array:23 [
  "pii" => "S2666275223001017"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2023.04.002"
  "estado" => "S300"
  "fechaPublicacion" => "2023-09-01"
  "aid" => "755"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:18 [
      "pii" => "S0365059623000867"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2022.08.008"
      "estado" => "S300"
      "fechaPublicacion" => "2023-09-01"
      "aid" => "755"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "635"
            "paginaFinal" => "643"
          ]
        ]
        "contieneResumen" => array:1 [
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1203
                "Ancho" => 3341
                "Tamanyo" => 282220
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0035"
                "detalle" => "Figure "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Alpha diversity&#46; Proportion distribution of the 13 most prevalent genera among the groups&#58; PSO &#40;psoriasis&#41;&#44; VEG &#40;vegetarian controls&#41;&#44; OMNI &#40;omnivore controls&#41;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Tatiana Cristina Figueira Polo, Mariana Righetto de R&#233; Lai, Luciane Donida Bartoli Miot, Giovana Fernanda Cosi Bento, M&#225;rcia Guimar&#227;es da Silva, Silvio Alencar Marques, H&#233;lio Amante Miot"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Tatiana Cristina Figueira"
                "apellidos" => "Polo"
              ]
              1 => array:2 [
                "nombre" => "Mariana Righetto de R&#233;"
                "apellidos" => "Lai"
              ]
              2 => array:2 [
                "nombre" => "Luciane Donida Bartoli"
                "apellidos" => "Miot"
              ]
              3 => array:2 [
                "nombre" => "Giovana Fernanda Cosi"
                "apellidos" => "Bento"
              ]
              4 => array:2 [
                "nombre" => "M&#225;rcia Guimar&#227;es da"
                "apellidos" => "Silva"
              ]
              5 => array:2 [
                "nombre" => "Silvio Alencar"
                "apellidos" => "Marques"
              ]
              6 => array:2 [
                "nombre" => "H&#233;lio Amante"
                "apellidos" => "Miot"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275223001017"
          "doi" => "10.1016/j.abdp.2023.04.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001017?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000867?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009800000005/v1_202307281023/S0365059623000867/v1_202307281023/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2666275223001339"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2023.05.010"
    "estado" => "S300"
    "fechaPublicacion" => "2023-09-01"
    "aid" => "768"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Quantifica&#231;&#227;o de pesticidas em amostras de cabelo de pacientes com p&#234;nfigo foli&#225;ceo e p&#234;nfigo vulgar no Sudeste do Brasil"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "644"
          "paginaFinal" => "650"
        ]
      ]
      "contieneResumen" => array:1 [
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Leonardo La Serra, Adriana Martinelli Salathiel, Rafael Lanaro, Bruno de Martinis, Ana Maria Roselino"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Leonardo"
              "apellidos" => "La Serra"
            ]
            1 => array:2 [
              "nombre" => "Adriana Martinelli"
              "apellidos" => "Salathiel"
            ]
            2 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Lanaro"
            ]
            3 => array:2 [
              "nombre" => "Bruno"
              "apellidos" => "de Martinis"
            ]
            4 => array:2 [
              "nombre" => "Ana Maria"
              "apellidos" => "Roselino"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059623000995"
        "doi" => "10.1016/j.abd.2022.10.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000995?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001339?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001339/v1_202307310652/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275223001340"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2023.05.011"
    "estado" => "S300"
    "fechaPublicacion" => "2023-09-01"
    "aid" => "766"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Dermatologia hospitalar&#58; an&#225;lise de consultas dermatol&#243;gicas em hospital universit&#225;rio terci&#225;rio"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "620"
          "paginaFinal" => "634"
        ]
      ]
      "contieneResumen" => array:1 [
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1309
              "Ancho" => 2215
              "Tamanyo" => 167774
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fluxo de encaminhamentos de consultas dermatol&#243;gicas hospitalares&#44; de agosto de 2018 a janeiro de 2020</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Iago Gon&#231;alves Ferreira, Camila Saraiva Almeida, Lucas Abascal Bulc&#227;o, Diego Gon&#231;alves Ferreira, Magda Blessmann Weber, Renan Rangel Bonamigo"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Iago Gon&#231;alves"
              "apellidos" => "Ferreira"
            ]
            1 => array:2 [
              "nombre" => "Camila Saraiva"
              "apellidos" => "Almeida"
            ]
            2 => array:2 [
              "nombre" => "Lucas Abascal"
              "apellidos" => "Bulc&#227;o"
            ]
            3 => array:2 [
              "nombre" => "Diego Gon&#231;alves"
              "apellidos" => "Ferreira"
            ]
            4 => array:2 [
              "nombre" => "Magda Blessmann"
              "apellidos" => "Weber"
            ]
            5 => array:2 [
              "nombre" => "Renan Rangel"
              "apellidos" => "Bonamigo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059623000971"
        "doi" => "10.1016/j.abd.2022.08.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000971?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001340?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001340/v1_202307310652/pt/main.assets"
  ]
  "pt" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
    "titulo" => "Caracteriza&#231;&#227;o do microbioma intestinal de homens adultos brasileiros com psor&#237;ase em compara&#231;&#227;o com controles on&#237;voros e vegetarianos"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "635"
        "paginaFinal" => "643"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Tatiana Cristina Figueira Polo, Mariana Righetto de R&#233; Lai, Luciane Donida Bartoli Miot, Giovana Fernanda Cosi Bento, M&#225;rcia Guimar&#227;es da Silva, Silvio Alencar Marques, H&#233;lio Amante Miot"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Tatiana Cristina Figueira"
            "apellidos" => "Polo"
            "email" => array:1 [
              0 => "tatiana.figueira@yahoo.com.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Mariana Righetto de R&#233;"
            "apellidos" => "Lai"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Luciane Donida Bartoli"
            "apellidos" => "Miot"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Giovana Fernanda Cosi"
            "apellidos" => "Bento"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#225;rcia Guimar&#227;es da"
            "apellidos" => "Silva"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Silvio Alencar"
            "apellidos" => "Marques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "H&#233;lio Amante"
            "apellidos" => "Miot"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Dermatologia&#44; Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Patologia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "b"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1232
            "Ancho" => 2175
            "Tamanyo" => 158697
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Compara&#231;&#227;o da mediana da abund&#226;ncia dos g&#234;neros que apresentaram diferen&#231;a entre os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Psor&#237;ase &#233; doen&#231;a cr&#244;nica inflamat&#243;ria sist&#234;mica que afeta entre 1&#37; e 2&#37; da popula&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> Sua patog&#234;nese &#233; multifatorial&#44; n&#227;o sendo totalmente esclarecida&#44; mas que envolve&#44; al&#233;m de uma base gen&#233;tica e est&#237;mulos ambientais&#44; a ativa&#231;&#227;o do sistema imune &#40;inato e adaptativo&#41;&#44; que desencadeia respostas inflamat&#243;rias locais na pele e articula&#231;&#245;es&#44; assim como promove inflama&#231;&#227;o sist&#234;mica de baixo grau&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Comorbidades como obesidade&#44; hipertens&#227;o arterial&#44; diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; s&#237;ndrome metab&#243;lica&#44; doen&#231;a cardiovascular&#44; dislipidemia e transtornos afetivos &#40;depress&#227;o&#44; ansiedade&#41; s&#227;o frequentes em pacientes com psor&#237;ase&#44; substanciando o processo inflamat&#243;rio sist&#234;mico subjacente&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Microbioma intestinal &#40;MI&#41; consiste em flora inconstante&#44; constitu&#237;da nos primeiros anos de vida&#44; mas que varia conforme est&#237;mulos ambientais&#44; como dieta&#44; estilo de vida &#40;tabagismo&#44; consumo de &#225;lcool&#44; exerc&#237;cios f&#237;sicos&#44; estresse&#44; sono&#41;&#44; higiene&#44; terap&#234;utica com antimicrobianos&#44; localiza&#231;&#227;o geogr&#225;fica&#44; sexo&#44; idade e certas doen&#231;as&#46; Cerca de 57&#37; do MI &#233; influenciado pela dieta&#44; e apenas 12&#37; por fatores gen&#233;ticos&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a> No microbioma fecal existem entre uma e 2&#46;000 esp&#233;cies de bact&#233;rias&#44; distribu&#237;das em mais de 50 filos&#46; Cerca de 90&#37; do MI s&#227;o compostos pelos filos <span class="elsevierStyleItalic">Firmicutes</span> e <span class="elsevierStyleItalic">Bacteroidetes</span>&#59; uma propor&#231;&#227;o maior de <span class="elsevierStyleItalic">Firmicutes&#47;Bacteroidetes</span> &#40;F&#47;B&#41; &#233; associada a maior est&#237;mulo inflamat&#243;rio sist&#234;mico&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A disbiose intestinal&#44; caracterizada pelo desequil&#237;brio da composi&#231;&#227;o do MI&#44; pode levar ao aumento da permeabilidade intestinal e a transloca&#231;&#227;o de mediadores inflamat&#243;rios intraluminais&#46; Portanto&#44; a caracteriza&#231;&#227;o do MI pode contribuir na compreens&#227;o sobre a patog&#234;nese de doen&#231;as inflamat&#243;rias sist&#234;micas como psor&#237;ase&#44; doen&#231;a de Crohn&#44; artrite reumatoide e obesidade&#44; pois h&#225; ind&#237;cios de que a composi&#231;&#227;o do MI esteja envolvida no curso das mesmas&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Estudos cl&#237;nicos foram conduzidos para explorar a rela&#231;&#227;o entre MI e a atividade cl&#237;nica da psor&#237;ase&#44; com resultados ainda conflitantes&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">7</span></a> Entretanto&#44; considera&#8208;se a modula&#231;&#227;o do MI por meio de tratamento diet&#233;tico&#44; suplementa&#231;&#245;es com probi&#243;ticos e transplante fecal&#44; com potencial de interferir&#44; al&#233;m da atividade da psor&#237;ase&#44; no curso de comorbidades&#44; al&#233;m de maximizar sua resposta terap&#234;utica&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Lipopolissacar&#237;dio &#40;LPS&#41; &#233; uma endotoxina que comp&#245;e a parede celular de bact&#233;rias gram&#8208;negativas e promove ativa&#231;&#227;o do sistema imune a partir da estimula&#231;&#227;o direta de macr&#243;fagos&#44; mon&#243;citos&#44; c&#233;lulas dendr&#237;ticas e linf&#243;citos B&#44; desencadeando febre&#44; vasodilata&#231;&#227;o &#40;&#243;xido n&#237;trico&#41; e secre&#231;&#227;o de eicosanoides&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a> A