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Avaliação dos mediadores inflamatórios e microbioma no exsudato de feridas de pacientes com úlcera falciforme

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dc.creator Oliveira, Gabriel Ferreira
dc.date.accessioned 2025-08-22T12:13:00Z
dc.date.available 2027-08-03
dc.date.available 2025-08-22T12:13:00Z
dc.date.issued 2025-07-03
dc.identifier.citation OLIVEIRA, Gabriel Ferreira. Avaliação dos Mediadores inflamatórios e microbioma no exsudato de feridas de pacientes com úlcera. Orientador: Vitor Fortuna; Coorientador: Roberto José Meyer Nascimento. 2025. 105 f. Dissertação (Mestrado em Imunologia) - Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador (BA), 2025. pt_BR
dc.identifier.uri https://repositorio.ufba.br/handle/ri/42768
dc.description.abstract Introduction: Leg ulcers in sickle cell disease (SCDLU) represent debilitating and chronic manifestations associated with disease severity, resulting in delayed wound healing and unpredictable recurrence linked to aberrant regulation of inflammatory mediators. Although elevated levels of cytokines and altered microbiome composition have been associated with impaired healing in other wound types, their specific role in SCDLU remains incompletely understood. Objective: To characterize the exudate profile of SCDLU, with particular emphasis on inflammatory mediator analysis and identification of lesion associated microbiome. Methods: Wound exudate samples were collected between January 2023 and June 2024 at the outpatient clinics of Professor Edgard Santos University Hospital (HUPES) and the State Reference Center for Sickle Cell Disease (CERPDF-RV/Hemoba) (CAAE: 56643222.0.0000.5662). This cross-sectional study analyzed clinical data, inflammatory profiles, and wound microbiome composition. Cytokines were quantified using sandwich ELISA (R&D Systems; Invitrogen), and statistical analyses were performed using GraphPad Prism (version 9). Results: The study included 40 SCD patients, comprising 63 analyzed ulcers. Median age was 41 years, with 55.0% male participants. Each patient was presented with 1-4 cutaneous lesions and laboratory data revealed chronic hemolysis and anemia. IL-6, PSGL-1, and P-selectin levels were significantly lower in ulcers with small diameter, while IFN-γ and IL-8 showed no significant differences between groups. ROC analysis indicated that IL-6, PSGL-1, and P-selectin effectively discriminated against lesion size, suggesting their potential as inflammatory biomarkers. Furthermore, larger ulcers exhibited greater bacterial diversity in microbiome analysis. Conclusion: Our findings demonstrate that IL-6, PSGL-1, and P-selectin play significant roles in SCDLU pathophysiology and may serve as reliable biomarkers for lesion size. The observed increase in bacterial diversity in extensive ulcers suggests potential microbiome involvement in perpetuating local inflammation. These results may contribute to improved clinical assessment and therapeutic management of SCD-associated ulcers. pt_BR
dc.description.sponsorship Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB) pt_BR
dc.language por pt_BR
dc.publisher Universidade Federal da Bahia pt_BR
dc.rights Acesso Restrito/Embargado pt_BR
dc.subject Úlcera falciforme pt_BR
dc.subject Anemia Falciforme pt_BR
dc.subject Inflamação pt_BR
dc.subject Cicatrização pt_BR
dc.subject Biomarcador pt_BR
dc.subject.other Sickle cell leg ulcer pt_BR
dc.subject.other Inflammation pt_BR
dc.subject.other Anemia, Sickle Cell pt_BR
dc.subject.other Healing pt_BR
dc.subject.other Biomarker pt_BR
dc.title Avaliação dos mediadores inflamatórios e microbioma no exsudato de feridas de pacientes com úlcera falciforme pt_BR
dc.title.alternative Evaluation of inflammatory mediators and the microbiome in wound exudate from patients with sickle cell ulcers pt_BR
dc.type Dissertação pt_BR
