Biomedical subjects

Maria Isabel Schinoni

Publications and source records attributed to Maria Isabel Schinoni.

5 recordsLinked to original sources

PubMed2006

Peripheral insulin resistance during treatment of chronic hepatitis C with peguilated interferon plus ribavirin.

UNLABELLED: Patients with hepatitis C virus (HCV) infection present higher risk of developing type-2 diabetes mellitus (DM). However, the mechanism of this association and the role of antiviral treatment are still unclear. The objective of this study was to investigate the relationship between the use of peguilated interferon and the development of insulin resistance (IR) in these patients. METHODS: HOMA index was evaluated in 30 HCV-infected patients just before and during the first 6 months of treatment with peguilated interferon plus ribavirin. Anthropometrical parameters and glucose/cholesterol profile were also monitored. RESULTS: No changes in HOMA after 6 months of treatment were observed. Glucose levels decreased but not significantly (P = 0.059). Patients with higher HOMA index after 6 months of treatment also presented higher aminotransferase levels (P = 0.03), higher fat index on computed tomography (P = 0.011), longer time of exposure to the virus (P = 0.021), and a positive smoking history when compared to non-insulin resistant patients (P = 0.045). There was no influence of fibrosis stage on liver biopsy in the insulin-resistance development. CONCLUSIONS: No changes in the IR were observed after 6 months of treatment. Insulin resistance is related to the abdominal fat and anthropometrical parameters rather than to the antiviral treatment.

Adult↗

PubMed2006

Anti-Golgi complex antibodies during pegylated-interferon therapy for hepatitis C.

BACKGROUND/AIM: Pegylated interferon (Peg-IFN) plus ribavirin is the standard therapy for hepatitis C. Peg-IFN has several antiviral mechanisms, but its role in hepatitis C treatment seems to be related to its immunomodulatory effect. Ribavirin, an antiviral agent, potentiates IFN activity when added to it. Both drugs are associated with adverse reactions of different magnitudes. Autoimmune phenomena have been reported with this treatment. In this paper, we describe cases of ALT/GGT flares during Peg-IFN plus ribavirin treatment, which related to the appearance of anti-Golgi antibody and disease progress. METHODS: We investigated three patients with hepatitis C and severe ALT/GGT flares during Peg-IFN and ribavirin treatment coinciding with anti-Golgi complex antibody as the only marker of autoimmunity. We then reviewed the medical files and tested anti-Golgi antibody in stored sera from 25 patients treated with conventional IFN and in 14 patients treated with Peg-IFN. RESULTS: The three patients were male, over 45 years of age; all were relapsers and non-responders. Anti-Golgi antibody was positive during treatment coinciding with ALT/GGT flares but with hepatitis C virus (HCV)-RNA negativity, disappearing after stopping treatment, with normalization of ALT/AST levels. One patient had progression of fibrosis from F2 to F3 despite negativity of HCV-RNA. In the last group, only two patients treated with Peg-IFN experienced ALT/GGT flares but without anti-Golgi antibody CONCLUSIONS: The presence of anti-Golgi complex antibody could be a marker of a temporary autoimmune phenomenon and progressive disease.

Alanine Transaminase↗

PubMed2006

Apoptosis and progression of hepatic fibrosis in hepatitis C patients.

Hepatitis C is a worldwide endemic disease, affecting roughly 200 million people. It has a variable prognosis, depending on the progression to fibrosis. During the last five years, the importance of apoptosis for the pathogenesis of various diseases, including hepatitis, has been recognized. It has been suggested that an increase in T cell-apoptosis during a hepatitis C virus infection is the cause of impaired regulation of the immune cellular response, helping to maintain infection. Thus, the interest in discovering the probable mechanisms by which the hepatitis C virus perpetuates in the liver, and to determine the conditions that predispose for progression of this disease, makes investigation of apoptosis in hepatic injury of great interest. We have made an overview of the various mechanisms by which the cell, more specifically the hepatic cell, is affected by apoptosis, and how it interacts with the hepatitis C virus and the immune system.

Apoptosis↗

PubMedDate not supplied

Effect of amantadine on depressive symptoms in chronic hepatitis C patients treated with pegylated interferon: a randomized, controlled pilot study.

OBJECTIVE: Assess the effect of amantadine on depressive symptoms during interferon alfa therapy for hepatitis C virus infection. METHODS: We performed a randomized, controlled trial with 14 hepatitis C virus-infected patients, treated with pegylated interferon alfa-2a 180 microg/wk plus ribavirin 1.200 mg/d. Eight patients were randomized to receive amantadine 200 mg/d, and 6 other individuals were randomized to control group without amantadine. Severity of depression and anxiety was measured using the Hospital Anxiety and Depression Scale, before starting re-treatment, and 4, 12, and 24 weeks after immunotherapy with pegylated interferon alfa-2a. Evaluations were performed by psychiatrists blinded in reference to the state of amantadine treatment. Friedman chi(2) test for repeated measures and Mann-Whitney test for nonparametric data were used to assess significant differences. RESULTS: From baseline to follow-up, no significant increase in mean Hospital Anxiety and Depression Scale scores of depressive symptoms were seen in amantadine group (P = 0.142), meanwhile there was a statistical increase of depression scores in the control group (P = 0.001). CONCLUSIONS: Our randomized pilot study, though small, clearly indicates that interferon alfa-induced depressive symptoms can be prevented by the use of amantadine. However, double-blind placebo-controlled trials with a higher sample size are required to confirm these preliminary findings.

Adult↗

PubMedDate not supplied

[Hepatitis E].

Hepatitis E virus (HEV) is the second most frequent hepatotropic virus transmitted via fecal-oral route, following closely behind hepatitis A virus. The great epidemics of hepatitis described during the 50s and 60s, in India, were caused by this virus. Epidemic bursts have also been described in Central Africa, Latin America, Middle East and in the independent Republics of the ex-Soviet Union. The clinical features of the disease do not differ from those reported for other viral hepatitides. There have been no cases of chronic hepatitis E reported. Around 20% of women infected during pregnancy develop a severe form of hepatitis which courses to liver failure. Diagnosis of hepatitis is confirmed when antibodies (using ELISA) of the IgM class (acute phase) and/or IgG (infected and cured) are found in the serum. Immunoblot and PCR-RNA may be used as necessary. There is no specific treatment for hepatitis E. Hyperimmune serum has been tried by some authors. Prevention is achieved by following the habitual hygienic and dietetic recommendations valid for diseases transmitted by contaminated water. There is no effective vaccine against the disease.

Disease Outbreaks↗