non-traditional risk factors related to ARDs works in the worsening of function and structural properties of arterial vessels, leading to high cardiovascular morbidity and mortality.

关键词： Arterial Stiffness Atherosclerosis Autoimmune Endothelial Dysfunction Rheumatic Diseases

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Transcranial Direct Current Stimulation Is Safe and Relieves Post-Herpetic Neuralgia in Patient with Dermatomyositis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 114-118页

作者： rafael giovani misse Alexandre Moura dos Santos Abrahão Fontes Baptista Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de S&#227 o Paulo S&#227 o Paulo Brazil Center for Mathematics Computation and Cognition Federal University of ABC (UFABC) S&#227 o Bernardo do Campo Brazil

To the best of our knowledge, this is the first report in the literature showing the efficacy of transcranial direct current stimulation (tDCS) in treating refractory post-herpetic neuralgia in a patient with dermatomyositis. In addition, our results showed that tDCS sessions are safe and do not lead to disease relapse. Therefore, despite the limitations of being a case report, this study provides encouraging results that need to be widely explored in studies with a representative number of patients and with an appropriate design for patients with this systemic rheumatic autoimmune disease.

关键词： Cerebral Neuromodulation Dermatomyositis Neuralgia Pain Treatment

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Functional and Structural Arterial Vessel Features of Female Patients with Stable Dermatomyositis and Antisynthetase Syndrome

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第3期9卷 101-110页

作者： rafael giovani misse Isabela Bruna Pires Borges Valéria Aparecida Costa Hong Luiz Aparecido Bortolotto Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo SP Brazil (BR) Hypertension Unit Instituto do Cora&#231 o Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo SP Brazil (BR)

Introduction: Dermatomyositis (DM) and antisynthetase syndrome (ASS) show a high frequency of metabolic syndrome, which can be preceded by endothelial dysfunction and arterial stiffness. To date, only one study has evaluated these vessel parameters in DM, and no study of ASS exists. Therefore, the aim of the study was to assess the structural and functional arterial of arterial vessels in DM and ASS. Methods: This cross-sectional study enrolled 21 adult female patients (14 DM and 7 ASS) who were age-, gender- and ethnicity-matched to 12 healthy individuals. Patients using lipid lowering agents or prednisone at doses ≥ 0.25 mg/kg/day, and patients with uncontrolled systemic arterial hypertension, diabetes mellitus, cardiac insufficiency, and disease activity were excluded. Arterial stiffness was evaluated using carotid-femoral pulse wave velocity (PWV), and endothelial function was evaluated using dependent flow-mediated dilatation (FMD) of the brachial artery. Results: The mean age of patients with DM or ASS were 45.4 ± 8.6 and 44.0 ± 6.1 years, respectively (P = 1.000), and patients were predominantly of white ethnicity. Six DM patients and three ASS patients had systemic arterial hypertension, whereas 9 DM patients and six ASS patients had dyslipidemia. Endothelial baseline diameter, hyperemia diameter and FMD values were similar among the three groups (P > 0.05). Moreover, the median FMD values were also similar between the patients with DM and patients with ASS [8.3% (4.5% - 10.9%) vs. 6.0% (−1.8% - 8.2%);P = 0.585]. The PWV values were comparable among the three groups (P = 0.253). In addition, no difference was observed between patients with DM and patients with ASS (7.4 ± 0.8 m/s vs. 7.4 ± 0.9 m/s;P = 1.000). Conclusions: Despite the high prevalence of dyslipidemia and systemic arterial hypertension, our female patients with stable DM and ASS had FMD and PWV values comparable to those of the control group.