prote&#237;na de liga&#231;&#227;o de lipopolissacar&#237;dios &#40;LPB&#41; liga&#8208;se ao LPS e transfere mon&#244;meros de LPS para as c&#233;lulas inflamat&#243;rias atrav&#233;s de CD14&#46; Os n&#237;veis plasm&#225;ticos de LPB s&#227;o influenciados pelas concentra&#231;&#245;es circulantes de LPS&#44; que t&#234;m meia&#8208;vida muito curta&#46; A exposi&#231;&#227;o ao LPS induz um aumento duradouro da produ&#231;&#227;o de LPB no f&#237;gado dentro de 15 a 30 minutos&#44; com n&#237;vel s&#233;rico m&#225;ximo ocorrendo ap&#243;s 24 a 48 horas&#46; O complexo LPS&#8208;LBP&#8208;CD14&#8208;MD2 induz uma resposta pr&#243;&#8208;inflamat&#243;ria pela ativa&#231;&#227;o de NF&#8208;&#954;B mediada pelo receptor <span class="elsevierStyleItalic">Toll&#8208;like</span>&#8208;4 &#40;TLR4&#41; e&#44; como tal&#44; os n&#237;veis circulantes de LPB foram associados &#224; inflama&#231;&#227;o sist&#234;mica&#46; Al&#233;m disso&#44; n&#237;veis plasm&#225;ticos da prote&#237;na C reativa quantitativa ultrassens&#237;vel &#40;PCRqt&#41;&#44; um biomarcador s&#233;rico de inflama&#231;&#227;o sist&#234;mica sintetizado pelo f&#237;gado&#44; est&#227;o associadas ao aumento de LPS&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Na Am&#233;rica do Sul&#44; s&#227;o raros os estudos controlados que caracterizem o MI de pacientes com psor&#237;ase&#46; Assim&#44; o objetivo desta investiga&#231;&#227;o foi caracterizar o MI de homens adultos brasileiros com psor&#237;ase&#44; comparando&#8208;os com controles on&#237;voros e vegetarianos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todo</span><p id="par0040" class="elsevierStylePara elsevierViewall">Estudo transversal envolvendo 42 homens adultos &#40;21&#8208;65 anos&#41; &#8211; 21 com psor&#237;ase &#40;PSO&#41; e 21 controles sem psor&#237;ase&#44; dos quais 14 on&#237;voros &#40;ONI&#41; e sete vegetarianos &#40;VEG&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Todos os participantes inclu&#237;dos eram n&#227;o tabagistas&#44; n&#227;o etilistas&#44; n&#227;o apresentaram altera&#231;&#245;es na dieta nos &#250;ltimos tr&#234;s meses&#59; n&#227;o usaram antibi&#243;ticos&#44; laxantes&#44; anti&#8208;inflamat&#243;rios&#44; ou referiram altera&#231;&#245;es intestinais na &#250;ltima semana&#44; aus&#234;ncia de doen&#231;a inflamat&#243;ria intestinal&#44; infec&#231;&#245;es&#44; doen&#231;as autoimunes e uso de probi&#243;ticos&#46; A amostra de homens adultos do interior do estado de S&#227;o Paulo foi escolhida para reduzir a variabilidade do MI&#44; que tamb&#233;m &#233; influenciada por sexo&#44; idade e localiza&#231;&#227;o geogr&#225;fica da popula&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa em Seres Humanos da Faculdade de Medicina de Botucatu &#40;FMB&#47;UNESP&#41; sob o parecer n&#176; 3&#46;743&#46;366&#46; Todos os participante assinaram o Termo de Consentimento Livre e Esclarecido&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A pesquisa foi realizada no Ambulat&#243;rio de Dermatologia da FMB&#44; no per&#237;odo de mar&#231;o de 2020 a fevereiro de 2021&#46; A popula&#231;&#227;o teve origem entre moradores da regi&#227;o de Botucatu &#40;SP&#41;&#44; pacientes com diagn&#243;stico de psor&#237;ase&#44; seus acompanhantes e convidados vegetarianos&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Foram obtidos dados cl&#237;nicos&#44; demogr&#225;ficos&#44; socioecon&#244;micos e diet&#233;ticos por meio de entrevistas presenciais&#59; as avalia&#231;&#245;es antropom&#233;trica e diet&#233;tica foram realizadas por nutricionista experiente &#40;T&#46;C&#46;F&#46;P&#46;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o diet&#233;tica foi obtida pelo Recordat&#243;rio de 24 horas &#40;R24<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; a partir do relato detalhado do consumo alimentar nas &#250;ltimas 24 horas&#44; com dados sobre os tipos de alimentos e bebidas&#44; al&#233;m do tamanho&#44; por&#231;&#245;es&#44; volume ou medidas caseiras&#46; Posteriormente&#44; os dados foram transformados em gramas&#44; valores de energia&#44; macronutrientes e micronutrientes pelo <span class="elsevierStyleItalic">software</span> NDSR &#40;<span class="elsevierStyleItalic">Nutritional Data System for Research</span>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para estimar a gravidade da doen&#231;a&#44; foi utilizado o escore PASI &#40;<span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#41;&#44; avaliado por dermatologista titulado &#40;L&#46;D&#46;B&#46;M&#46; ou M&#46;R&#46;R&#46;L&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Para avaliar o MI&#44; coletaram&#8208;se amostras de fezes para obten&#231;&#227;o do material gen&#233;tico&#46; Os indiv&#237;duos foram orientados a realizar a coleta de fezes da primeira evacua&#231;&#227;o do dia em tubo espec&#237;fico em sua resid&#234;ncia&#46; Ap&#243;s a coleta&#44; as amostras foram entregues &#224; pesquisadora respons&#225;vel &#40;T&#46;C&#46;F&#46;P&#46;&#41; e transportadas refrigeradas &#40;gelo seco&#58; &#8722;28<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; at&#233; o laborat&#243;rio Biotecnologia Pesquisa e Inova&#231;&#227;o &#40;BPI&#44; Botucatu&#8208;SP&#41;&#44; e armazenadas em freezer &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C at&#233; o momento da extra&#231;&#227;o do DNA&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Para extra&#231;&#227;o do material gen&#233;tico&#44; foram utilizadas al&#237;quotas de 1<span class="elsevierStyleHsp" style=""></span>g e o <span class="elsevierStyleItalic">kit</span> Quick&#8208;DNA Fungal&#47;Bacterial Miniprep &#40;Zymo Research&#41;&#44; de acordo com protocolo descrito pelo fabricante&#46; Posteriormente&#44; o material passou pelo teste de qualidade por meio da quantifica&#231;&#227;o por fluoresc&#234;ncia com a utiliza&#231;&#227;o do equipamento Qubit&#174; 3&#46;0 Fluorometer &#40;Thermo Fisher Scientific&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Para as rea&#231;&#245;es de amplifica&#231;&#227;o da regi&#227;o 16S foram realizadas triplicatas de amostras&#44; tendo como volume final de 20 &#956;L&#44; contendo 10 &#956;L de GoTaq&#174; Colorless Master Mix 2<span class="elsevierStyleHsp" style=""></span>&#215; &#40;Promega&#44; USL&#41;&#44; 0&#44;3 &#956;M de oligonucleot&#237;dio <span class="elsevierStyleItalic">forward</span> e 0&#44;3 &#956;M de oligonucleot&#237;dio <span class="elsevierStyleItalic">reverse</span>&#44; 3 &#956;L de DNA gen&#244;mico e &#225;gua ultrapura est&#233;ril suficiente para completar 20 &#956;L&#46; As rea&#231;&#245;es de amplifica&#231;&#227;o foram conduzidas em termociclador Veriti<span class="elsevierStyleSup">TM</span> Thermal Cycler &#40;Applied Biosystems&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ap&#243;s a rea&#231;&#227;o de amplifica&#231;&#227;o do DNA de cada amostra&#44; a comprova&#231;&#227;o da amplifica&#231;&#227;o foi realizada por eletroforese em gel de agarose 2&#37; corado com gel Red &#40;Uniscience&#41;&#44; aproximadamente 300 bp &#40;tamanho do <span class="elsevierStyleItalic">amplicon</span>&#41;&#46; Submeteu&#8208;se PCR para etapas de purifica&#231;&#227;o utilizando <span class="elsevierStyleItalic">bead</span> magn&#233;tica Agencourt AMPure XP &#40;Beckman Coulter&#41; para remo&#231;&#227;o de fragmentos muito pequenos da popula&#231;&#227;o total de mol&#233;culas e restos de <span class="elsevierStyleItalic">primers</span> da rea&#231;&#227;o&#46; Ap&#243;s essa etapa&#44; foi realizada a quantifica&#231;&#227;o pela metodologia de PCR em tempo real utilizando termociclador QuantStudio 3 Real Time &#40;Applied Biosystems&#41; e <span class="elsevierStyleItalic">kit</span> KAPA&#8208;KK4824 &#40;Library Quantification Kit &#8208; Illumina&#47;Universal&#41;&#44; todos de acordo com protocolo do fabricante&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Foi gerado um <span class="elsevierStyleItalic">pool</span> equimolar de DNA&#44; por meio da normaliza&#231;&#227;o de todas as amostras a 3<span class="elsevierStyleHsp" style=""></span>nM para a realiza&#231;&#227;o do sequenciamento&#44; o qual foi conduzido utilizando o sistema Illumina MiSeq de sequenciamento de nova gera&#231;&#227;o &#40;Illumina Sequencing&#41; e <span class="elsevierStyleItalic">kit</span> MiSeq Reagent Kit V2 Nano 300 ciclos &#8211; leitura de 2 &#215; 150 pb&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Utilizou&#8208;se o banco de dados Greengenes 13&#95;8 99&#37; OTUs from 515F&#47;806R region of sequences para identifica&#231;&#227;o das sequ&#234;ncias de t&#225;xons e foram consideradas apenas sequ&#234;ncias com mais de 97&#37; de analogia &#40;confiabilidade&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A abund&#226;ncia relativa das unidades taxon&#244;micas &#40;UTN&#41; nas amostras foi explorada a partir de seus componentes extra&#237;dos pelo m&#233;todo <span class="elsevierStyleItalic">Partial Least Squares</span> &#40;PLS&#41;&#44; com dados escalonados pelos desvios&#8208;padr&#227;o&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">As principais vari&#225;veis do estudo s&#227;o a diversidade da flora intestinal identificada em cada MI avaliado&#44; segundo cada categoria de UTN&#58; abund&#226;ncia relativa dos grupos&#44; pelos &#237;ndices de diversidade de Hill &#40;riqueza&#44; Shannon e Simpson&#41;&#44; a rela&#231;&#227;o entre os filos <span class="elsevierStyleItalic">Firmicutes</span>&#47;<span class="elsevierStyleItalic">Bacteroidetes</span>&#44; abund&#226;ncia dos g&#234;neros bacterianos &#40;alfa diversidade&#41; e os componentes dos padr&#245;es PLS &#40;beta diversidade&#41; identificados para os grupos&#46; Define&#8208;se riqueza como n&#250;mero total de UTN identificadas na amostra&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Foram ainda coletadas amostras de 10<span class="elsevierStyleHsp" style=""></span>mL de sangue dos pacientes no ambulat&#243;rio de dermatologia&#44; pela m&#233;dica respons&#225;vel pelo tratamento dos pacientes &#40;M&#46;R&#46;R&#46;L&#46;&#41;&#44; para avalia&#231;&#227;o do LPB e PCRqt s&#233;ricos&#46; Ap&#243;s as coletas&#44; as amostras foram imediatamente levadas sob refrigera&#231;&#227;o para a Unidade de Pesquisa Experimental &#40;UNIPEX&#41; da FMB&#8208;Unesp&#44; para centrifuga&#231;&#227;o e extra&#231;&#227;o do soro&#46; Para a an&#225;lise do LPB&#44; foi utilizado o m&#233;todo ELISA <span class="elsevierStyleItalic">sandwich</span>&#44; conforme as orienta&#231;&#245;es do fabricante do kit &#40;<span class="elsevierStyleItalic">Human LBP DuoSet ELISA &#8208;</span> DY870&#8208;05&#44; R&#38;D Systems&#44; Inc&#46;&#44; Minneapolis&#44; MN&#44; EUA&#41;&#46; As amostras foram dilu&#237;das na fra&#231;&#227;o 1&#58;500&#46; As concentra&#231;&#245;es finais de LPB foram determinadas conforme a curva padr&#227;o&#46; As an&#225;lises do PCRqt foram realizadas pelo m&#233;todo de imunoturbidimetria&#46; Adotaram&#8208;se como valores normais de PCRqt &#8804; 3 mg&#47;dL&#44; e de LPB &#8804; 10 mg&#47;mL&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Vari&#225;veis qualitativas foram representadas pelos percentuais&#46; Vari&#225;veis quantitativas foram representadas como m&#233;dias e desvios&#8208;padr&#227;o&#44; se a normalidade for verificada pelo teste de Shapiro&#8208;Wilk&#44; ou medianas e quartis &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41;&#44; se indicado&#46; As abund&#226;ncias dos g&#234;neros foram comparadas entre os grupos pelo teste de Kruskal&#8208;Wallis&#46; Os &#237;ndices de diversidade ecol&#243;gica foram comparados entre os grupos por modelos lineares generalizados&#44; ajustado pela idade dos participantes&#46; Os modelos foram ajustados para as distribui&#231;&#245;es de probabilidade mais adequadas a cada amostra &#40;p&#46; ex&#46;&#44; gama&#41;&#44; e a corre&#231;&#227;o para m&#250;ltiplas compara&#231;&#245;es foi realizada pelo procedimento de &#352;id&#225;k&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">As cargas dos componentes PLS foram