ABC2-Artigos (em revistas ou actas indexadas)
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- Zebrafish Avatar-test forecasts clinical response to chemotherapy in patients with colorectal cancerPublication . Costa, Bruna; Estrada, Marta F.; Gomes, António; Fernandez, Laura M.; Azevedo, José M.; Póvoa, Vanda; Fontes, Márcia; Alves, António; Galzerano, António; Castillo-Martin, Mireia; Herrando, Ignacio; Brandão, Shermann; Carneiro, Carla; Nunes, Vítor; Carvalho, Carlos; Parvaiz, Amjad; Marreiros, Ana; Fior, RitaCancer patients often undergo rounds of trial-and-error to find the most effective treatment because there is no test in the clinical practice for predicting therapy response. Here, we conduct a clinical study to validate the zebrafish patient-derived xenograft model (zAvatar) as a fast predictive platform for personalized treatment in colorectal cancer. zAvatars are generated with patient tumor cells, treated exactly with the same therapy as their corresponding patient and analyzed at single-cell resolution. By individually comparing the clinical responses of 55 patients with their zAvatar-test, we develop a decision tree model integrating tumor stage, zAvatar-apoptosis, and zAvatar-metastatic potential. This model accurately forecasts patient progression with 91% accuracy. Importantly, patients with a sensitive zAvatar-test exhibit longer progression-free survival compared to those with a resistant test. We propose the zAvatar-test as a rapid approach to guide clinical decisions, optimizing treatment options and improving the survival of cancer patients.
- Identification of novel DNA methylation prognostic biomarkers for AML with normal cytogeneticsPublication . Cardoso, Cândida; Pestana, Daniel; Gokuladhas, Sreemol; Marreiros, Ana; Justin M. O'Sullivan; Binnie, Alexandra; Teotónio Fernandes, Mónica Alexandra; Castelo-Branco, PedroPURPOSE AML is a hematologic cancer that is clinically heterogeneous, with a wide range of clinical outcomes. DNA methylation changes are a hallmark of AML but are not routinely used as a criterion for risk stratification. The aim of this study was to explore DNA methylation markers that could risk stratify patients with cytogenetically normal AML (CN-AML), currently classified as intermediate-risk.MATERIALS AND METHODSDNA methylation profiles in whole blood samples from 77 patients with CN-AML in The Cancer Genome Atlas (LAML cohort) were analyzed. Individual 5'-cytosine-phosphate-guanine-3' (CpG) sites were assessed for their ability to predict overall survival. The output was validated using DNA methylation profiles from bone marrow samples of 79 patients with CN-AML in a separate data set from the Gene Expression Omnibus.RESULTSIn the training set, using DNA methylation data derived from the 450K array, we identified 2,549 CpG sites that could potentially distinguish patients with CN-AML with an adverse prognosis (intermediate-poor) from those with a more favorable prognosis (intermediate-favorable) independent of age. Of these, 25 CpGs showed consistent prognostic potential across both the 450K and 27K array platforms. In a separate validation data set, nine of these 25 CpGs exhibited statistically significant differences in 2-year survival. These nine validated CpGs formed the basis for a combined prognostic biomarker panel, which includes an 8-CpG Somatic Panel and the methylation status of cg23947872. This panel displayed strong predictive ability for 2-year survival, 2-year progression-free survival, and complete remission in the validation cohort.CONCLUSIONThis study highlights DNA methylation profiling as a promising approach to enhance risk stratification in patients with CN-AML, potentially offering a pathway to more personalized treatment strategies.
- Oxidative stress and aging: synergies for age related diseasesPublication . Filipa Santos, Daniela; Simao, Sonia; Nóbrega, Clévio; Bragança, José; Castelo-Branco, Pedro; Pombinho de Araújo, Inês Maria; ALFA Score ConsortiumAging is characterized by a progressive decline in physiological function and underlies several disabilities, including the increased sensitivity of cells and tissues to undergo pathological oxidative stress. In recent years, efforts have been made to better understand the relationship between age and oxidative stress and further develop therapeutic strategies to minimize the impact of both events on age-related diseases. In this work, we review the impact of the oxidant and antioxidant systems during aging and disease development and discuss the crosstalk of oxidative stress and other aging processes, with a focus on studies conducted in elderly populations.
- Pantoprazole-induced liver injury in the setting of diabetic ketoacidosisPublication . de Oliveira, Raquel; Almeida, Manuel; Lavado, Pedro; Baptista, AlexandreCritically ill patients are at higher risk of acquired liver in-jury, given the multiple coexisting potential causes of injury.1They are also at risk of stress ulcers, and prophylaxis with proton pump inhibitors (PPIs) is common in Intensive Care Units (ICUs). A 54-year-old woman was admitted to the ICU due to diabetic ketoacidosis (DKA). On admission, she was hemo-dynamically stable, with a Glasgow Coma Scale score of 7 (E2V1M4). Her abdominal examination was normal, without palpable organomegalies, and her liver blood tests were within the normal range. She was intubated for airway pro-tection and started on intravenous fluids, insulin perfusion, and prophylaxis with intravenous pantoprazole 40 mg/day.