关键词： Arterial Stiffness Atherosclerosis Endothelial Dysfunction Systemic Autoimmune Myopathies

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Impact of an Exercise Training Program in a Patient with Relapsing Polychondritis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2018年第3期8卷 93-98页

作者： Alexandre Moura dos Santos Diego Sales de Oliveira rafael giovani misse Letícia Alves Perin Jean Marcos de Souza Fernanda Rodrigues Lima Rosa Maria Rodrigues Pereira Samuel Katsuyuki Shinjo Division of Rheumatology Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil

Background: Exercise training has demonstrating to be safe and promote benefits for several rheumatologic autoimmune diseases. However, no study has evaluated the safety and benefits of exercise in relapsing polychondritis. Aim: To evaluate the effectiveness of an exercise training program in a patient with relapsing polychondritis. Case presentation: A 67-year-old female patient with relapsing polychondritis in remission was submitted to a 12-week, twice weekly, aerobic and resistance training program. Aerobic capacity, muscle strength and function capacity, as well as body composition, were evaluated at baseline and after 12-weeks. Conclusions: Exercise training program demonstrated to be effective for increasing aerobic capacity, muscle strength and function, and for improving body composition in the patient. Further studies are necessary to confirm these findings.

关键词： Exercise Training Relapsing Polychondritis Aerobic Training Resistance Training

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Effects of Exercise Training on Endothelial Function,Arterial Structure,and Physical Conditioning in Patients with Systemic Autoimmune Myopathies:A Case Series Study

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Open Journal of Rheumatology and Autoimmune Diseases 2019年第2期9卷 57-68页

作者： rafael giovani misse Isabela Bruna Pires Borges Alexandre Moura dos Santos Diego Sales de Oliveira Jean Marcos de Souza Bruno Gualano Valéria Aparecida Costa Hong Luis Aparecido Bortolotto Samuel Katsuyuki Shinjo Faculdade de Medicina FMUSP Universidade de Sao Paulo SP Brazil Hypertension Unit Instituto do Coracao Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo SP Brazil

Introduction. Exercise training has been effective in improving endothelial function and decreasing arterial stiffness in several systemic autoimmune diseases. However, to date, no studies have assessed patients with systemic autoimmune myopathies (SAM). Methods. Five female patients with definite SAM (3 dermatomyositis and 2 polymyositis) who underwent a 12-week, twice-a-week, exercise training program were assessed prospectively. The following parameters were assessed: endothelial function measured by flow-mediated dilatation (FMD), carotid femoral by pulse wave velocity (PWV), disease status by International Myositis Assessment & Clinical Studies Group (IMACS) set score, the ventilatory anaerobic threefold (VAT), respiratory compensation point (RCP), maximum effort (ME), maximal oxygen uptake (VO2max) measured by ergospyrometer, and strength and muscle function. Results. Mean age of the patients and duration of disease were 43.9 and 10.5 years, respectively. The median FMD and PWV were 10.2% and 7.1 m/s. After exercise training, important FMD reduction was observed in 4 out of 5 patients, whereas the PWV parameters decreased in only 2 out of 5 patients. The exercise training was safe, without clinical intercurrences or disease relapses. Moreover, an increase in strength and functionality was observed. Concerning aerobic capacity, there was a decrease in the VAT and an increase in ME, without al-terations in the maximum oxygen consumption. Conclusions. In general, exercise training does not alter endothelial function and PWV values, but improves muscle strength and function and also, does not lead to disease reactivation (Clinical Trials (NCT03092167)).

关键词： Dermatomyositis Endothelial Function Exercise Polymyositis Pulse Wave Velocity

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Transcranial Direct Current Stimulation Is Safe and Relieves Post-Herpetic Neuralgia in Patient with Dermatomyositis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases（风湿病与自身免疫疾病期刊） 2022年第4期

作者： rafael giovani misse alexandre moura dos santos abrahão fontes baptista samuel katsuyuki shinjo

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Transcranial Direct Current Stimulation Combined with Peripheral Neuromuscular Stimulation Improves Quality of Life, Fatigue, and Pain in a Patient with Rheumatoid Arthritis and Refractory Radicular Pain Related to Spinal Stenosis