correlacionadas com dados nutricionais&#44; n&#237;veis de LPB e de PCRqt pelo teste de correla&#231;&#227;o de Spearman&#44; e representado como mapa t&#233;rmico&#46; Os dados foram tabulados em Excel 2010 e analisados nos <span class="elsevierStyleItalic">softwares</span> IBM SPSS 25<span class="elsevierStyleHsp" style=""></span>v e Statistica 10<span class="elsevierStyleHsp" style=""></span>v&#46; A signific&#226;ncia estat&#237;stica foi definida como p &#8804; 0&#44;05&#59; bicaudal&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Como se trata de estudo explorat&#243;rio&#44; foi utilizada amostragem por conveni&#234;ncia a fim de se determinar o comportamento global dos grupos e fundamentar a an&#225;lise pormenorizada de amostras <span class="elsevierStyleItalic">a posteriori</span>&#46; Al&#233;m disso&#44; o m&#233;todo PLS n&#227;o exige amostragem m&#237;nima para sua execu&#231;&#227;o&#46; Para as an&#225;lises de correla&#231;&#227;o bivariada&#44; considera&#8208;se suficiente uma amostra de 41 participantes para a detec&#231;&#227;o de correla&#231;&#227;o moderada &#40;rho &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#41;&#44; considerando &#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01 e poder de 90&#37;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os principais dados cl&#237;nicos&#44; demogr&#225;ficos&#44; alimentares&#44; LPB s&#233;rico e PCRqt est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Idade e IMC dos grupos PSO e ONI foram maiores que do grupo VEG&#46; Do ponto de vista alimentar&#44; os grupos PSO e ONI relataram maior consumo de carboidratos e prote&#237;nas que o grupo VEG&#46; Quanto &#224;s fibras alimentares&#44; o grupo PSO relatou menor ingesta de fibras que ONI e que VEG&#46; Os n&#237;veis plasm&#225;ticos de LPB&#44; assim como os n&#237;veis de PCRqt&#44; foram maiores no grupo PSO em rela&#231;&#227;o ao VEG&#44; por&#233;m&#44; PCRqt foi maior no PSO em rela&#231;&#227;o ao ONI&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Nenhum controle VEG nem ONI eutr&#243;ficos apresentou valores elevados de LPB&#59; por&#233;m&#44; um ONI obeso&#44; um PSO eutr&#243;fico e dois PSO obesos apresentaram LPB &#62;<span class="elsevierStyleHsp" style=""></span>10 mg&#47;mL&#46; Do mesmo modo&#44; nenhum controle VEG nem ONI eutr&#243;ficos apresentou valores elevados de PCRqt&#44; por&#233;m dois ONI obesos&#44; quatro PSO eutr&#243;ficos e tr&#234;s PSO obesos apresentaram PCR<span class="elsevierStyleHsp" style=""></span>&#62; 3 mg&#47;mL&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Entre os pacientes com psor&#237;ase&#44; oito &#40;32&#37;&#41; apresentavam doen&#231;a articular&#44; seis &#40;24&#37;&#41; eram tratados exclusivamente com t&#243;picos&#44; seis &#40;24&#37;&#41; utilizavam metotrexato&#44; oito &#40;32&#37;&#41; utilizavam acitretina e cinco &#40;20&#37;&#41; utilizavam secuquinumabe&#46; O PASI variou entre 1 e 18&#44; com mediana &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41; de 4 &#40;1&#8208;7&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Quanto &#224;s comorbidades&#44; entre os pacientes com psor&#237;ase encontraram&#8208;se dois &#40;17&#37;&#41; com diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; tr&#234;s &#40;25&#37;&#41; com hipertens&#227;o arterial e cinco &#40;42&#37;&#41; com dislipidemia&#46; Entre os on&#237;voros&#44; dois &#40;13&#37;&#41; eram diab&#233;ticos&#44; quatro &#40;28&#37;&#41; hipertensos e seis &#40;43&#37;&#41; com dislipidemia&#46; Nenhum dos vegetarianos apresentava comorbidades&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">A an&#225;lise do MI dos participantes resultou na identifica&#231;&#227;o de 1&#46;496 diferentes UTN&#44; reunidos em 94 g&#234;neros &#40;tabela suplementar 1&#41;&#46; Os &#237;ndices de diversidade ecol&#243;gica do MI diferiram entre os grupos e est&#227;o representados na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Quando ajustado pela idade e IMC&#44; o filo <span class="elsevierStyleItalic">Firmicutes</span> foi menos abundante em VEG&#44; e a rela&#231;&#227;o F&#47;B foi maior no grupo PSO que no VEG&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Quando comparados os obesos com psor&#237;ase e controles obesos&#44; a rela&#231;&#227;o F&#47;B n&#227;o apresentou diferen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;078&#41;&#46; Entretanto&#44; quando s&#227;o comparados eutr&#243;ficos com psor&#237;ase e controles eutr&#243;ficos&#44; os portadores de psor&#237;ase apresentaram maiores valores m&#233;dios &#40;DP&#41; da rela&#231;&#227;o F&#47;B &#40;12&#44;1 &#91;2&#44;9&#93; <span class="elsevierStyleItalic">vs</span>&#46; 2&#44;0 &#91;1&#44;0&#93;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o &#224; alfa&#8208;diversidade&#44; entre os 13 g&#234;neros mais prevalentes nos tr&#234;s grupos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; foi identificada maior propor&#231;&#227;o do g&#234;nero <span class="elsevierStyleItalic">Prevotella</span> &#40;36&#37;&#41; no grupo VEG e <span class="elsevierStyleItalic">Blautia</span> em PSO &#40;14&#37;&#41; e ONI &#40;18&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0170" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o ao grupo PSO&#44; houve diferen&#231;a na abund&#226;ncia dos g&#234;neros <span class="elsevierStyleItalic">Prevotella</span>&#44; <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Dorea</span>&#44; <span class="elsevierStyleItalic">Bifidobacterium e Coprococcus</span>&#44; quando compararados com VEG<span class="elsevierStyleItalic">&#46;</span> J&#225; os g&#234;neros <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Collinsella</span>&#44; <span class="elsevierStyleItalic">Desulfovibrio</span> diferiram entre os grupos PSO e ONI &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Quanto &#224; beta&#8208;diversidade&#44; dois componentes PLS representaram at&#233; 79&#44;5&#37; da vari&#226;ncia dos subgrupos&#46; A <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a> apresenta a proje&#231;&#227;o dos casos de acordo com a carga de seus componentes&#44; individualizando&#8208;os em quadrantes distintos&#46; O padr&#227;o plsPSO pode ser compreendido como os carregamentos negativos de PLS1 e 2 &#40;plsPSO<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;PLS1&#8722;PLS2&#41;&#59; inversamente&#44; o padr&#227;o plsVEG pode ser representado pelos carregamentos positivos de PLS1 e 2 &#40;plsPVEG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>PLS1&#43;PLS2&#41;&#59; j&#225; o padr&#227;o plsONI pode ser representado pelo carregamento positivo de PS1 e negativo de PS2 &#40;plsONI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>PLS1<span class="elsevierStyleItalic">&#8208;</span>PLS2&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0180" class="elsevierStylePara elsevierViewall">Os carregamentos das UTN segundo PLS1 e PLS2 est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#sec0050">figura suplementar 1</a>&#46; Segundo os componentes plsPSO&#44; as bact&#233;rias com maior carregamento do padr&#227;o de MI do grupo PSO foram do g&#234;nero <span class="elsevierStyleItalic">Coprococcus</span>&#44; <span class="elsevierStyleItalic">Lachnospira</span>&#44; <span class="elsevierStyleItalic">Paraprevotella</span>&#44; e as esp&#233;cies <span class="elsevierStyleItalic">Faecalibacterium prausnitzii</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Prevotella stercorea</span> sp&#46;&#44; <span class="elsevierStyleItalic">Prevotella copri</span> sp&#46; e <span class="elsevierStyleItalic">Ruminococcus callidus</span> sp&#46; J&#225; as com menor carregamento foram dos g&#234;neros <span class="elsevierStyleItalic">Lactobacillus</span>&#44; <span class="elsevierStyleItalic">Streptococcus</span>&#44; <span class="elsevierStyleItalic">Dialister</span>&#44; <span class="elsevierStyleItalic">Megasphera</span>&#44; <span class="elsevierStyleItalic">Slackia</span>&#44; e as esp&#233;cies <span class="elsevierStyleItalic">Bacteroides</span><span class="elsevierStyleItalic">fragilis</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Bacteroides uniformis</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Blautia producta</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Butyricoccus pullicaerum</span> sp<span class="elsevierStyleItalic">&#46; e Parabacteroides distasonis</span> sp&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#fig0020">figura 4</a> apresenta as correla&#231;&#245;es entre os n&#237;veis de LPB&#44; PCRqt&#44; ingesta nutricional e os padr&#245;es de MI&#58; PSO&#44; ONI&#44; e VEG&#46; Os n&#237;veis de LPB se correlacionaram inversamente com a ingesta de fibras &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#8208;</span>0&#44;53&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; por&#233;m&#44; positivamente com o componente do padr&#227;o de MI dos pacientes com psor&#237;ase &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;39&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; O comportamento do PCRqt n&#227;o se associou ao componente do padr&#227;o plsPSO &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;28&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;11&#41;&#44; mas com a ingesta de carboidratos &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;41&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; e com os n&#237;veis de LPB &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;46&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Do ponto de vista alimentar&#44; o componente do padr&#227;o de MI plsPSO se correlacionou de maneira fortemente negativa com a ingesta de fibras &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#8208;</span>0&#44;71&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; assim como a menor ingesta de fibras se associou a maiores n&#237;veis de LPB e PCRqt&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0190" class="elsevierStylePara elsevierViewall">Nosso estudo indicou que caracter&#237;sticas do MI de homens adultos com psor&#237;ase diferiram dos controles on&#237;voros e vegetarianos residentes de uma mesma regi&#227;o do Brasil&#46; Aspectos et&#225;rios&#44; alimentares e de composi&#231;&#227;o corporal tamb&#233;m podem contribuir por parte dessas diferen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Nessa amostra&#44; o grupo PSO apresentou maior ingesta de carboidratos&#44; por&#233;m baixa ingesta de fibras&#44; mostrando ainda maior rela&#231;&#227;o F&#47;B no MI que o grupo VEG&#44; que contou com maior ingesta de fibras e menor abund&#226;ncia de <span class="elsevierStyleItalic">Firmicutes</span>&#46; Al&#233;m disso&#44; os h&#225;bitos alimentares dos pacientes com psor&#237;ase mostraram&#8208;se desequilibrados&#44; pois tamb&#233;m foram identifcados aumento de gorduras de baixa qualidade e alta densidade cal&#243;rica&#44; caracter&#237;sticas da dieta ocidental que &#233; associada &#224; disbiose intestinal e redu&#231;&#227;o de diversidade bacteriana&#46; Tais h&#225;bitos diet&#233;ticos podem se correlacionar com a gravidade da doen&#231;a e das comorbidades&#44; j&#225; que gorduras saturadas&#44; a&#231;&#250;cares&#44; carne bovina e &#225;lcool interferem no <span class="elsevierStyleItalic">status</span> inflamat&#243;rio sist&#234;mico&#44; enquanto a ingesta de fibras alimentares pode contribuir com a supress&#227;o de certas vias inflamat&#243;rias e na indu&#231;&#227;o de c&#233;lulas&#8208;T reguladoras&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;14</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">A disbiose intestinal tamb&#233;m atua no desequil&#237;brio dos &#225;cidos graxos de cadeia curta &#40;AGCC&#41;&#44; dos quais butirato e acetato s&#227;o os mais estudados&#44; e s&#227;o produzidos a partir da fermenta&#231;&#227;o de fibras pelas bact&#233;rias intestinais&#46; Acetato &#233; associado &#224; produ&#231;&#227;o de grelina&#44; que controla o apetite e a resist&#234;ncia &#224; insulina&#59; j&#225; o butirato &#233; fonte de energia para