- Potentially inappropriate medication: a pilot study in institutionalized older adultsPublication . Andrade, Amanda de Oliveira; Nascimento, Tânia; Cabrita, Catarina; Leitao, Helena; Pinto, EzequielInstitutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.
- Spatio-temporal dynamics of early somite segmentation in the chicken embryoPublication . Maia-Fernandes, Ana C; Martins, Ana; Borralho Martins, Nísia; Pais de Azevedo, Tomás; Magno, Ramiro; dos Santos Duarte, Guilhermina Isabel; Andrade, Raquel; MDuring vertebrate embryo development, the body is progressively segmented along the anterior-posterior (A-P) axis early in development. The rate of somite formation is controlled by the somitogenesis embryo clock (EC), which was first described as gene expression oscillations of hairy1 (hes4) in the presomitic mesoderm of chick embryos with 15-20 somites. Here, the EC displays the same periodicity as somite formation, 90 min, whereas the posterior-most somites (44-52) only arise every 150 minutes, matched by a corresponding slower pace of the EC. Evidence suggests that the rostral-most somites are formed faster, however, their periodicity and the EC expression dynamics in these early stages are unknown. In this study, we used time-lapse imaging of chicken embryos from primitive streak to somitogenesis stages with high temporal resolution (3-minute intervals). We measured the length between the anterior-most and the last formed somitic clefts in each captured frame and developed a simple algorithm to automatically infer both the length and time of formation of each somite. We found that the occipital somites (up to somite 5) form at an average rate of 75 minutes, while somites 6 onwards are formed approximately every 90 minutes. We also assessed the expression dynamics of hairy1 using half-embryo explants cultured for different periods of time. This showed that EC hairy1 expression is highly dynamic prior to somitogenesis and assumes a clear oscillatory behaviour as the first somites are formed. Importantly, using ex ovo culture and live-imaging techniques, we showed that the hairy1 expression pattern recapitulates with the formation of each new pair of somites, indicating that somite segmentation is coupled with EC oscillations since the onset of somitogenesis.
- Editorial: Endocrine regulation and physiological adaptation of stress response in aquatic organismsPublication . Li, Yiming; Li, Yi-Feng; Campinho, Marco António; Fuentes, JuanOrganismal growth is a complex, genetically regulated process that integrates various physiological signaling pathways, where endocrine regulation is pivotal. In fully developed animals, endocrine regulation plays a central role in maintaining homeostasis and adapting to changing environmental and biological conditions. In aquatic organisms, environmental stressors such as environmental temperature, hypoxia, salinity changes, and exposure to pollutants can disrupt homeostasis, leading to physiological, molecular, and behavioral responses. Understanding the molecular and cellular mechanisms of endocrine regulation and physiological adaptation in response to environmental stresses is crucial, significantly impacting aquatic ecosystems. The main objective of this Research Topic was to explore and discuss these mechanisms, providing valuable insights into aquatic animal biology and adaptation.
- Comparison of the ABC and ACMG systems for variant classificationPublication . Houge, Gunnar; Bratland, Eirik; Aukrust, Ingvild; Tveten, Kristian; Žukauskaitė, Gabrielė; Sansovic, Ivona; Brea-Fernández, Alejandro J.; Mayer, Karin; Paakkola, Teija; McKenna, Caoimhe; Wright, William; Markovic, Milica Keckarevic; Lildballe, Dorte L.; Konecny, Michal; Smol, Thomas; Alhopuro, Pia; Gouttenoire, Estelle Arnaud; Obeid, Katharina; Todorova, Albena; Jankovic, Milena; Lubieniecka, Joanna M.; Stojiljkovic, Maja; Buisine, Marie-Pierre; Haukanes, Bjørn Ivar; Lorans, Marie; Roomere, Hanno; Petit, François M.; Haanpää, Maria K.; Beneteau, Claire; Pérez, Belén; Plaseska-Karanfilska, Dijana; Rath, Matthias; Fuhrmann, Nico; ferreira, Bibiana; Stephanou, Coralea; Sjursen, Wenche; Maver, Aleš; Rouzier, Cécile; Chirita-Emandi, Adela; Gonçalves, João; Kuek, Wei Cheng David; Broly, Martin; Haer-Wigman, Lonneke; Thong, Meow-Keong; Tae, Sok-Kun; Hyblova, Michaela; Dunnen, Johan T. den; Laner, AndreasThe ABC and ACMG variant classification systems were compared by asking mainly European clinical laboratories to classify variants in 10 challenging cases using both systems, and to state if the variant in question would be reported as a relevant result or not as a measure of clinical utility. In contrast to the ABC system, the ACMG system was not made to guide variant reporting but to determine the likelihood of pathogenicity. Nevertheless, this comparison is justified since the ACMG class determines variant reporting in many laboratories. Forty-three laboratories participated in the survey. In seven cases, the classification system used did not influence the reporting likelihood when variants labeled as “maybe report” after ACMG-based classification were included. In three cases of population frequent but disease-associated variants, there was a difference in favor of reporting after ABC classification. A possible reason is that ABC step C (standard variant comments) allows a variant to be reported in one clinical setting but not another, e.g., based on Bayesian-based likelihood calculation of clinical relevance. Finally, the selection of ACMG criteria was compared between 36 laboratories. When excluding criteria used by less than four laboratories (<10%), the average concordance rate was 46%. Taken together, ABC-based classification is more clear-cut than ACMG-based classification since molecular and clinical information is handled separately, and variant reporting can be adapted to the clinical question and phenotype. Furthermore, variants do not get a clinically inappropriate label, like pathogenic when not pathogenic in a clinical context, or variant of unknown significance when the significance is known.
