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Brunetto S, Bernardi JR, Ribas Werlang IC, Nunes M, Rechenmacher C, Marcelino TB, Homrich da Silva C, Goldani MZ. Breast milk leptin concentrations and infant anthropometric indicators in SGA versus non-SGA breastfed infants born at term. Heliyon 2023; 9:e17717. [PMID: 37483797 PMCID: PMC10362072 DOI: 10.1016/j.heliyon.2023.e17717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Leptin concentrations in breast milk can influence metabolic programming during the first months of life. Small for gestational age (SGA) newborns show a peculiar growth pattern after birth, which can lead to adulthood diseases. This study aims to assess an association between leptin concentration in mature breast milk and the infant anthropometric indicators of the SGA and the non-SGA groups, in addition, to comparing the hormone level between these groups. A longitudinal study was performed with mother-infant pairs. The maternal sociodemographic information was collected in the first 48 h postpartum. Breast milk was collected at one month postpartum and leptin concentrations were obtained by immunoassays. The infant anthropometric measurements were collected at three and six months postpartum and included weight, height (to body mass index-BMI calculated), triceps skinfold (TSF), and subscapular skinfold (SSF). The BMI for age (BMI/A), TSF, and SSF were calculated by Z-score indicators. Data from 67 mother-infant pairs (n = 16 SGA and n = 51 non-SGA) were analyzed. In univariate analyses, the breast milk of the SGA group had lower leptin concentrations than the non-SGA group (p = 0.006), however, after adjustment, there was no difference between groups (p = 0.181). In the SGA group, there was a significant association between leptin concentrations and lower SSF at six months in infants, after adjustment (p = 0.003). In the non-SGA group, the breast milk leptin was associated with lower BMI/A at three and six months in infants, after adjustment (p = 0.002 and p = 0.010, respectively). The association between breast milk leptin concentrations with SSF in the SGA group and BMI/A in the non-SGA group suggests that leptin may be a modulating factor in infant growth in the first months of life.
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Affiliation(s)
- Sara Brunetto
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Juliana Rombaldi Bernardi
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Isabel Cristina Ribas Werlang
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Marina Nunes
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Ciliana Rechenmacher
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Thiago Beltram Marcelino
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil
| | - Clécio Homrich da Silva
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
| | - Marcelo Zubaran Goldani
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Brazil
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil
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2
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Hahn MC, Werlang ICR, Rechenmacher C, Morais RVD, Barbé-Tuana FM, Grun LK, Guma FTCR, Silva CHD, Bernardi JR, Michalowski MB, Goldani MZ. Telomere length in healthy newborns is not affected by adverse intrauterine environments. Genet Mol Biol 2021; 44:e20200411. [PMID: 34874050 PMCID: PMC8647199 DOI: 10.1590/1678-4685-gmb-2020-0411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/26/2021] [Indexed: 11/22/2022] Open
Abstract
Different intrauterine exposures are associated with different metabolic profiles
leading to growth and development characteristics in children and also relate to
health and disease patterns in adult life. The objective of this work was to
evaluate the impact of four different intrauterine environments on the telomere
length of newborns. This is a longitudinal observational study using a
convenience sample of 222 mothers and their term newborns (>37 weeks of
gestational age) from hospitals in Porto Alegre, Rio Grande do Sul (Brazil),
from September 2011 to January 2016. Sample was divided into four groups:
pregnant women with Gestational Diabetes Mellitus (DM) (n=38), smoking pregnant
women (TOBACCO) (n=52), mothers with small-for-gestational age (SGA) children
due to idiopathic intrauterine growth restriction (n=33), and a control group
(n=99). Maternal and newborn genomic DNA were obtained from epithelial mucosal
cells. Telomere length was assessed by qPCR, with the calculation of the
telomere and single copy gene (T/S ratio). In this sample, there was no
significant difference in telomere length between groups (p>0.05). There was
also no association between childbirth weight and telomere length in children
(p>0.05). For term newborns different intrauterine environments seems not to
influence telomere length at birth.