c&#233;lulas intestinais&#44; associado com preven&#231;&#227;o e redu&#231;&#227;o da inflama&#231;&#227;o sist&#234;mica e aumento da diversidade bacteriana&#44; favorecendo a prolifera&#231;&#227;o de bact&#233;rias do filo <span class="elsevierStyleItalic">Bacteroidetes</span>&#46; Dietas com alto teor de fibras&#44; vegetais e frutas promovem aumento de <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; e por consequ&#234;ncia maior diversidade bacteriana&#46; Por outro lado&#44; dietas com excesso de frituras&#44; s&#243;dio&#44; prote&#237;na e gordura animal podem propiciar maior ativa&#231;&#227;o pr&#243;&#8208;inflamat&#243;ria sist&#234;mica e propor&#231;&#227;o F&#47;B no MI&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> Al&#233;m disso&#44; os AGCC s&#227;o moduladores diretos da s&#237;ntese de interleucina 17 &#40;IL&#8208;17&#41; por linf&#243;citos&#8208;T&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">A disbiose intestinal pode promover o aumento intraluminal de LPS&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> e dietas com baixa qualidade nutricional &#40;p&#46; ex&#46;&#44; dieta ocidental&#41;&#44; estresse f&#237;sico e psicol&#243;gico&#44; certos medicamentos &#40;p&#46; ex&#46;&#44; antimicrobianos&#41; s&#227;o fatores que favorecem o aumento da permeabilidade intestinal&#46; Um intestino mais perme&#225;vel propicia a transloca&#231;&#227;o de LPS para a corrente sangu&#237;nea &#40;endotoxemia metab&#243;lica&#41;&#44; favorecendo resist&#234;ncia &#224; insulina&#44; inflama&#231;&#227;o no tecido adiposo&#44; infiltra&#231;&#227;o tecidual de mon&#243;citos&#47;macr&#243;fagos&#44; que aumentam o risco de doen&#231;as como esteatose hep&#225;tica&#44; obesidade&#44; diabetes&#46; Assim&#44; parte da resposta inflamat&#243;ria sist&#234;mica pode ser atribu&#237;da &#224; composi&#231;&#227;o do MI&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">Em modelo murino de psor&#237;ase induzida por imiquimode&#44; a administra&#231;&#227;o oral de <span class="elsevierStyleItalic">Staphylococcus aureus</span> e <span class="elsevierStyleItalic">Streptococcus danieliae</span> levou &#224; inflama&#231;&#227;o cut&#226;nea e ao aumento da express&#227;o de TNF e IL17&#44; subsidiando a hip&#243;tese de que a disbiose intestinal possa levar &#224; piora cl&#237;nica da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Este estudo investigou&#44; de maneira original&#44; rela&#231;&#245;es entre n&#237;veis plasm&#225;ticos de LPB&#44; PCRqt&#44; e padr&#227;o alimentar em on&#237;voros&#44; vegetarianos e pacientes com psor&#237;ase&#44; demonstrando que os n&#237;veis de LPB se correlacionaram inversamente com o consumo de fibras&#46; Nessa amostra&#44; os participantes com psor&#237;ase apresentaram n&#237;veis de LPB maiores que os vegetarianos&#44; levando &#224; hip&#243;tese de que a modula&#231;&#227;o do MI &#40;p&#46; ex&#46;&#44; pode meio da dieta&#41; contribua com a redu&#231;&#227;o dos n&#237;veis de LPB s&#233;ricos&#59; portanto&#44; esses achados subsidiam que a sa&#250;de intestinal pode ser modulada por meio de escolhas alimentares&#46; Al&#233;m disso&#44; os n&#237;veis de PCRqt foram maiores em PSO&#44; associados &#224; ingesta de carboidratos e LPB&#46; Apesar de a permeabilidade intestinal n&#227;o ser avaliada de maneira direta&#44; os n&#237;veis elevados de LPB e PCRqt podem indicar maior permeabilidade intestinal em pacientes com psor&#237;ase&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Pesquisas com n&#237;veis s&#233;ricos de LPB em humanos s&#227;o escassas&#44; mas existem evid&#234;ncias de que o LPB esteja elevado em pacientes com psor&#237;ase&#44; havendo correla&#231;&#227;o com os n&#237;veis de PCRqt&#46; Desse modo&#44; LPB pode ser um indicador de inflama&#231;&#227;o sist&#234;mica e progress&#227;o para s&#237;ndrome metab&#243;lica em pacientes com psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> &#201; importante ressaltar que&#44; recentemente&#44; o LPB revelou&#8208;se um biomarcador para a permeabilidade intestinal em adultos&#44; independentemente de idade&#44; IMC e g&#234;nero&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Em estudos controlados que analisaram o MI de pacientes com psor&#237;ase&#44; utilizando grupos populacionais diversos&#44; foram encontrados achados diferentes&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a> Em um estudo israelense que avaliou a diversidade beta em pacientes com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41; em compara&#231;&#227;o com controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41; sem psor&#237;ase&#44; pareados por idade&#44; IMC e comorbidades&#44; identificou&#8208;se aumento significante em <span class="elsevierStyleItalic">Ruminoccocus gnavus</span>&#44; <span class="elsevierStyleItalic">Dorea formicigenerans</span> e <span class="elsevierStyleItalic">Collinsella aerofaciens</span> no MI da psor&#237;ase&#44; enquanto <span class="elsevierStyleItalic">Prevotella copri</span> e <span class="elsevierStyleItalic">Parabacteroides distasonis</span> foram significantemente menores em compara&#231;&#227;o com os controles<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a> &#8211; um padr&#227;o algo diverso da estrutura de MI encontrada em nossa amostra&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Outro estudo conduzido na China evidenciou que pacientes com psor&#237;ase t&#234;m perfis de MI significantemente perturbados&#44; pois ao analisar o MI de 35 pacientes com psor&#237;ase e 27 controles&#44; mostrou diferen&#231;a nas abund&#226;ncias relativas de <span class="elsevierStyleItalic">Firmicutes</span> e <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; com aumento de <span class="elsevierStyleItalic">Bacteroides</span>&#44; <span class="elsevierStyleItalic">Actinobacteria</span> e redu&#231;&#227;o de <span class="elsevierStyleItalic">Firmicutes</span>&#44; <span class="elsevierStyleItalic">Proteobacteria</span> e <span class="elsevierStyleItalic">Bifidobacterium&#46;</span><a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> Em contrapartida&#44; um estudo espanhol de pacientes com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#44; em compara&#231;&#227;o com um grupo controle saud&#225;vel &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; mostrou menor diversidade bacteriana e diferente abund&#226;ncia relativa de certos t&#225;xons bacterianos em pacientes com psor&#237;ase&#44; com aumento de <span class="elsevierStyleItalic">Actinobacteria</span>&#44; <span class="elsevierStyleItalic">Firmicutes</span> e redu&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; <span class="elsevierStyleItalic">Proteobacterias</span> e <span class="elsevierStyleItalic">Fecalibacterium</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">Em uma an&#225;lise do MI de 52 pacientes com psor&#237;ase &#40;PASI &#8805; 6&#41; em compara&#231;&#227;o com popula&#231;&#227;o saud&#225;vel &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>300&#41;&#44; evidenciou&#8208;se maior frequ&#234;ncia do padr&#227;o chamado enter&#243;tipo 2&#44; com tend&#234;ncia a apresentar transloca&#231;&#227;o bacteriana mais frequente e maior estado inflamat&#243;rio &#40;71&#37;&#41; do que outros enter&#243;tipos&#44; havendo predom&#237;nio de <span class="elsevierStyleItalic">Akkermansia</span>&#44; <span class="elsevierStyleItalic">Faecalibacterium</span>&#44; <span class="elsevierStyleItalic">Ruminococcus</span> e menor propor&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> Nossa amostra tamb&#233;m indicou maiores propor&#231;&#245;es de <span class="elsevierStyleItalic">Faecalibacterium</span> e <span class="elsevierStyleItalic">Ruminococcus</span>&#44; al&#233;m de menores &#237;ndices de <span class="elsevierStyleItalic">Bactroidetes</span> no perfil &#40;PLS&#41; dos pacientes com psor&#237;ase&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Recentemente&#44; um estudo conduzido na Argentina demonstrou mudan&#231;as na composi&#231;&#227;o do MI dependendo do <span class="elsevierStyleItalic">status</span> da psor&#237;ase&#44; com aumento de <span class="elsevierStyleItalic">Firmicutes</span> e deple&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span> em 55 pacientes com psor&#237;ase&#44; em compara&#231;&#227;o com 27 controles&#46; Al&#233;m disso&#44; os g&#234;neros <span class="elsevierStyleItalic">Faecalibacterium</span> e <span class="elsevierStyleItalic">Blautia</span> foram maiores em pacientes com psor&#237;ase&#44; enquanto <span class="elsevierStyleItalic">Bacteroides</span> e <span class="elsevierStyleItalic">Paraprevotella</span> foram maiores em controles sem psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a> Como nossos pacientes estavam em tratamento e a maior parte com PASI &#60;<span class="elsevierStyleHsp" style=""></span>4&#44; n&#227;o foi poss&#237;vel estratificar o MI de acordo com a gravidade da doen&#231;a&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">Outro estudo de caso&#8208;controle na &#193;sia Central&#44; com pacientes entre 30 e 45 anos&#44; com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41; e controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; pareados por idade e sexo&#44; encontrou associa&#231;&#227;o com psor&#237;ase e n&#237;veis elevados de <span class="elsevierStyleItalic">Firmicutes</span>&#44; <span class="elsevierStyleItalic">Faecalibacterium</span> e abund&#226;ncia reduzida de <span class="elsevierStyleItalic">Oscillibacter</span> e <span class="elsevierStyleItalic">Roseburia</span>&#44; mas n&#227;o houve diferen&#231;a na diversidade e rela&#231;&#227;o F&#47;B&#44; bastante alinhado com nossos resultados&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a></p><p id="par0250" class="elsevierStylePara elsevierViewall">Um estudo brasileiro mostrou menor diversidade no MI de mulheres com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41; em compara&#231;&#227;o com controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; identificando aumento do g&#234;nero <span class="elsevierStyleItalic">Dialister</span> e da esp&#233;cie <span class="elsevierStyleItalic">Prevotella copri</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; mas redu&#231;&#227;o nos g&#234;neros <span class="elsevierStyleItalic">Ruminococcus</span>&#44; <span class="elsevierStyleItalic">Lachnospira</span>&#44; <span class="elsevierStyleItalic">Blautia</span> e nas esp&#233;cies <span class="elsevierStyleItalic">Akkermansia muciniphila</span> sp&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a></p><p id="par0255" class="elsevierStylePara elsevierViewall">No presente estudo&#44; o perfil de MI encontrado nos homens adultos portadores de psor&#237;ase foi associado aos descritos em outras comorbidades&#44; como na s&#237;ndrome metab&#243;lica&#44; obesidade e doen&#231;as afetivas&#44; o que pode decorrer do estilo de vida ocidental&#46; Ainda de acordo com a literatura&#44; o <span class="elsevierStyleItalic">Coprococcus</span> foi associado a doen&#231;as afetivas como depress&#227;o&#44; obesidade e m&#225; qualidade do sono&#59;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a><span class="elsevierStyleItalic">Lachnospira</span> foi associado ao desenvolvimento de diabetes <span class="elsevierStyleItalic">mellitus</span>&#59;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> e <span class="elsevierStyleItalic">Paraprevotella</span> com maior ingest&#227;o de gorduras&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a> Apesar de haver associa&#231;&#227;o com dietas vegetarianas&#44; <span class="elsevierStyleItalic">Prevotella</span> tamb&#233;m &#233; relacionada &#224; elevada ingesta de carboidratos&#44; e como apresenta alta diversidade gen&#233;tica dentro e entre esp&#233;cies&#44; podem explicar sua descri&#231;&#227;o tanto em MI saud&#225;veis como em disbi&#243;ticos&#59; uma carga elevada de <span class="elsevierStyleItalic">Prevotella</span> no MI foi associada &#224; obesidade&#44; resist&#234;ncia &#224; insulina&#44; hipertens&#227;o