- Thiopurines have no impact on outcomes of Crohn's disease patients beyond 12 months of maintenance treatment with infliximabPublication . Sousa, Paula; Patita, Marta; Arroja, Bruno; Lago, Paula; Rosa, Isadora; Sousa, Helena Tavares; Ministro, Paula; Mocanu, Irina; Vieira, Ana; Castela, Joana; Moleiro, Joana; Cancela, Eugenia; Roseira, Joana; Portela, Francisco; Correia, Luis; Santiago, Mafalda; Dias, Sandra; Alves, Catarina; Afonso, Joana; Dias, Claudia Camila; Magro, FernandoThe emergence of new treatments the inflammatory bowel diseases (IBD) raised questions regarding the role of older agents, namely thiopurines. Aims: To clarify the benefits of combination treatment with thiopurines on Crohn's disease (CD) patients in the maintenance phase of infliximab. Methods: In this analysis of the 2 -year prospective multicentric DIRECT study, patients were assessed in terms of clinical activity, faecal calprotectin (FC), C -reactive protein (CRP), and infliximab pharmacokinetics. A composite outcome based on clinical- and drug -related items was used to define treatment failure. Results: The study included 172 patients; of these, 35.5 % were treated with combination treatment. Overall, 18 % of patients achieved the composite outcome, without statistically significant differences between patients on monotherapy and on combination treatment (21.6% vs 11.5 %, p = 0.098). Median CRP, FC, and infliximab pharmacokinetic parameters were similar in both groups. However, in the sub -analysis by infliximab treatment duration, in patients treated for less than 12 months, the composite outcome was reached in fewer patients in the combination group than in the monotherapy group (7.1% vs 47.1 %, p = 0.021). Conclusion: In CD patients in maintenance treatment with infliximab, combination treatment does not seem to have benefits over infliximab monotherapy beyond 12 months of treatment duration.
- The polyglutamine protein ATXN2: from its molecular functions to its involvement in diseasePublication . Gomes da Costa, Rafael; Vieira da Conceição, André Filipe; Albuquerque Andrade de Matos, Carlos Adriano; Nóbrega, ClévioA CAG repeat sequence in the ATXN2 gene encodes a polyglutamine (polyQ) tract within the ataxin-2 (ATXN2) protein, showcasing a complex landscape of functions that have been progressively unveiled over recent decades. Despite significant progresses in the field, a comprehensive overview of the mechanisms governed by ATXN2 remains elusive. This multifaceted protein emerges as a key player in RNA metabolism, stress granules dynamics, endocytosis, calcium signaling, and the regulation of the circadian rhythm. The CAG overexpansion within the ATXN2 gene produces a protein with an extended poly(Q) tract, inducing consequential alterations in conformational dynamics which confer a toxic gain and/or partial loss of function. Although overexpanded ATXN2 is predominantly linked to spinocerebellar ataxia type 2 (SCA2), intermediate expansions are also implicated in amyotrophic lateral sclerosis (ALS) and parkinsonism. While the molecular intricacies await full elucidation, SCA2 presents ATXN2-associated pathological features, encompassing autophagy impairment, RNA-mediated toxicity, heightened oxidative stress, and disruption of calcium homeostasis. Presently, SCA2 remains incurable, with patients reliant on symptomatic and supportive treatments. In the pursuit of therapeutic solutions, various studies have explored avenues ranging from pharmacological drugs to advanced therapies, including cell or gene-based approaches. These endeavours aim to address the root causes or counteract distinct pathological features of SCA2. This review is intended to provide an updated compendium of ATXN2 functions, delineate the associated pathological mechanisms, and present current perspectives on the development of innovative therapeutic strategies.