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Affiliation(s)
- Monique Cabral Hahn
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Isabel Cristina Ribas Werlang
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Ciliana Rechenmacher
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Rahuany Velleda de Morais
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Florencia María Barbé-Tuana
- Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Bioquímica, Laboratório de Biologia Molecular e Bioinformática, Programa de Pós-Graduação em Bioquímica, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Grupo de Inflamação e Senescência Celular, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil
| | - Lucas Kich Grun
- Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Bioquímica, Laboratório de Biologia Molecular e Bioinformática, Programa de Pós-Graduação em Bioquímica, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Grupo de Inflamação e Senescência Celular, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil
| | - Fátima Theresinha Costa Rodrigues Guma
- Universidade Federal do Rio Grande do Sul (UFRGS), Instituto de Ciências Básicas da Saúde, Departamento de Bioquímica, Laboratório de Biologia Molecular e Bioinformática, Programa de Pós-Graduação em Bioquímica, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Grupo de Inflamação e Senescência Celular, Porto Alegre, RS, Brazil.,Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Ciências, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil
| | - Clécio Homrich da Silva
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | - Juliana Rombaldi Bernardi
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Porto Alegre, RS, Brazil
| | - Mariana Bohns Michalowski
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
| | - Marcelo Zubaran Goldani
- Hospital de Clínicas de Porto Alegre, Laboratório de Pediatria Translacional, Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA), Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Pediatria, Porto Alegre, RS, Brazil
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da Rosa LA, Escott GM, Simonetti RB, da Silva JCD, Werlang ICR, Goldani MZ, de Fraga LS, Loss EDS. Role of non-classical effects of testosterone and epitestosterone on AMH balance and testicular development parameters. Mol Cell Endocrinol 2020; 511:110850. [PMID: 32387527 DOI: 10.1016/j.mce.2020.110850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/02/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022]
Abstract
Testosterone (T) and its 17-α epimer, epitestosterone (EpiT), are described as having non-classical effects in addition to their classical androgen actions via the intracellular androgen receptor (iAR). The actions of these androgens play an essential role in triggering factors that shift Sertoli cells from the proliferation phase to the maturation phase. This process is essential for successful spermatogenesis and normal fertility. The aim of this work was to investigate the difference between T and EpiT effects in normal and in chemically castrated Wistar rats. We also tested the effects of these hormones when the iAR-dependent pathways were inhibited by the antiandrogen flutamide. Rats were chemically castrated on postnatal day (pnd) 5 using EDS, a cytotoxic agent that promotes apoptosis of Leydig cells, reducing androgen levels. Then, animals received replacement with T or EpiT and were treated or not with flutamide from pnd 6 to pnd 13 or 20 and were euthanized on pnd 14 and 21. Animals treated with EpiT and flutamide had lower body weight overall. Epididymis weight was also reduced in animals treated with EpiT and flutamide. Flutamide per se reduced epididymis weight at both ages (pnd 14 and 21). Testicular weight and the testicular/body weight ratio were reduced in EDS animals, and flutamide further reduced this weight in animals which received T replacement. EDS administration reduced mRNA levels of both AMH (anti-Müllerian hormone) and its receptor, AMHR2, at pnd 14. In the testes of flutamide-treated animals, EpiT reduced AMH, and both T and EpiT replacement diminished AMHR2 mRNA expression also on pnd 14. EDS decreased iAR expression, and androgen replacement did not change this effect on pnd 21. In rats receiving flutamide, only those also receiving T and EpiT replacement exhibited decreased iAR expression. An increase in connexin 43 expression was observed in animals treated with EpiT without flutamide, whereas in rats treated with flutamide, both hormones were ineffective to increase connexin 43 expression reduced by EDS. Our results suggest that EpiT has an antiandrogen effect on androgen-sensitive tissues such as the epididymis. Nonetheless, the effects of T and EpiT on testicular development parameters are similar. Both hormones may act through their iAR-independent non-classical pathway, regulating AMH and AMHR2, as well as iAR expression.