e doen&#231;a hep&#225;tica gordurosa n&#227;o alco&#243;lica&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">A composi&#231;&#227;o do MI de psor&#237;ase encontrado nessa amostra se op&#244;s &#224; encontrada nos vegetarianos&#44; ricos em <span class="elsevierStyleItalic">Bacteroides</span> e <span class="elsevierStyleItalic">Lactobacillus</span>&#44; associados &#224; menor permeabilidade intestinal&#46; De fato&#44; a preval&#234;ncia de psor&#237;ase em vegetarianos &#233; excepcional&#44; e a dieta vegetariana leva &#224; melhora de les&#245;es cut&#226;neas da psor&#237;ase&#44; o que sugere que a modula&#231;&#227;o do MI possa subsidiar o desenvolvimento de doen&#231;as inflamat&#243;rias como a psor&#237;ase&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">35&#44;36</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">Estudos metagen&#244;micos do MI apresentam alta variabilidade de resultados entre as publica&#231;&#245;es&#46; Diferen&#231;as populacionais &#233;tnicas&#44; culturais e alimentares podem explicar os resultados controversos entre os estudos que caracterizaram MI em psor&#237;ase&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Assim&#44; ainda n&#227;o foi definido o que constitui um MI saud&#225;vel&#44; quando exclu&#237;das as bact&#233;rias sabidamente patog&#234;nicas&#46; Por isso&#44; &#233; essencial destacar que as esp&#233;cies comensais n&#227;o devem ser consideradas absolutamente &#8220;boas&#8221; ou &#8220;ruins&#8221;&#44; j&#225; que todas desempenham fun&#231;&#245;es no ecossistema intestinal&#46; A problem&#225;tica emerge do desequil&#237;brio&#44; ou seja&#44; a predomin&#226;ncia de grupos de esp&#233;cies comensais que promovem altera&#231;&#245;es na permeabilidade intestinal&#46; Al&#233;m disso&#44; quando se caracteriza o MI de um grupo&#44; pretende&#8208;se entender o padr&#227;o de desequil&#237;brio&#44; apesar de a composi&#231;&#227;o do MI ser &#250;nica em cada indiv&#237;duo&#44; adquirida nos primeiros anos de vida e moldada pelas caracter&#237;sticas ambientais&#44; como os h&#225;bitos alimentares&#44; ao longo da vida&#46;<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">37&#8211;39</span></a></p><p id="par0275" class="elsevierStylePara elsevierViewall">Este estudo apresenta limita&#231;&#245;es ligadas &#224; amostra modesta&#44; n&#227;o aleatorizada&#44; o que n&#227;o impediu a identifica&#231;&#227;o de padr&#245;es de MI entre os grupos&#59; al&#233;m disso&#44; a origem comum quanto ao grupo populacional maximiza a homogeneidade da amostra&#46; O efeito dos tratamentos da psor&#237;ase no MI &#233; tema a ser investigado&#44; e nossos participantes utilizaram diversos medicamentos diferentes&#59; entretanto&#44; o uso de adalimumabe n&#227;o mostrou modificar o padr&#227;o de MI em 10 pacientes&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a> Nossos participantes ainda apresentavam escores de PASI baixos&#44; decorrente do controle da doen&#231;a com a terap&#234;utica estabelecida&#46; Na verdade&#44; s&#227;o necess&#225;rios estudos de MI com pacientes com psor&#237;ase sem tratamento sist&#234;mico&#46; Outro aspecto se refere &#224; amostragem do microbioma fecal&#44; que consiste na flora transit&#243;ria do c&#243;lon&#44; em contrapartida &#224; flora permanente que &#233; ligada &#224; mucosa&#44; menos sujeita a varia&#231;&#227;o&#46; Finalmente&#44; LPB &#233; utilizado como <span class="elsevierStyleItalic">proxy</span> da medida de LPS&#44; em decorr&#234;ncia de sua labilidade&#46; As varia&#231;&#245;es alimentares podem dificultar as compara&#231;&#245;es entre os grupos&#44; visto que mesmo dentro dos grupos on&#237;voros&#44; vegetarianos e psor&#237;ase&#44; existem alimentos que podem atuar de maneira diferente no MI&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Estudos cl&#237;nicos controlados em psor&#237;ase que visem a manipula&#231;&#227;o do MI&#44; quer com transplante de fezes&#44; interven&#231;&#245;es diet&#233;ticas &#40;p&#46; ex&#46;&#44; adequa&#231;&#227;o de fibras&#41;&#44; pr&#243;&#47;pr&#233;&#8208;bi&#243;ticos ou sais biliares&#44; devem ser conduzidos para melhor compreens&#227;o do papel do MI na atividade cl&#237;nica da psor&#237;ase&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclus&#227;o</span><p id="par0285" class="elsevierStylePara elsevierViewall">Identificou&#8208;se diferen&#231;a no MI de homens adultos brasileiros com psor&#237;ase em rela&#231;&#227;o a on&#237;voros e vegetarianos saud&#225;veis&#46; O padr&#227;o de MI encontrado correlacionou&#8208;se com a ingesta de fibras alimentares&#44; com os n&#237;veis s&#233;ricos de LPB&#46; Mudan&#231;as nos h&#225;bitos alimentares podem remodelar o MI&#44; e por consequ&#234;ncia&#44; auxiliar no controle cl&#237;nico da psor&#237;ase&#46; Ressalta&#8208;se a necessidade de conscientiza&#231;&#227;o da import&#226;ncia nutricional no tratamento da doen&#231;a e no manejo das comorbidades&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suporte financeiro</span><p id="par0290" class="elsevierStylePara elsevierViewall">FUNADERM &#8208; Fundo de Apoio &#224; Dermatologia&#44; da Sociedade Brasileira de Dermatologia&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Contribui&#231;&#227;o dos autores</span><p id="par0295" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Concep&#231;&#227;o do estudo&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">Tatiana Cristina Figueira Polo&#58; Concep&#231;&#227;o do estudo&#59; coleta de dados&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Mariana Righetto de R&#233; Lai&#58; Concep&#231;&#227;o do estudo&#59; coleta de dados&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">Luciane Donida Bartoli Miot&#58; Coleta de dados&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0315" class="elsevierStylePara elsevierViewall">Giovana Fernanda Cosi Bento&#58; An&#225;lise dos resultados&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">M&#225;rcia Guimar&#227;es da Silva&#58; Revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">Silvio Alencar Marques&#58; Revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflito de interesses</span><p id="par0330" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1940764"
          "titulo" => "Resumo"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Fundamentos"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objetivo"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "M&#233;todo"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Limita&#231;&#245;es do estudo"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1672270"
          "titulo" => "Palavras&#8208;chave"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        3 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todo"
        ]
        4 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
        ]
        5 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discuss&#227;o"
        ]
        6 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclus&#227;o"
        ]
        7 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Suporte financeiro"
        ]
        8 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        9 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conflito de interesses"
        ]
        10 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-05-02"
    "fechaAceptado" => "2022-08-09"
    "PalabrasClave" => array:1 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec1672270"
          "palabras" => array:7 [
            0 => "Dieta"
            1 => "Dieta ocidental"
            2 => "Dieta vegetariana"
            3 => "Microbioma gastrintestinal"
            4 => "Microbiota"
            5 => "Obesidade"
            6 => "Psor&#237;ase"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Psor&#237;ase &#233; doen&#231;a inflamat&#243;ria cr&#244;nica associada &#224; inflama&#231;&#227;o sist&#234;mica e comorbidades&#46; Altera&#231;&#245;es na composi&#231;&#227;o do microbioma intestinal est&#227;o envolvidas na patog&#234;nese de doen&#231;as inflamat&#243;rias e s&#237;ndrome metab&#243;lica&#46; Caracterizar o microbioma intestinal de pacientes com psor&#237;ase pode ser relevante no entendimento do seu curso cl&#237;nico e na preven&#231;&#227;o de comorbidades&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Caracterizar o microbioma intestinal de homens com psor&#237;ase em compara&#231;&#227;o a controles &#40;sem psor&#237;ase&#41; on&#237;voros e vegetarianos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal envolvendo 42 homens adultos&#58; 21 com psor&#237;ase on&#237;voros&#44; 14 controles on&#237;voros e 7 controles vegetarianos&#46; A caracteriza&#231;&#227;o do microbioma intestinal foi realizada por an&#225;lise metagen&#244;mica&#46; Avaliaram&#8208;se os n&#237;veis s&#233;ricos da prote&#237;na ligadora de lipopolissacar&#237;dio &#40;LPB&#41; e prote&#237;na C reativa &#40;PCR&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Os grupos diferiram entre si quanto aos aspectos nutricionais e do microbioma&#46; Pacientes com psor&#237;ase apresentaram maior consumo de prote&#237;nas e menor de fibras&#46; N&#237;veis de LPB&#44; PCR e a rela&#231;&#227;o <span class="elsevierStyleItalic">Firmicutes&#47;Bacteroidetes</span> foram maiores no grupo com psor&#237;ase que no grupo controle vegetariano &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Os g&#234;neros <span class="elsevierStyleItalic">Prevotella<span class="elsevierStyleBold">&#44;</span> Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Dorea</span>&#44; <span class="elsevierStyleItalic">Bifidobacterium</span> e <span class="elsevierStyleItalic">Coprococcus</span> diferiram no grupo com psor&#237;ase em compara&#231;&#227;o com vegetarianos&#59; j&#225; os g&#234;neros <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Collinsella</span> e <span class="elsevierStyleItalic">Desulfovibrio</span> diferiram dos on&#237;voros&#46; Identificou&#8208;se padr&#227;o de microbioma ligado &#224; psor&#237;ase &#40;plsPSO&#41; que se associou a maiores n&#237;veis de LPB &#40;rho &#61; 0&#44;39&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; e menor ingesta de fibras diet&#233;ticas &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;71&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Apenas homens adultos foram avaliados&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Houve diferen&#231;a no microbioma intestinal de homens adultos com psor&#237;ase em rela&#231;&#227;o a on&#237;voros e vegetarianos saud&#225;veis&#46; O padr&#227;o de microbioma encontrado correlacionou&#8208;se com a ingesta de fibras alimentares e com os n&#237;veis s&#233;ricos de LPB&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Fundamentos"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todo"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Limita&#231;&#245;es do estudo"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Como citar este artigo&#58; Polo TCF&#44; Lai MRR&#44; Miot LDB&#44; Bento GFC&#44; Silva MG&#44; Marques SA&#44; Miot HA&#46; Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls&#46; An Bras Dermatol&#46; 2023&#59;98&#58;635&#8211;43&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Trabalho realizado no Departamento de Dermatologia&#44; Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0340" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Material suplementar"
            "identificador" => "sec0050"
          ]
        ]
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1203
            "Ancho" => 3341
            "Tamanyo" => 271716
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Distribui&#231;&#227;o da propor&#231;&#227;o dos 13 g&#234;neros mais prevalentes entre os grupos PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1232
            "Ancho" => 2175
            "Tamanyo" => 158697
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Compara&#231;&#227;o da mediana da abund&#226;ncia dos g&#234;neros que apresentaram diferen&#231;a entre os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1383