dc.publisher.program Programa de Pós-Graduação em Imunologia - (PPGIM)  pt_BR
dc.publisher.initials UFBA pt_BR
dc.publisher.country Brasil pt_BR
dc.subject.cnpq CNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA::IMUNOLOGIA APLICADA pt_BR
dc.contributor.advisor1 Fortuna, Vitor Antônio
dc.contributor.advisor1ID https://orcid.org/0000-0001-7281-3287 pt_BR
dc.contributor.advisor1Lattes http://lattes.cnpq.br/3535550424970530 pt_BR
dc.contributor.advisor-co1 Nascimento, Roberto José Meyer
dc.contributor.advisor-co1ID https://orcid.org/0000-0002-4727-4805 pt_BR
dc.contributor.advisor-co1Lattes http://lattes.cnpq.br/9574426480028427 pt_BR
dc.contributor.referee1 Aleluia, Milena Magalhães
dc.contributor.referee1ID https://orcid.org/0000-0001-6928-824X pt_BR
dc.contributor.referee1Lattes http://lattes.cnpq.br/4312312024270025 pt_BR
dc.contributor.referee2 Cordeiro, Soraia Machado
dc.contributor.referee2ID https://orcid.org/0000-0001-5320-892X pt_BR
dc.contributor.referee2Lattes http://lattes.cnpq.br/9277624701608674 pt_BR
dc.contributor.referee3 Fortuna, Vitor Antônio
dc.contributor.referee3ID https://orcid.org/0000-0001-7281-3287 pt_BR
dc.contributor.referee3Lattes http://lattes.cnpq.br/3535550424970530 pt_BR
dc.creator.ID https://orcid.org/0009-0008-1163-1402 pt_BR
dc.creator.Lattes https://lattes.cnpq.br/9844466316389564 pt_BR
dc.description.resumo Introdução: Úlceras em membros inferiores na doença falciforme (DF) são manifestações debilitantes e crônicas associadas à gravidade patológica que resultam em cicatrização tardia e recorrência imprevisível associadas à desregulação de mediadores inflamatórios e hemolíticos. Embora altos níveis dos mediadores inflamatórios e microbioma tenham sido relacionados à cicatrização prejudicada em outras lesões, seu papel específico em úlceras de DF ainda não está totalmente esclarecido. Objetivo: Caracterizar os aspectos do exsudato de úlceras falciformes, com ênfase na análise de mediadores inflamatórios e na identificação do microbioma associado às lesões. Metodologia: Foram coletadas amostras de exsudato de feridas entre janeiro de 2023 e junho de 2024 no ambulatório do Hospital Universitário Professor Edgard Santos (HUPES) e no Centro Estadual de Referência à Pessoa com Doença Falciforme (CERPDF-RV/Hemoba) (CAAE: 56643222.0.0000.5662). O estudo, de delineamento transversal, analisou dados clínicos, perfil inflamatório e composição do microbioma das lesões. As citocinas foram quantificadas por ELISA sanduíche (R&D Systems; Invitrogen), e as análises estatísticas foram realizadas no GraphPad Prism (versão 9). Resultados: 40 pacientes incluídos com doença falciforme, totalizando 63 úlceras analisadas. A mediana de idade foi de 41 anos, com 55,0% sendo do sexo masculino. Cada paciente apresentou de 1 a 4 lesões cutâneas e exames laboratoriais indicaram hemólise e anemia crônica. Níveis de IL-6, PSGL-1 e P-selectina foram significativamente menores em úlceras de menor dimensão, enquanto o IFN-γ e IL-8 não diferiu entre os grupos avaliados. A análise ROC indicou que IL-6, PSGL-1 e P-selectina discriminaram bem o tamanho das lesões, sugerindo seu potencial como biomarcadores inflamatórios. Além disso, úlceras maiores apresentaram maior diversidade bacteriana no microbioma. Conclusão: Os resultados indicam que IL-6, PSGL-1 e P-selectina desempenham um papel relevante na fisiopatologia das úlceras em pacientes com DF, podendo servir como biomarcadores associados ao tamanho das lesões. Além disso, a maior diversidade bacteriana em úlceras extensas sugere uma possível influência do microbioma na perpetuação da inflamação local. Esses achados podem auxiliar na avaliação clínica e no tratamento dessas lesões. pt_BR
dc.publisher.department Instituto de Ciências da Saúde - ICS pt_BR
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dc.type.degree Mestrado Acadêmico pt_BR


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