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Open Journal of Rheumatology and Autoimmune Diseases 2023年第1期13卷 1-7页

作者： rafael giovani Missé Lucas De Macedo Dos Santos Clarice Tanaka Abrahão Fontes Baptista Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Sao Paulo Brazil Department of Physical Therapy Speech Therapy and Ocupacional Therapy Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Sao Paulo Brazil Center for Mathematics Computing and Cognition Universidade Federal de ABC Sao Paulo Brazil

Background: Transcranial direct current stimulation (tDCS) has emerged as an adjuvant noninvasive neuromodulation tool to control fatigue and pain. To date, no studies have assessed the safety and efficiency of tDCS in patients with rheumatoid arthritis and with fatigue, poor quality of life, and refractory radicular pain associated with spinal stenosis. Case Presentation: An 85-year-old woman patient presented with rheumatoid arthritis in remission, refractory radicular pain-associated spinal stenosis, fatigue, and impaired quality of life. The patient underwent 16 daily sessions of tDCS intervention (2 mA, 20 min, positively and negatively charged electrodes were positioned at C1 and Fp2, respectively), in addition to simultaneous peripheral neuromuscular electrical stimulation (frequency of 100 Hz and amplitude of 500 μs). After the intervention, neither disease relapse nor clinical intercurrence occurred. Moreover, there was a significant and sustained improvement in her health-related quality of life, with a reduction in the level of pain and chronic fatigue. Conclusion: The present case report shows that tDCS is safe and may be an adjuvant tool for the treatment of pain and fatigue in patients with systemic autoimmune disease, as well as for improving quality of life. Further studies are required to corroborate this case report.

关键词： Neuromodulation Pain Radiculopathy Rheumatoid Arthritis Treatment

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Safety of Transcranial Direct Current Electrical Stimulation in Dermatomyositis: A Case Report

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Open Journal of Rheumatology and Autoimmune Diseases 2020年第2期10卷 88-93页

作者： rafael giovani Missé Luiz Felipe Adsuara de Sousa Lucas de Macedo dos Santos Abrahão Fontes Baptista Clarice Tanaka Julia Maria D’Andréa Greve Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSPUniversidade de Sao PauloSao PauloSPBrazil(BR) Department of Physical Therapy Speech Therapy and Occupational TherapyHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSao PauloSPBrazil(BR) Center for Mathematics Computing and CognitionUniversidade Federal de ABCSPBrazil(BR) Laboratory of Movement Studies Institute of Orthopedics and TraumatologyHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloBrazil(BR)

Transcranial direct current stimulation (tDCS) has emerged as a nonpharmacological tool in physical rehabilitation. There have currently no studies that evaluated the safety and efficacy of tDCS in patients with dermatomyositis. Case-report: Three adult women with dermatomyositis were allocated randomly to intervention (i-tDCS, one patient) or not (sham-tDCS, two patients) of three consecutive days of tDCS and evaluated in four periods: before-tDCS (PRE), 15 minutes after-tDCS (0th POST), 15 days after-tDCS (15th POST), and 30 days after-tDCS (30th POST). The tDCS was safe throughout the protocol, without disease relapsing or adverse effects related to tDCS. Furthermore, the tDCS increased the muscle torque and total work of dominant and non-dominant elbow flexors in the patient with i-tDCS, when compared to two patients with sham-tDCS. Conclusions: The tDCS was safe and appeared to influence long-term strength in the limb of the patient with stable dermatomyo-sitis.