            "Ancho" => 1675
            "Tamanyo" => 88054
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Carregamento dos participantes segundo os componentes PLS &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&#46; Em destaque&#44; composi&#231;&#245;es que discriminam os grupos</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">PLS&#44; componente partial least squares&#59; ONI&#44; controles on&#237;voros&#59; VEG&#44; controles vegetarianos&#59; PSO&#44; psor&#237;ase&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1921
            "Ancho" => 2175
            "Tamanyo" => 213640
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mapa t&#233;rmico com as correla&#231;&#245;es bivariadas entre os n&#237;veis de LPB&#44; PCR&#44; caracter&#237;sticas nutricionais da dieta e o padr&#227;o de microbioma intestinal dos pacientes com psor&#237;ase&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">LPB&#44; n&#237;vel s&#233;rico da prote&#237;na de liga&#231;&#227;o de Lipopolissacar&#237;deos&#59; PCRqt&#44; n&#237;vel s&#233;rico da prote&#237;na C reativa ultrassens&#237;vel &#40;teste quantitativo&#41;&#59; CHg&#44; carboidratos &#40;em gramas&#41;&#59; PRg&#44; prote&#237;nas &#40;em gramas&#41;&#59; LIPg&#44; lip&#237;dios &#40;em gramas&#41;&#59; FIBg&#44; fibras &#40;em gramas&#41;&#59; plsPSO&#44; componente PLS do microbioma intestinal dos participantes com psor&#237;ase</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">IMC&#44; &#237;ndice de massa corporal&#59; LPB&#44; prote&#237;na ligadora de polissacar&#237;dios&#59; PCRqt&#44; prote&#237;na C reativa ultrassens&#237;vel&#44; teste quantitativo&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles on&#237;voros &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles vegetarianos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Idade &#40;anos&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#44;6 &#40;11&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;4 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;1 &#40;11&#44;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">IMC &#40;kg&#47;m</span><a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup"><span class="elsevierStyleBold">2</span></span></a><span class="elsevierStyleBold">&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;1 &#40;9&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;4 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;5 &#40;6&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Energia &#40;cal&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;859&#44;4 &#40;1297&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;314&#44;3 &#40;129&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;058&#44;0 &#40;512&#44;0&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Carboidratos &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">539&#44;5 &#40;185&#44;7&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">362&#44;2 &#40;22&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">466&#44;9 &#40;86&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Prote&#237;nas &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">198&#44;9 &#40;76&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#44;4 &#40;21&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&#44;4 &#40;39&#44;3&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Lip&#237;dios &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#44;2 &#40;45&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#44;0 &#40;9&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;9 &#40;23&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Fibras &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;1 &#40;9&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;4 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;8 &#40;7&#44;4&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">LPB &#40;mg&#47;mL&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;1 &#40;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;6 &#40;2&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">PCRqt &#40;mg&#47;dL&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;2 &#40;9&#44;2&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3233293.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">M&#233;dia &#40;desvio&#8211;padr&#227;o&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">p &#8804; 0&#44;05 &#8211; comparado ao vegetariano&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">p &#8804; 0&#44;05 &#8211; comparado ao on&#237;voro&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Principais dados demogr&#225;ficos&#44; alimentares&#44; LPB e PCRqt s&#233;ricos dos participantes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">F&#47;B&#44; Firmicutes&#47;Bacteroidetes&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles on&#237;voros&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles vegetarianos&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Psor&#237;ase&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abund&#226;ncia relativa &#40;10<span class="elsevierStyleSup">3</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#44;0 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;7 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;6 &#40;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diversidade de Hill<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0 &#40;Riqueza&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">141&#44;2 &#40;53&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136&#44;6 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#44;5 &#40;49&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;353&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1 &#40;Shannon&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;0 &#40;18&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;6 &#40;15&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;4 &#40;18&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3 &#40;Simpson&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;4 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;8 &#40;7&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;5 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abund&#226;ncia segundo o filo<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Firmicutes</span> &#40;10<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;1 &#40;37&#44;9&#8208;46&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;1 &#40;29&#44;6&#8208;37&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;1 &#40;33&#44;1&#8208;48&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;049</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Bacteroidetes</span> &#40;10<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;7 &#40;6&#44;5&#8208;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;0 &#40;10&#44;9&#8208;40&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;1 &#40;6&#44;8&#8208;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rela&#231;&#227;o F&#47;B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;1&#44;8&#8208;6&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#40;0&#44;9&#8208;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1 &#40;2&#44;2&#8208;5&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;045</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3233294.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">p&#8208;valor ajustado para idade e &#237;ndice de massa corporal&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">M&#233;dia &#40;desvio&#8208;padr&#227;o&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Mediana &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41;&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">p &#8804; 0&#44;05 &#8211; comparado aos vegetarianos&#59;</p> <p class="elsevierStyleNotepara" id="npar0040"><span class="elsevierStyleSup">b</span> p &#8804; 0&#44;05 &#8211; comparado aos on&#237;voros&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#205;ndices de diversidade ecol&#243;gica do microbioma intestinal entre os grupos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.zip"
          "ficheroTamanyo" => 413232
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of psoriasis in Brazil &#8208; a geographical survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Romiti"
                            1 => "M&#46; Arnone"
                            2 => "A&#46; Menter"
                            3 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2017"
                        "volumen" => "56"
                        "paginaInicial" => "167"
                        "paginaFinal" => "168"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "National&#44; regional&#44; and worldwide epidemiology of psoriasis&#58; systematic analysis and modelling study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Parisi"
                            1 => "I&#46;Y&#46;K&#46; Iskandar"
                            2 => "E&#46; Kontopantelis"
                            3 => "M&#46; Augustin"
                            4 => "C&#46;E&#46;M&#46; Griffiths"
                            5 => "D&#46;M&#46; Ashcroft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ&#46;"
                        "fecha" => "2020"
                        "volumen" => "8247"
                        "paginaInicial" => "1590"
                        "paginaFinal" => "1605"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic and therapeutic guidelines for plaque psoriasis &#8208; Brazilian Society of Dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Arnone"
                            1 => "M&#46;D&#46;F&#46; Takahashi"
                            2 => "A&#46;V&#46;E&#46; Carvalho"
                            3 => "W&#46;M&#46; Bernardo"
                            4 => "A&#46;L&#46; Bressan"
                            5 => "A&#46;M&#46;C&#46; Ramos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/abd1806-4841.2019940211"
                      "Revista" => array:7 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "94"
                        "paginaInicial" => "76"
                        "paginaFinal" => "107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31166402"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1808869416301033"
                          "estado" => "S300"
                          "issn" => "18088694"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of Oral and Gut Microbiota in Patients with psoriatic diseases&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Todberg"
                            1 => "H&#46; Kaiser"
                            2 => "C&#46; Zachariae"
                            3 => "A&#46; Egeberg"
                            4 => "A&#46; Halling"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "2021"
                        "volumen" => "30"
                        "paginaInicial" => "101"
                        "paginaFinal" => "107"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The firmicutes&#47;bacteroidetes ratio&#58; a relevant marker of gut dysbiosis in obese patients&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Magne"
                            1 => "M&#46; Gotteland"
                            2 => "L&#46; Gauthier"
                            3 => "A&#46; Zazueta"
                            4 => "S&#46; Pesoa"
                            5 => "P&#46; Navarrete"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu12051474"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2020"
                        "volumen" => "12"
                        "paginaInicial" => "1474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32438689"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota and metabolic specificity in ulcerative colitis and crohn&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Sankarasubramanian"
                            1 => "R&#46; Ahmad"
                            2 => "N&#46; Avuthu"
                            3 => "A&#46;B&#46; Singh"
