Browsing by Author "Faria, B"
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- 3. Perfil de utilização de imunoglobulinas não específicas no Hospital de BragaPublication . Plácido, A; Faria, B; Barroso, S; Martins, S
- Análise das alterações do esquemas de tratamento antiretrovíricoPublication . Plácido, A; Faria, B; Gonçalves, J; Fortunato, R; Barroso, S; Martins, S
- Desenvolvimento de uma base de dados sobre estabilidade de medicamentos/produtos farmacêuticos após aberturaPublication . Plácido, A; Faria, B; Marcos, I; Fortunato, R
- Intradialytic Complement Activation Precedes the Development of Cardiovascular Events in Hemodialysis PatientsPublication . Poppelaars, F; Gaya da Costa, M; Faria, B; Berger, SP; Assa, S; Daha, MR; Medina Pestana, JO; van Son, WJ; Franssen, CF; Seelen, MABackground: Hemodialysis (HD) is a life-saving treatment for patients with end stage renal disease. However, HD patients have markedly increased rates of cardiovascular morbidity and mortality. Previously, a link between the complement system and cardiovascular events (CV-events) has been reported. In HD, systemic complement activation occurs due to blood-to-membrane interaction. We hypothesize that HD-induced complement activation together with inflammation and thrombosis are involved in the development of CV-events in these patients. Methods: HD patients were followed for the occurrence of CV-events during a maximum follow-up of 45 months. Plasma samples were collected from 55 patients at different time points during one HD session prior to follow-up. Plasma levels of mannose-binding lectin, properdin and C3d/C3 ratios were assessed by ELISA. In addition, levels of von Willebrand factor, TNF-α and IL-6/IL-10 ratios were determined. An ex-vivo model of HD was used to assess the effect of complement inhibition. Results: During median follow-up of 32 months, 17 participants developed CV-events. In the CV-event group, the C3d/C3-ratio sharply increased 30 min after the start of the HD session, while in the event-free group the ratio did not increase. In accordance, HD patients that developed a CV-event also had a sustained higher IL-6/IL-10-ratio during the first 60 min of the HD session, followed by a greater rise in TNF-α levels and von Willebrand factor at the end of the session. In the ex-vivo HD model, we found that complement activation contributed to the induction of TNF-α levels, IL-6/IL-10-ratio and levels of von Willebrand factor. Conclusions: In conclusion, these findings suggest that early intradialytic complement activation predominantly occurred in HD patients who develop a CV-event during follow-up. In addition, in these patients complement activation was accompanied by a pro-inflammatory and pro-thrombotic response. Experimental complement inhibition revealed that this reaction is secondary to complement activation. Therefore, our data suggests that HD-induced complement, inflammation and coagulation are involved in the increased CV risk of HD patients.
- Medicamentos biológicos - terapêutica evolutiva: Caracterização das patologias dos doentes medicados com medicamentos biológicos em ambulatórioPublication . Plácido, A; Faria, B; Gonçalves, J; Fortunato, R; Barroso, S