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Affiliation(s)
- Luciana Abreu da Rosa
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA)/Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Gustavo Monteiro Escott
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Rajla Bressan Simonetti
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Jessica Caroline Dias da Silva
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Isabel Cristina Ribas Werlang
- Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA)/Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Marcelo Zubaran Goldani
- Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA)/Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Luciano Stürmer de Fraga
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Eloísa da Silveira Loss
- Laboratório de Endocrinologia Experimental e Eletrofisiologia, Departamento de Fisiologia, Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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4
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Werlang ICR, Bernardi JR, Nunes M, Marcelino TB, Bosa VL, Michalowski MB, da Silva CH, Goldani MZ. Impact of Perinatal Different Intrauterine Environments on Child Growth and Development: Planning and Baseline Data for a Cohort Study. JMIR Res Protoc 2019; 8:e12970. [PMID: 31714249 PMCID: PMC6880232 DOI: 10.2196/12970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 08/05/2019] [Accepted: 08/21/2019] [Indexed: 12/19/2022] Open
Abstract
Background Several studies have shown that exposure of the fetus and newborn to prenatal and perinatal events, respectively, may influence the health outcomes of the child throughout their life cycle. Objective This study aimed to increase the knowledge on the impact of different intrauterine environments on child growth and development, as we know that pregnancy and early years are a window of opportunity for health promotion and prevention interventions of diseases. Methods The recruitment occurred 24 to 48 hours after delivery and involved mothers and their newborns in 2 public hospitals in Porto Alegre, Brazil, from December 2011 to January 2016. The mothers-newborns dyads were allocated to 5 groups: diabetes mellitus, mothers with a clinical diagnosis of diabetes; systemic arterial hypertension (SAH), mothers with a clinical diagnosis of systematic arterial hypertensive disease during pregnancy; maternal smoking, mothers who smoked at any moment of gestation; small for gestational age (SGA), mothers with SGA newborns because of intrauterine growth restriction; and control, mothers without the clinical characteristics previously mentioned. Several protocols and anthropometric measurements were applied in the interviews at immediate postpartum and 7 and 15 days and 1, 3, and 6 months after birth. For this study, we analyzed only data collected during postpartum interviews. The statistical analyses were performed using Pearson chi-square test, Mann-Whitney test, or Kruskal-Wallis test with Dunn post hoc. The significance level was set at 5%. The Hospital Ethics and Research Committees approved the study. Results Of the 485 eligible mothers-newborns dyads, 400 agreed to participate (82.5%, 400/485). As expected, newborns from the SGA group had significantly lower birth weight, smaller stature, and lower cephalic perimeter (P<.001). This group also had the highest percentage of primiparous women in comparison with other groups (P=.005) except for control. Mothers from the SAH group had the highest mean age, the highest percentage of cesarean sections, and presented greater gestational weight gain. Conclusions In this study, we describe the planning and structure for the systematic follow-up of mother-newborn dyads in the first 6 months after birth, considering the important demographic and epidemiological transition scenario in Brazil. The results of this prospective longitudinal study may provide a better understanding of the causal mechanisms involved in health and life course disease related to different adverse intrauterine environments.
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Affiliation(s)
- Isabel Cristina Ribas Werlang
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós Graduação em Alimentação, Nutrição e Saúde, Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marina Nunes
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Thiago Beltram Marcelino
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vera Lucia Bosa
- Programa de Pós Graduação em Alimentação, Nutrição e Saúde, Departamento de Nutrição, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mariana Bohns Michalowski
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Clécio Homrich da Silva
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo Zubaran Goldani
- Laboratório de Pediatria Translacional, Centro de Pesquisa Experimental, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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5
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Cecconello DK, Magalhães MRD, Werlang ICR, Lee MLDM, Michalowski MB, Daudt LE. Asparaginase: an old drug with new questions. Hematol Transfus Cell Ther 2019; 42:275-282. [PMID: 31801703 PMCID: PMC7417439 DOI: 10.1016/j.htct.2019.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/19/2019] [Accepted: 07/20/2019] [Indexed: 02/08/2023] Open
Abstract
The long-term outcome of acute lymphoblastic leukemia has improved dramatically due to the development of more effective treatment strategies. L-asparaginase (ASNase) is one of the main drugs used and causes death of leukemic cells by systematically depleting the non-essential amino acid asparagine. Three main types of ASNase have been used so far: native ASNase derived from Escherichia coli, an enzyme isolated from Erwinia chrysanthemi and a pegylated form of the native E. coli ASNase, the ASNase PEG. Hypersensitivity reactions are the main complication related to this drug. Although clinical allergies may be important, a major concern is that antibodies produced in response to ASNase may cause rapid inactivation of ASNase, leading to a worse prognosis. This reaction is commonly referred to as "silent hypersensitivity" or "silent inactivation". We are able to analyze hypersensitivity and inactivation processes by the measurement of the ASNase activity. The ability to individualize the ASNase therapy in patients, adjusting the dose or switching patients with silent inactivation to an alternate ASNase preparation may help improve outcomes in those patients. This review article aims to describe the pathophysiology of the inactivation process, how to diagnose it and finally how to manage it.