                            4 => "C&#46; Guda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Front Med&#46;"
                        "fecha" => "2020"
                        "volumen" => "7"
                        "paginaInicial" => "606298"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review&#58; the gut microbiome and its potential clinical application in inflammatory bowel disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Aldars-Garc&#237;a"
                            1 => "M&#46; Chaparro"
                            2 => "J&#46;P&#46; Gisbert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/microorganisms9050977"
                      "Revista" => array:5 [
                        "tituloSerie" => "Microorganisms&#46;"
                        "fecha" => "2021"
                        "volumen" => "9"
                        "paginaInicial" => "977"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33946482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriasis and gut microbiome &#8211; current state of art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Polak"
                            1 => "B&#46; Bergler-Czop"
                            2 => "M&#46; Szczepanek"
                            3 => "K&#46; Wojciechowska"
                            4 => "A&#46; Fr&#261;tczak"
                            5 => "N&#46; Kiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2021"
                        "volumen" => "22"
                        "paginaInicial" => "4529"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic endotoxemia initiates obesity and insulin resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;D&#46; Cani"
                            1 => "J&#46; Amar"
                            2 => "M&#46;A&#46; Iglesias"
                            3 => "M&#46; Poggi"
                            4 => "C&#46; Knauf"
                            5 => "D&#46; Bastelica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/db06-1491"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes&#46;"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "1761"
                        "paginaFinal" => "1772"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17456850"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "ncbi&#46;nlm &#91;Internet&#93;&#46; Gonzalez&#8208;Quintela A&#44; Alonso M&#44; Campos J&#44; Vizcaino L&#44; Loidi L&#44; Gude F&#44; et al&#46; Determinants of serum concentrations of lipopolysaccharide&#8208;binding protein &#40;LBP&#41; in the adult population&#58; the role of obesity&#46; PLoS ONE&#46; 2013&#59;8&#58;e54600&#46; &#91;citado em 20 jul&#46; 2022&#93;&#46; Dispon&#237;vel em&#58; https&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;pmc&#47;articles&#47;PMC3551812&#47;&#35;&#58;&#8764;&#58;text<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Serum&#37;20LBP&#37;20concentrations&#37;20increased&#37;20with&#37;20age&#46;&#44;in&#37;20these&#37;20inflammatory&#37;2C&#37;20metabolic&#37;20abnormalities&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of the intestinal microbiome in eutrophic&#44; obese omnivores&#44; and vegetarians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;C&#46;F&#46; Polo"
                            1 => "M&#46;R&#46; de R&#233; Lai"
                            2 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Nutrire&#46;"
                        "fecha" => "2022"
                        "volumen" => "47"
                        "paginaInicial" => "2"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition and Psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Kanda"
                            1 => "T&#46; Hoashi"
                            2 => "H&#46; Saeki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijms21155405"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "5405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32751360"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1575092210000446"
                          "estado" => "S300"
                          "issn" => "15750922"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evolution of the human diet and its impact on gut microbiota&#44; immune responses&#44; and brain health"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;M&#46; Gonz&#225;lez Olmo"
                            1 => "M&#46;J&#46; Butler"
                            2 => "R&#46;M&#46; Barrientos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13010196"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33435203"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microbiota intestinal humana y dieta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;A&#46; Padr&#243;n Pereira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cienc Tecnol&#46;"
                        "fecha" => "2019"
                        "volumen" => "12"
                        "paginaInicial" => "31"
                        "paginaFinal" => "42"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary fiber intervention on gut microbiota composition in healthy adults&#58; a systematic review and meta&#8208;analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; So"
                            1 => "K&#46; Whelan"
                            2 => "M&#46; Rossi"
                            3 => "M&#46; Morrison"
                            4 => "G&#46; Holtmann"
                            5 => "J&#46;T&#46; Kelly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcn/nqy041"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr&#46;"
                        "fecha" => "2018"
                        "volumen" => "107"
                        "paginaInicial" => "965"
                        "paginaFinal" => "983"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29757343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota&#8208;derived short&#8208;chain fatty acids regulate IL&#8208;17 production by mouse and human intestinal &#947;&#948; T cells"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Dupraz"
                            1 => "A&#46; Magniez"
                            2 => "N&#46; Rolhion"
                            3 => "M&#46;L&#46; Richard"
                            4 => "G&#46; Da Costa"
                            5 => "S&#46; Touch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.celrep.2021.109332"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cell Rep&#46;"
                        "fecha" => "2021"
                        "volumen" => "36"
                        "paginaInicial" => "109332"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34233192"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short&#8208;Chain fatty acids and lipopolysaccharide as mediators between gut dysbiosis and amyloid pathology in alzheimer&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Marizzoni"
                            1 => "A&#46; Cattaneo"
                            2 => "P&#46; Mirabelli"
                            3 => "C&#46; Festari"
                            4 => "N&#46; Lopizzo"
                            5 => "V&#46; Nicolosi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3233/JAD-200306"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Alzheimers Dis&#46;"
                        "fecha" => "2020"
                        "volumen" => "78"
                        "paginaInicial" => "683"
                        "paginaFinal" => "697"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33074224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The gut microbiome in psoriasis and psoriatic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Myers"
                            1 => "N&#46; Brownstone"
                            2 => "V&#46; Reddy"
                            3 => "S&#46; Chan"
                            4 => "Q&#46; Thibodeaux"
                            5 => "A&#46; Truong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.berh.2020.101494"
                      "Revista" => array:5 [
                        "tituloSerie" => "Best Pract Res Clin Rheumatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "33"
                        "paginaInicial" => "101494"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32360228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genomic alterations driving psoriasis pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Singh"
                            1 => "D&#46; Pradhan"
                            2 => "P&#46; Puri"
                            3 => "V&#46; Ramesh"
                            4 => "S&#46; Aggarwal"
                            5 => "A&#46; Nayek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gene&#46;"
                        "fecha" => "2019"
                        "volumen" => "683"
                        "paginaInicial" => "61"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of gut microbiome in psoriasis&#58; oral administration of staphylococcus aureus and streptococcus danieliae exacerbates skin inflammation of imiquimod&#8208;induced psoriasis&#8208;like dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Okada"
                            1 => "Y&#46; Matsushima"
                            2 => "K&#46; Mizutani"
                            3 => "K&#46; Yamanaka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijms21093303"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "3303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32392785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lipopolysaccharide&#8208;binding protein is increased in patients with psoriasis with metabolic syndrome and correlates with C&#8208;reactive protein&#58; lipopolysaccharide&#8208;binding protein in patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Roman&#237;"
                            1 => "A&#46; Caix&#224;s"
                            2 => "X&#46; Escot&#233;"
                            3 => "J&#46;M&#46; Carrascosa"
                            4 => "M&#46; Ribera"
                            5 => "M&#46; Rigla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ced.12007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol&#46;"
                        "fecha" => "2013"
                        "volumen" => "38"
                        "paginaInicial" => "81"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23082944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biomarkers for assessment of intestinal permeability in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Seethaler"
                            1 => "M&#46; Basrai"
                            2 => "A&#46;M&#46; Neyrinck"
                            3 => "J&#46;A&#46; Nazare"
                            4 => "J&#46; Walter"
                            5 => "N&#46;M&#46; Delzenne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Physiol&#8208;Gastrointest Liver Physiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "321"
                        "paginaInicial" => "11"
                        "paginaFinal" => "17"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of gut microbiome in inflammatory skin disorders&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Widhiati"
                            1 => "D&#46; Purnomosari"
                            2 => "T&#46; Wibawa"
                            3 => "H&#46; Soebono"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Dermatol Rep&#46;"
                        "fecha" => "2021"
                        "volumen" => "14"
                        "paginaInicial" => "9188"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriatic patients have a distinct structural and functional fecal microbiota compared with controls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Shapiro"
                            1 => "N&#46;A&#46; Cohen"
                            2 => "V&#46; Shalev"
                            3 => "A&#46; Uzan"
                            4 => "O&#46; Koren"
                            5 => "N&#46; Maharshak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.14933"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "46"
