Yara Cristina de Paiva Maia

A Pilot Study Addressing the Impact of Religious Practice on Quality of Life of Breast Cancer Patients During Chemotherapy

The aim of this preliminary study was to investigate whether religious practice can modify quality of life (QoL) in BC patients during chemotherapy. QoL and religion practice questionnaire (RPQ) scores were evaluated in a sample of BC patients in different moments. Before chemotherapy initiation, women with lower physical and social functional scores displayed higher RPQ scores. On the other hand, low RPQ patients worsened some QoL scores over time. Body image acceptance was positively correlated with religious practice and specifically praying activity. This preliminary study suggests the importance of religion in coping with cancer chemotherapy.

Dynamic dialog between cytokeratin 18 and annexin A1 in breast cancer: A transcriptional disequilibrium

Cytokeratins (CKs) constitute the cytoskeletal network and are regulated by post-translational modifications, acting not only as a mechanical support, but also in cell signaling and regulatory processes. Signaling is mediated by CK-associated proteins, such as Annexin A1 (ANXA1), a ligand of the CK18/CK8 complex. ANXA1 has a pivotal role in cellular and immunological responses, and together with CK18 have been implicated in several processes related to malignant transformation in breast cancer (BC). Our aim was to demonstrate how their interaction might be linked to BC development. We investigated transcript levels, protein expression and distribution for both targets in breast tissues of 92 patients (42 BCs and 50 benign diseases) using qPCR and immunohistochemistry, respectively. ANXA1 and CK18 mRNAs were inversely correlated, and their ratio in each TNM stage significantly differentiated BC from benign diseases (OR=5.62). These differences did not mirror tissue protein levels, but a significant dichotomous protein distribution in tumor tissues was observed, differing from the expected co-localization observed during cell homeostasis. The disequilibrium of transcriptional levels between ANXA1/CK18 and alterations in their tissue distribution are present either in initial events or tumor progression, which suggest a critical event in BC. The broken dialog between ANXA1 and CK18 in normal breast tissues may play a critical role in BC development, and together may be used as combined targets for BC diagnostics.

Impact of chemotherapy on perceptions related to food intake in women with breast cancer: A prospective study

Breast cancer (BC) treatment includes mostly chemotherapy (CT), which can cause side effects like nausea, taste changes, early satiety, slow gastric emptying and xerostomia. In this way, the individual’s relationship with food may change during the treatment. The aim of this study was to evaluate the impact of chemotherapy on perceptions related to food intake of women with BC. Fifty-five women with BC were followed, and data were collected at three periods during first-line CT: beginning (T0), intermediate (T1) and end (T2). A visual analogue scale (VAS) (0 to 10 cm) for hunger, appetite for various food categories and meal enjoyment was investigated. The frequency and intensity of side effects were evaluated using a 4 cm scale. The results showed a higher prevalence of taste changes in T1 (p = 0.044) and more nausea in T1 and T2 (p = 0.018). Furthermore, the intensity of nausea was higher in T2 (p = 0.01) than in the other periods. We observed moderate hunger in T0, T1 and T2 (p = 0.113), but the overall appetite increased between T0 and T2 (p = 0.003). Meal enjoyment was reduced from T0 to T1and returned back to the initial value in T2 (p = 0.021). The appetite for salty (p = 0.004) and spicy (p = 0.03) foods was increased in T1. There was an increase of body weight (p = 0.008), body mass index (BMI) (p = 0.009) and waist circumference (WC) (p = 0.03) during CT. CT changes food hedonism, increasing the overall appetite and the appetite for salty and spicy foods. Moreover, we observed the negative impact of CT on meal enjoyment and an increase in side effects and anthropometric parameters.