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Affiliation(s)
- Daiane Keller Cecconello
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, RS, Brazil
| | | | - Isabel Cristina Ribas Werlang
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, RS, Brazil
| | | | - Mariana Bohns Michalowski
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, RS, Brazil.
| | - Liane Esteves Daudt
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, RS, Brazil
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6
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Werlang ICR, Mueller NT, Pizoni A, Wisintainer H, Matte U, Costa SHDAM, Ramos JGL, Goldani MZ, Dominguez-Bello MG, Goldani HAS. Associations of birth mode with cord blood cytokines, white blood cells, and newborn intestinal bifidobacteria. PLoS One 2018; 13:e0205962. [PMID: 30388115 PMCID: PMC6214518 DOI: 10.1371/journal.pone.0205962] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/04/2018] [Indexed: 01/15/2023] Open
Abstract
The associations of Cesarean delivery with offspring metabolic and immune-mediated diseases are believed to derive from lack of mother-to-newborn transmission of specific microbes at birth. Bifidobacterium spp., in particular, has been hypothesized to play a health-promoting role, yet little is known about how delivery mode modifies colonization of the newborn by this group of microbes. The aim of this research was to examine the presence of Bifidobacterium in meconium and in the transitional stool, and to assess cytokine levels and hematological parameters in the venous cord blood of infants born by elective, pre-labor Cesarean section vs. vaginal delivery in Southern Brazil. We recruited 89 mother-newborn pairs (23 vaginal delivery and 66 elective cesarean delivery), obtained demographic information from a structured questionnaire and clinical information from medical records. We obtained umbilical cord venous blood and meconium samples following delivery and the transitional stool (the first defecation after meconium) before discharge. We determined plasma levels of IL-1β, IL-10, IL-6, GM-CSF, IL-5, IFN-γ, TNF-α, IL-2, IL-4 and IL-8 in the cord blood, and presence of stool Bifidobacterium by real time PCR. Compared to vaginally-delivered neonates, Cesarean-delivered neonates had a lower leukocyte count (p = 0.037), lower hemoglobin (p = 0.04), and lower levels of the cytokine GM-CSF (p = 0.009) in the cord blood. Moreover, Bifidobacterium was detected less often in the transitional stool of Cesarean-delivered neonates compared to vaginally-delivered neonates (p = 0.001). The results indicate that pre-labor Cesarean birth may be associated with microbial and hematological alterations in the neonate. The clinical significance of these findings remains to be determined in larger prospective birth cohort studies.
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Affiliation(s)
- Isabel Cristina Ribas Werlang
- Laboratory of Translational Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- Post-Graduate Program in Health of Child and Adolescent, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
| | - Noel Theodore Mueller
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Welch Center for Epidemiology, Prevention, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States of America
| | - Aline Pizoni
- Laboratory of Translational Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- Post-Graduate Program Sciences in Gastroenterology and Hepatology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
| | | | - Ursula Matte
- Department of Genetics, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
| | - Sergio Hofmeister de Almeida Martins Costa
- Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul and Hospital Mae de Deus. Porto Alegre–RS, Brazil
| | - Jose Geraldo Lopes Ramos
- Department of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul and Hospital Mae de Deus. Porto Alegre–RS, Brazil
| | - Marcelo Zubaran Goldani
- Laboratory of Translational Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- Post-Graduate Program in Health of Child and Adolescent, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
| | - Maria Gloria Dominguez-Bello
- Department of Biochemistry and Microbiology and of Anthropology, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Helena Ayako Sueno Goldani
- Laboratory of Translational Pediatrics, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- Post-Graduate Program in Health of Child and Adolescent, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- Post-Graduate Program Sciences in Gastroenterology and Hepatology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre–RS, Brazil
- * E-mail:
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Cecconello DK, Werlang ICR, Alegretti AP, Hahn MC, de Magalhães MR, Battistel AP, Zenatti PP, Yunes JA, Cabreira-Cagliari C, Rechenmacher C, Goldani MZ, Daudt LE, Michalowski MB. Monitoring asparaginase activity in middle-income countries. Lancet Oncol 2018; 19:1149-1150. [DOI: 10.1016/s1470-2045(18)30584-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 12/15/2022]
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Werlang ICR, Hahn MC, Bernardi JR, Nast M, Goldani MZ, Michalowski MB. Exposure to different intrauterine environments: implications for telomere attrition in early life. J Matern Fetal Neonatal Med 2018; 32:3675-3684. [PMID: 29681194 DOI: 10.1080/14767058.2018.1468879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: Studies focusing on telomere attrition in newborns and what factors could be involved in this issue are sparse; most reports have been in adult populations. Thereby, the aim of this study was to present an overview of what is currently known about the relationship between environmental exposure of the fetus during pregnancy and telomere length outcomes in early life. Methods: The MEDLINE (via PubMed) and Bireme databases were searched for studies published until 1 June 2016. Studies that reported telomere length measurement from birth to age 1 year were included. Results: Fifteen articles were selected that evaluated possible relationships between maternal smoking, hyperglycemia, hypertension, sleep apnea, psychological stress, folate concentration in early pregnancy, and radiation, in addition to small-for-gestational-age status and preterm birth. We found that sleep apnea, psychological stress, and folate concentration in early pregnancy were associated with telomere shortening in the newborn. No association was found with radiation, small-for-gestational-age status, or preterm birth. Results for maternal smoking, hyperglycemia, and hypertension were conflicting, and further studies should be considered. Conclusion: The actual clinical implications of these findings have yet to be investigated.