关键词： Dermatomyositis Neuromodulation Safety Systemic Autoimmune Myopathies

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Pain and Fatigue Perceptions of Patients with Systemic Autoimmune Myopathies before and during the COVID-19 Pandemic Period

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Open Journal of Rheumatology and Autoimmune Diseases 2022年第4期12卷 83-98页

作者： rafael giovani Missé Isabela Bruna Pires Borges Bruna Lindoso Correia Lorenza Rosa Silvério da Silva Marlise Sítima Mendes Simões Alexandre Moura dos Santos Samuel Katsuyuki Shinjo Division of Rheumatology Faculdade de Medicina FMUSP Universidade de Sao Paulo Brazil

Objective: To assess general pain and fatigue and their association with the disease status of patients with systemic autoimmune myopathies (SAMs), in terms of the impact of the COVID-19 pandemic on these parameters. Methods: This is a cross-sectional and prospective cohort study that included 72 patients with SAMs who were matched by age and gender with 67 healthy individuals. The patients engaged in an interview via a validity survey to measure disease status, and assess a visual analog scale (VAS) for pain and fatigue in two periods: before (phase I) and during (phase II) of the Brazilian COVID-19 pandemic. For cross-sectional analysis, patients’ data from phase I were compared to healthy individuals’ information, whereas for prospective analysis, data of the patients who were assessed in phase II were compared to the same patients’ data from phase I. Results: The patients had significantly more pain perception, comparable fatigue perception and fatigue severity, when compared to the healthy individuals. During the COVID-19 pandemic period, the disease activity, pain and fatigue perceptions, and fatigue severity remained unchanged. Despite this, the pain and fatigue perceptions correlated significantly with patients’ VAS, the patient health outcome, and fatigue severity. In addition, the pain perception correlated to creatine phosphokinase, whereas fatigue perceptions correlated to physicians' VAS. Conclusions: The study showed that patients with SAMs have significantly increased pain perceptions compared to healthy individuals. During the COVID-19 pandemic period, the pain and fatigue perceptions remained unchanged in patients with SAMs but they correlated to several disease status parameters.

关键词： COVID-19 Pandemic Fatigue Inflammatory Myopathies Myositis Physical Activity

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Above-Optimum Temperature-Induced Differential Photosynthetic and Roots Morphometric Responses in Two Contrasting Rice Genotypes

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Journal of Agricultural Science and Technology(B) 2017年第5期7卷 309-319页

作者： Diogo da Silva Moural Italo Lucas de Moraes Rodrigo da Silva Armestol rafael Silva da Silva Femanda Reolon Junior Borela Paulo Ricardo Reis Fagundes giovani Greigh de Brito Sidnei Deuner Institute of Biology Department of Botany Federal University of Pelotas (UFPel) Capao do Leao 96010-900 RS Brazil EMBRAPA Temperate Climate Brazilian Agricultural Research Corporation Pelotas 96010-971 RS Brazil

Temperature thresholds during the rice （Oryza sativa L.） cycle development have been reported to affect plant metabolism Therefore, this study aimed to evaluate the effects of the above-optimal temperature on photosynthetic and morphometric parameters in two contrasting irrigated rice genotypes （BRS Quer^ncia--sensitive and Nagina 22 （N22）~tolerant）. Plants of both genotypes were grown in rhizotrons and always maintained under two temperature conditions： Out--under environmental temperature conditions, and In--rhizotrons inside a plastic structure, which increased the temperature about 3 ~C to 5 ~C above the external one. In the genotype N22, there was an increase （twofold higher） in CO2 assimilation in plants cultivated under elevated temperature （In）. In BRS Quer^ncia, the stomatal conductance （gs） and transpiration rate （E） decreased upon high temperature. The rise in the temperature also negatively impacted in the modulated fluorescence parameters in both genotypes. Increases in root dry weight （RDW） and shoot dry weight （SDW） were also observed in the genotype N22 when compared to BRS Quer^ncia upon temperature rise. In general, the N22 genotype showed greater response to the above-optimal temperature due to its intrinsic thermotolerance traits over BRS Quer^ncia. Thus, N22 appeared as a potential donor of heat tolerance genes aiming to obtain new cultivar to face current global wanning.

关键词： Oryza sativa L. heat thermotolerance photosynthesis root system.

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