Longer Times of Receipt of Adjuvant Endocrine Therapy Correspond to Improved Functional Capacity and Lower Adiposity in Women Receiving Adjuvant Therapy

Micro‐Abstract This clinical research studied functional capacity level, length of time of receipt of therapy with aromatase inhibitors (AIs), and adiposity parameters. Women with breast cancer in the first years of the use of AIs showed greater functional disability and worse adiposity parameters, thus reinforcing the need for special attention during this time and emphasizing the importance of multiprofessional follow‐up. Purpose: To study the use of functional capacity (FC) level and duration of aromatase inhibitor (AI) therapy with adiposity parameters in women with breast cancer. Patients and Methods: FC was evaluated through the Health Assessment Questionnaire, which was assessed by classification and divided into 3 groups: G1 = mild to moderate difficulty, G2 = moderate to severe disability, and G3 = severe or very severe disability. Body mass, height, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Bioelectrical impedance analysis was used to calculate body fat (BF) and fat‐free mass. The women were divided into 2 time groups (T1 and T2), which were determined by the median months of AI use (T1 ≤ 29.5 and T2 > 29.5 months). Results: Impaired FC and adiposity parameters were significantly positively correlated. In addition, physical exercise was significantly lower in women assessed as G2 and G3 compared to those assessed as G1. The effect of FC on BMI, BF, and WC was also verified, as was the effect of the duration of AI receipt on BMI and BF. Women at T1 had significantly greater functional disability, BMI, and BF values. In addition, although not statistically significant, women in T1 who were assessed as G3 presented higher BMI, WC, and BF values than those in T2. Conclusion: Adiposity above the recommended parameters and impaired FC were associated with the shortest time of receipt of adjuvant endocrine therapy with AI.

Time-related eating patterns and chronotype are associated with diet quality in pregnant women

ABSTRACT Animal studies strongly suggest that timed feeding can have beneficial physiological effects, including protection against the obesogenic and metabolic consequences of a high-fat diet. However, the relationship between variables related to the timing of eating and diet quality in pregnancy women, which is considered as a period of nutritional vulnerability, is still poorly described in the literature. Therefore, the aim of the present study was to investigate the associations between time-related eating patterns and chronotype with diet quality of pregnant women. This cross-sectional study was conducted with 100 pregnant women in the first gestational trimester (≤12 weeks of gestation). The information regarding food intake was obtained by three 24-Hour Dietary Recall (24HR). Time-related eating patterns, i.e., the interval between the first and the last meal (eating duration), nightly fasting, time of the first and last meals, and number of meals eating on a day were determined. Chronotype was derived using the mid-sleep time on free days on weekends, with a further correction for calculated sleep debt. Diet quality was evaluated using the Brazilian Healthy Eating Index-Revised (BHEI-R), validated for the Brazilian population. Linear regression modeling analyses adjusted for confounders were used to investigate the association between time-related eating patterns and chronotype with diet quality. The BHEI-R total score was negatively associated with time of the first meal (β = −0.355; p = 0.002; r2 adjusted = 0.141), and positively associated with eating duration (β = 0.262; p = 0.024; r2 adjusted = 0.086) and number of meals (β = 0.273; p = 0.019; r2 adjusted = 0.091). In addition, the score of total fruit component was negatively associated with chronotype (β = −0.236; p = 0.033; r2 adjusted = 0.078), time of the first meal (β = −0.393; p = 0.001; r2 adjusted = 0.171), and positively associated with eating duration (β = 0.259; p = 0.022; r2 adjusted = 0.087) and number of meals (β = 0.376; p = 0.001; r2 adjusted = 0.159). The score for whole fruit component was negatively associated with time of the first meal (β = −0.388; p = 0.001; r2 adjusted = 0.152), and positively associated with number of meals (β = 0.403; p = 0.001; r2 adjusted = 0.164). A longer eating duration, earlier time of the first meal, higher number of meals and morningness tendency are associated with a better diet quality in the first gestational trimester – higher scores of the total BHEI-R and/or fruit components. We suggest that nutritional guidelines should consider time-related eating patterns and chronotype to ensure good diet quality of pregnant women since the beginning of gestation, contributing on prevention of metabolic-nutritional complications.