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Affiliation(s)
- Isabel Cristina Ribas Werlang
- a Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,b Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Monique Cabral Hahn
- a Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,b Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Juliana Rombaldi Bernardi
- a Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,b Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil.,c Departamento de Nutrição, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Martha Nast
- d Research Center, Dr von Hauser Children's Hospital , Ludwig-Maximilians-Universität München , Munich , Germany.,e Department of Pediatric Cardiology and Intensive Care , Ludwig-Maximilians-Universität München , Munich , Germany
| | - Marcelo Zubaran Goldani
- a Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,b Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil.,f Departamento de Pediatria, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Mariana Bohns Michalowski
- a Laboratório de Pediatria Translacional/Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) , Hospital de Clínicas de Porto Alegre , Porto Alegre , Brazil.,f Departamento de Pediatria, Faculdade de Medicina , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
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Nunes M, da Silva CH, Bosa VL, Bernardi JR, Werlang ICR, Goldani MZ. Could a remarkable decrease in leptin and insulin levels from colostrum to mature milk contribute to early growth catch-up of SGA infants? BMC Pregnancy Childbirth 2017; 17:410. [PMID: 29212463 PMCID: PMC5719575 DOI: 10.1186/s12884-017-1593-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/23/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Breast milk is known to contain many bioactive hormones and peptides, which can influence infant growth and development. In this context, the purpose of this study was to evaluate the influence of different clinical pregnancy conditions on hormone concentrations in colostrum and mature breast milk. METHODS An observational study was performed with mother-newborn pairs divided into five groups according to maternal clinical background: diabetes (12), hypertension (5), smoking (19), intrauterine growth restriction of unknown causes with small-for-gestational-age newborns at delivery (12), and controls (21). Socioeconomic data, anthropometric measurements and breast milk samples were collected between the first 24 and 48 h and 30 days postpartum. Leptin, adiponectin, and insulin levels in breast milk were measured by immunoassays. RESULTS A significant decrease in leptin (p = 0.050) and insulin (p = 0.012) levels from colostrum to mature breast milk in mothers of small-for-gestational-age infants was observed. Maternal body mass index was correlated with both leptin and insulin, but not with adiponectin. Insulin levels were negatively correlated to infant weight gain from birth to one month (p = 0.050). In addition, catch-up growth was verified for small-for-gestational-age infants throughout the first month of life. CONCLUSIONS This study suggests that a remarkable decrease in leptin and insulin levels in mature milk of mothers of small-for-gestational-age newborns may be involved in the rapid weight gain of these newborns. The physiological and external mechanisms by which these significant decreases and rapid weight gains occur in this group remain to be elucidated.
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Affiliation(s)
- Marina Nunes
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Clécio Homrich da Silva
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil.,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Vera Lucia Bosa
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Juliana Rombaldi Bernardi
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Isabel Cristina Ribas Werlang
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil.,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil
| | - Marcelo Zubaran Goldani
- Laboratório de Pediatria Translacional / Núcleo de Estudos em Saúde da Criança e do Adolescente (NESCA) - Hospital de Clínicas de Porto Alegre, Porto Alegre/RS, Brazil. .,Programa de Pós-Graduação em Saúde da Criança e do Adolescente - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil. .,Departamento de Pediatria - Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre/RS, Brazil.
