Research Grants 17/08651-1 - Resposta imune, Doença de Crohn - BV FAPESP
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Immunomodulatory effects of dehidroepiandrosterone (DHEA) in the immune response of Crohn's disease patients refractory to anti-TNF treatment

Abstract

Anti-TNF monoclonal antibodies are commonly used in IBD treatment. However, some patients are not responsive to this therapy and the concomitant use of this biologics with other immunosuppressive drugs that ameliorate treatment leads to important adverse effects. On the other hand, the levels of the hormone dehydroepiandrosterone (DHEA) are reduced in CD and UC patients, while the supplementation with DHEA ameliorates experimental colitis. Therefore, it is evident that the understanding of this immune-endocrine interaction may be an important tool to the development of alternative therapies for IBD to improve the responses to this high cost biological anti-TNF. Then, in this study we aim to evaluate the immune response profile of CD patients non responsive to anti-TNF treatment and to investigate the potential role of DHEA in reversing this non-responsiveness to the biological therapy. For that, the clinical, endocrine and immune (plasma mediators such as cytokines, LPS and oncostatin M) evaluations of the enrolled patients will be performed and correlated especially with patients DHEA levels. Peripheral blood mononuclear cells will be isolated for leukocyte phenotyping and to define a non-toxic DHEA dosis to be used in in vitro supplementation assays. The proliferation assays of PBMC from non-responsive patients will be performed in the presence of DHEA, as well as the evaluation of Th1, Th2, Th17, IL-9 and inflammatory responses in the culture supernatants. Another set of PBMC culture will be stimulated with LPS and treated with DHEA, to investigate the inflammatory profile of monocytes from patients non-responsive to anti-TNF therapy, as well as the capacity of the hormone to attenuate or reverse such hypo responsiveness to the biological treatment. Finally, we expect that the correlation between our results and the clinical data may point to the relevant immunomodulatory activity of DHEA in reversing the non responsiveness to anti-TNF therapy, in order to underline the development of novel treatments for IBD. (AU)

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Scientific publications (4)
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
BASSO, PAULO JOSE; SALES-CAMPOS, HELIOSWILTON; NARDINI, VIVIANI; DUARTE-SILVA, MURILLO; FREITAS ALVES, VANESSA BEATRIZ; BONFA, GIULIANO; RODRIGUES, CASSIANO COSTA; GHIROTTO, BRUNO; LAZO CHICA, JAVIER EMILIO; NOMIZO, AURO; et al. Peroxisome Proliferator-Activated Receptor Alpha Mediates the Beneficial Effects of Atorvastatin in Experimental Colitis. FRONTIERS IN IMMUNOLOGY, v. 12, . (10/20162-7, 17/08651-1, 13/11042-6)
MURILLO, DUARTE-SILVA; ROGERIO, PARRA; MARLEY, FEITOSA; OMAR, FERES; JOAQUIM, ROCHA JOSE; CRISTINA, CARDOSO. Persistent inflammatory markers and deregulated immune response in clinical remission Crohn's disease patients treated with infliximab. AMERICAN JOURNAL OF GASTROENTEROLOGY, v. 114, p. 2-pg., . (17/08651-1)
DA SILVA, JEFFERSON LUIZ; BARBOSA, LIA VEZENFARD; PINZAN, CAMILA FIGUEIREDO; NARDINI, VIVIANI; BRIGO, IRISLENE SIMOES; SEBASTIAO, CASSIA APARECIDA; ELIAS-OLIVEIRA, JEFFERSON; BRAZAO, VANIA; DO PRADO JUNIOR, JOSE CLOVIS; CARLOS, DANIELA; et al. The Microbiota-Dependent Worsening Effects of Melatonin on Gut Inflammation. MICROORGANISMS, v. 11, n. 2, p. 16-pg., . (17/08651-1)
DUARTE-SILVA, M.; PARRA, R. S.; FEITOSA, M. R.; FERES, O.; RIBEIRO DA ROCHA, J. J.; CARDOSO, C. R. D. B.. Crohn's disease patients under combined therapy with Azathioprine and Infliximab present persistent inflammation together with a counter regulatory response during clinical disease remission. JOURNAL OF CROHNS & COLITIS, v. 13, p. 2-pg., . (17/08651-1)

Filed patent(s) as a result of this research project

NANOEMULSÃO COMPREENDENDO DESIDROEPIANDROSTERONA (DHEA) E SEU USO NA PREPARAÇÃO DE UM MEDICAMENTO PARA O TRATAMENTO DE DOENÇAS INFLAMATÓRIAS INTESTINAIS BR1020200164864 - Universidade de São Paulo (USP) . RENATA FONSECA VIANNA LOPEZ / CRISTINA RIBEIRO DE BARROS CARDOSO / CAMILA FIGUEIREDO PINZAN / GABRIELA FÁVERO GALVÃO / JOSÉ JOAQUIM RIBEIRO DA ROCHA / LUCIANA FACCO DALMOLIN / MARLEY RIBEIRO FEITOSA / MURILLO DUARTE SILVA / OMAR FERES / ROGÉRIO SERAFIM PARRA - August 2020, 13