Inhibition of the AnxA1/FPR1 autocrine axis reduces MDA-MB-231 breast cancer cell growth and aggressiveness in vitro and in vivo

Breast Cancer (BC) is a highly heterogeneous disease whose most aggressive behavior is displayed by triple-negative breast cancer (TNBC), which lacks an efficient targeted therapy. Despite its controversial role, one of the proteins that having been linked with BC is Annexin A1 (AnxA1), which is a Ca+2 binding protein that acts modulating the immune system, cell membrane organization and vesicular trafficking. In this work we analyzed tissue microarrays of BC samples and observed a higher expression of AnxA1 in TNBCs and in lymph node metastasis. We also observed a positive correlation in primary tumors between expression levels of AnxA1 and its receptor, FPR1. Despite displaying a lesser strength, this correlation also exists in BC lymph node metastasis. In agreement, we have found that AnxA1 was highly expressed and secreted in the TNBC cell line MDA-MB-231 that also expressed high levels of FPR1. Furthermore, we demonstrated, by using the specific FPR1 inhibitor Cyclosporin H (CsH) and the immunosuppressive drug Cyclosporin A (CsA), the existence of an autocrine signaling of AnxA1 through the FPR1. Such signaling, elicited by AnxA1 upon its secretion, increased the aggressiveness and survival of MDA-MB-231 cells. In this manner, we demonstrated that CsA works very efficiently as an FPR1 inhibitor. Finally, by using CsA, we demonstrated that FPR1 inhibition decreased MDA-MB-231 tumor growth and metastasis formation in nude mice. These results indicate that FPR1 inhibition could be a potential intervention strategy to manage TNBCs displaying the characteristics of MDA-MB-231 cells. FPR1 inhibition can be efficiently achieved by CsA.

Effect of the implementation of the mixed cafeteria system in a hospital nutrition and dietetic service

INTRODUCTION The type of service offered by the nutrition and dietetics service (NDS) of a hospital has a direct impact on food waste. OBJECTIVE To evaluate waste in the transition from a simple to a mixed cafeteria service. METHODOLOGY The study was carried out in a NDS of a University Hospital during 60 days (30 days for each type of service). The meals prepared and distributed and the leftovers of lunch and dinner were weighed. RESULTS Per capita values of non-usable leftovers were below the acceptable range (7-25 g), not varying with the service transition (p = 0.3) at lunch. At dinner, on the contrary, values were above the acceptable range, with a median of 190 g and 202 g, also showing no difference with the service modification (p = 0.5). At lunch, with the transition, there was a reduction in the plate waste-ingestion (p < 0.0001), percentage of plate waste-ingestion (p < 0.0001) and percentage of non-usable foods (p = 0.007). At dinner, there was a reduction in the plate waste-ingestion (p < 0.0001) and in the percentage of plate waste-ingestion (p = 0.0001). CONCLUSION The modification of the service type was effective in reducing the plate waste-ingestion, but did not lead to operational modifications of the service, since the amount of non-usable leftovers remained high at dinner. Greater control of the production and distribution of meals is suggested, as well as training of food handlers and supervisors, implementation of standardized operating procedures and cost control in order to reduce waste, which has an economic, social and political impact.

Altered Leukocyte Sphingolipid Pathway in Breast Cancer

Sphingolipid metabolism pathway is essential in membrane homeostasis, and its dysfunction has been associated with favorable tumor microenvironment, disease progression, and chemotherapy resistance. Its major components have key functions on survival and proliferation, with opposing effects. We have profiled the components of the sphingolipid pathway on leukocytes of breast cancer (BC) patients undergoing chemotherapy treatment and without, including the five sphingosine 1-phosphate (S1P) receptors, the major functional genes, and cytokines, in order to better understand the S1P signaling in the immune cells of these patients. To the best of our knowledge, this is the first characterization of the sphingolipid pathway in whole blood of BC patients. Skewed gene profiles favoring high SPHK1 expression toward S1P production during BC development was observed, which was reversed by chemotherapy treatment, and reached similar levels to those found in healthy donors. Such levels were also correlated with high levels of TNF-α. Our data revealed an important role of the sphingolipid pathway in immune cells in BC with skewed signaling of S1P receptors, which favored cancer development even under chemotherapy, and may probably be a trigger of cancer resistance. Thus, these molecules must be considered as a target pathway for combined BC therapeutics.