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Santetti D, de Albuquerque Wilasco MI, Dornelles CTL, Werlang ICR, Fontella FU, Kieling CO, dos Santos JL, Vieira SMG, Goldani HAS. Serum proinflammatory cytokines and nutritional status in pediatric chronic liver disease. World J Gastroenterol 2015; 21:8927-8934. [PMID: 26269683 PMCID: PMC4528036 DOI: 10.3748/wjg.v21.i29.8927] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/06/2015] [Accepted: 02/13/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the nutritional status and its association with proinflammatory cytokines in children with chronic liver disease.
METHODS: We performed a cross-sectional study with 43 children and adolescents, aged 0 to 17 years, diagnosed with chronic liver disease. All patients regularly attended the Pediatric Hepatology Unit and were under nutritional follow up. The exclusion criteria were fever from any etiology at the time of enrollment, inborn errors of the metabolism and any chronic illness. The severity of liver disease was assessed by Child-Pugh, Model for End-stage Liver Disease (MELD) and Pediatric End Stage Liver Disease (PELD) scores. Anthropometric parameters were height/age, body mass index/age and triceps skinfold/age according to World Health Organization standards. The cutoff points for nutritional status were risk of malnutrition (Z-score < -1.00) and malnutrition (Z-score < -2.00). Interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α levels were assessed by commercial ELISA kits. For multivariate analysis, linear regression was applied to assess the association between cytokine levels, disease severity and nutritional status.
RESULTS: The median (25th-75th centile) age of the study population was 60 (17-116)-mo-old, and 53.5% were female. Biliary atresia was the main cause of chronic liver disease (72%). With respect to Child-Pugh score, cirrhotic patients were distributed as follows: 57.1% Child-Pugh A, a mild presentation of the disease, 34.3% Child-Pugh B, a moderate stage of cirrhosis and 8.6% Child-Pugh C, were considered severe cases. PELD and MELD scores were only above the cutoff point in 5 cases. IL-6 values were increased in patients at nutritional risk (34.9%) compared with those who were well-nourished [7.12 (0.58-34.23) pg/mL vs 1.63 (0.53-3.43) pg/mL; P = 0.02], correlating inversely with triceps skinfold-for-age z-score (rs = -0.61; P < 0.001). IL-6 levels were associated with liver disease severity assessed by Child-Pugh score (P = 0.001). This association remained significant after adjusting for nutritional status in a linear regression model.
CONCLUSION: High IL-6 levels were found in children with chronic liver disease at nutritional risk. Inflammatory activity may be related to nutritional status deterioration in these patients.
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Machado TD, Dalle Molle R, Laureano DP, Portella AK, Werlang ICR, Benetti CDS, Noschang C, Silveira PP. Early life stress is associated with anxiety, increased stress responsivity and preference for "comfort foods" in adult female rats. Stress 2013; 16:549-56. [PMID: 23781957 DOI: 10.3109/10253890.2013.816841] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Chronic stress increases anxiety and encourages intake of palatable foods as "comfort foods". This effect seems to be mediated by altered function of the hypothalamic-pituitary-adrenal axis. In the current study, litters of Wistar rats were subjected to limited access to nesting material (Early-Life Stress group - ELS) or standard care (Control group) from postnatal day 2 to 9. In adult life, anxiety was assessed using the novelty-suppressed feeding test (NSFT), and acute stress responsivity by measurement of plasma corticosterone and ACTH levels. Preference for palatable foods was monitored by a computerized system (BioDAQ, Research Diets(®)) in rats receiving only regular chow or given the choice of regular and palatable diet for 30 days. ELS-augmented adulthood anxiety in the NSFT (increased latency to eat in a new environment; decreased chow intake upon return to the home cage) and increased corticosterone (but not ACTH) secretion in response to stress. Despite being lighter and consuming less rat chow, ELS animals ate more palatable foods during chronic exposure compared with controls. During preference testing, controls receiving long-term access to palatable diet exhibited reduced preference for the diet relative to controls exposed to regular chow only, whereas ELS rats demonstrated no such reduction in preference after prolonged palatable diet exposure. The increased preference for palatable foods showed by ELS animals may result from a habit of using this type of food to ameliorate anxiety.
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Affiliation(s)
- Tania Diniz Machado
- Programa de Pós Graduaçño em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
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