Frontiers of biology in human diseases: strategies for biomolecule's discovery, nanobiotechnologies and biophotonics.

The current frontiers in biological sciences demand an interface among disciplines of biology, chemistry, and physics to achieve new paradigms in applied nanobiotechnologies to health. An extraordinary amount of information on genomes, transcriptomes, proteomes, metabolomes, miRNAs, lncRNAs, protein editing, post-translational modifications, exosomes, molecular interactions, cell signaling, structural biology, immunology, cellular receptors, interactomes, and bioinformatics are opening new possibilities for biological manipulations aiming improved diagnostics and therapeutics. New rationale is required to use available technologies that intersect among imaging, electrochemistry, biophotonics, nanotechnologies and combinatorial molecules. A massive, diverse and broad knowledge on multidisciplinary aspects have been provided in the last few years, and the challenge is to combine recent technologies and information to identify revolutionary platforms for the progression of life sciences. This brief review will discuss examples of epitope-based and combinatorial antibody and nucleic acid (aptamers) selection technologies in association with nanobiotechnologies and their multiple applications in biomedical sciences.

Painful cervical esophageal erosion in a patient with advanced colorectal cancer treated with bevacizumab

To the Editor Bevacizumab is a humanized monoclonal antibody directed against vascular endothelial growth factor A (VEGF-A), an important cytokine with antiangiogenic properties [1]. It is commonly used in addition to fluoropyrimidine-based chemotherapy for the treatment of advanced colorectal cancer (CRC), both in first and second lines of therapy [2]. Bevacizumab is considered to be a well tolerated and safe drug. The most common adverse events reported are proteinuria and hypertension [1]. Gastrointestinal (GI) perforation is a well-known serious complication of bevacizumab use, occurring in ∼1% of the cases [3]. The development of GI ulcers (with or without perforation) has been recently described in patients treated with bevacizumab [4]. We report a case involving a 30-year-old Brazilian woman diagnosed with stage III CRC in January 2008. After surgical resection of the primary tumor, she was treated with three cycles of adjuvant oxaliplatin-bolus fluorouracil/folinic acid (FLOX regimen). In October 2008, (18)F-fluorodeoxyglucose positron emission tomography showed metastasis in liver segment VI and an isolated peritoneal recurrence near the left kidney. On day 6 of the fourth cycle of chemotherapy with FOLFIRI plus bevacizumab (intravenous bevacizumab 5 mg/kg, irinotecan 180 mg/m as 90-min i.v. infusion together with folinic acid 200 mg/m i.v. over 2 h, followed by 5-fluorouracil 400 mg/m i.v. bolus then by 5-fluorouracil 2,400 mg/m i.v. as a 46-hour continuous infusion, on day 1, every 2 weeks), she complained of moderate odynophagia that progressed to severe conditions in 48 h. At that time, she unable to digest solid or liquid food due to the pain. She then experienced an episode of bloody vomiting. There were no antecedents of gastroesophageal reflux disease, cervical radiotherapy, alcohol consumption or tabagism. She denied recent use of nonsteroidal antiinflammatory agents or oral bisphosphonates. An urgent endoscopy was performed on day 9, revealing easy bleeding erosion, 2.5 cm×1.0 cm, located in the posterior layer of the cervical esophagus immediately below the level of the cricopharyngeus muscle. After five days of clinical treatment (sucralfate 2,000 mg/day plus pantoprazole 40 mg/day), odynophagia diminished to mild symptoms. A second endoscopy showed that the erosion was painless and with no easy bleeding (Fig. 1). A biopsy of the lesion showed unspecified C. E. Paiva Oncological and Hemato-oncological Center, São Paulo State University, Botucatu, SP, Brazil