                        "paginaInicial" => "595"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31141234"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dysbiosis of gut microbiota was closely associated with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Huang"
                            1 => "R&#46; Gao"
                            2 => "N&#46; Yu"
                            3 => "Y&#46; Zhu"
                            4 => "Y&#46; Ding"
                            5 => "H&#46; Qin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11427-018-9376-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sci China Life Sci&#46;"
                        "fecha" => "2019"
                        "volumen" => "62"
                        "paginaInicial" => "807"
                        "paginaFinal" => "815"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30264198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota dysbiosis in a cohort of patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Hidalgo-Cantabrana"
                            1 => "J&#46; G&#243;mez"
                            2 => "S&#46; Delgado"
                            3 => "S&#46; Requena-L&#243;pez"
                            4 => "R&#46; Queiro-Silva"
                            5 => "A&#46; Margolles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "181"
                        "paginaInicial" => "1287"
                        "paginaFinal" => "1295"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbial composition in patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;M&#46; Codo&#241;er"
                            1 => "A&#46; Ram&#237;rez-Bosca"
                            2 => "E&#46; Climent"
                            3 => "M&#46; Carri&#243;n-Gutierrez"
                            4 => "M&#46; Guerrero"
                            5 => "J&#46;M&#46; P&#233;rez-Orqu&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-018-22125-y"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep&#46;"
                        "fecha" => "2018"
                        "volumen" => "8"
                        "paginaInicial" => "3812"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29491401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metagenomic analysis of gut microbiota in non&#8208;treated plaque psoriasis patients stratified by disease severity&#58; development of a new psoriasis&#8208;microbiome index"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Dei-Cas"
                            1 => "F&#46; Giliberto"
                            2 => "L&#46; Luce"
                            3 => "H&#46; Dopazo"
                            4 => "A&#46; Penas-Steinhardt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-020-69537-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep&#46;"
                        "fecha" => "2020"
                        "volumen" => "10"
                        "paginaInicial" => "12754"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32728075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriasis is associated with elevated gut IL&#8208;1&#945; and intestinal microbiome alterations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Yegorov"
                            1 => "D&#46; Babenko"
                            2 => "S&#46; Kozhakhmetov"
                            3 => "L&#46; Akhmaltdinova"
                            4 => "I&#46; Kadyrova"
                            5 => "A&#46; Nurgozhina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fimmu.2020.571319"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol&#46;"
                        "fecha" => "2020"
                        "volumen" => "11"
                        "paginaInicial" => "571319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33117362"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The gut microbiota profile in psoriasis&#58; a Brazilian case&#8208;control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Schade"
                            1 => "D&#46; Mesa"
                            2 => "A&#46;R&#46; Faria"
                            3 => "J&#46;R&#46; Santamaria"
                            4 => "C&#46;A&#46; Xavier"
                            5 => "D&#46; Ribeiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/lam.13630"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lett Appl Microbiol&#46;"
                        "fecha" => "2022"
                        "volumen" => "74"
                        "paginaInicial" => "498"
                        "paginaFinal" => "504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34897759"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut Microbiome composition associated with major depressive disorder and sleep quality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Q&#46; Zhang"
                            1 => "Y&#46; Yun"
                            2 => "H&#46; An"
                            3 => "W&#46; Zhao"
                            4 => "T&#46; Ma"
                            5 => "Z&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fpsyt.2021.645045"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Psychiatry&#46;"
                        "fecha" => "2021"
                        "volumen" => "12"
                        "paginaInicial" => "645045"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34093266"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intestinal colonization by a lachnospiraceae bacterium contributes to the development of diabetes in obese mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Kameyama"
                            1 => "K&#46; Itoh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1264/jsme2.ME14054"
                      "Revista" => array:6 [
                        "tituloSerie" => "Microbes Environ&#46;"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "427"
                        "paginaFinal" => "430"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25283478"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations between maternal diet&#44; body composition and gut microbial ecology in pregnancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; Ruebel"
                            1 => "S&#46;P&#46; Gilley"
                            2 => "C&#46;R&#46; Sims"
                            3 => "Y&#46; Zhong"
                            4 => "D&#46; Turner"
                            5 => "S&#46;V&#46; Chintapalli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13093295"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "3295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34579172"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut Prevotella as a possible biomarker of diet and its eubiotic versus dysbiotic roles&#58; a comprehensive literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Precup"
                            1 => "D&#46;C&#46; Vodnar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Nutr&#46;"
                        "fecha" => "2019"
                        "volumen" => "122"
                        "paginaInicial" => "131"
                        "paginaFinal" => "140"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Wolters"
                            1 => "Diet"
                            2 => "psoriasis&#58; experimental data"
                            3 => "evidence&#46; clinical"
                            4 => "J&#46; Br"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dermatol"
                        "fecha" => "2005"
                        "volumen" => "153"
                        "paginaInicial" => "706"
                        "paginaFinal" => "714"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A fasting and vegetarian diet treatment trial on chronic inflammatory disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Lithell"
                            1 => "A&#46; Bruce"
                            2 => "I&#46;B&#46; Gustafsson"
                            3 => "N&#46;J&#46; H&#246;glund"
                            4 => "B&#46; Karlstr&#246;m"
                            5 => "K&#46; Ljunghall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "1983"
                        "volumen" => "63"
                        "paginaInicial" => "397"
                        "paginaFinal" => "403"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6197838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High&#8208;fat diet&#8211;induced colonocyte dysfunction escalates microbiota&#8208;derived trimethylamine N&#8208;oxide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Yoo"
                            1 => "J&#46;K&#46; Zieba"
                            2 => "N&#46;J&#46; Foegeding"
                            3 => "T&#46;P&#46; Torres"
                            4 => "C&#46;D&#46; Shelton"
                            5 => "N&#46;G&#46; Shealy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1126/science.aba3683"
                      "Revista" => array:6 [
                        "tituloSerie" => "Science&#46;"
                        "fecha" => "2021"
                        "volumen" => "373"
                        "paginaInicial" => "813"
                        "paginaFinal" => "818"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34385401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The crosstalk between gut bacteria and host immunity in intestinal inflammation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Q&#46; Yang"
                            1 => "Y&#46; Wang"
                            2 => "A&#46; Jia"
                            3 => "Y&#46; Wang"
                            4 => "Y&#46; Bi"
                            5 => "G&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jcp.30024"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cell Physiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "236"
                        "paginaInicial" => "2239"
                        "paginaFinal" => "2254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32853458"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microbiota in health and disease &#8208; potential clinical applications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Laudes"
                            1 => "C&#46; Geisler"
                            2 => "N&#46; Rohmann"
                            3 => "J&#46; Bouwman"
                            4 => "T&#46; Pischon"
                            5 => "K&#46; Schlicht"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13020386"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "386"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33513722"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful treatment of psoriasis with adalimumab induced no changes in the gut microbiota"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Todberg"
                            1 => "A&#46; Egeberg"
                            2 => "C&#46; Zachariae"
                            3 => "N&#46; S&#248;rensen"
                            4 => "O&#46; Pedersen"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2022"
                        "volumen" => "36"
                        "paginaInicial" => "464"
                        "paginaFinal" => "467"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001017/v1_202307310652/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "89618"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigo Original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009800000005/v1_202307310652/S2666275223001017/v1_202307310652/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001017?idApp=UINPBA00008Z"
]
Compartilhar
Informação da revista

Estatísticas

Siga este link para acessar o texto completo do artigo

Artigo original
Caracterização do microbioma intestinal de homens adultos brasileiros com psoríase em comparação com controles onívoros e vegetarianos
Tatiana Cristina Figueira Poloa,
Autor para correspondência
tatiana.figueira@yahoo.com.br

Autor para correspondência.
, Mariana Righetto de Ré Laia, Luciane Donida Bartoli Miota, Giovana Fernanda Cosi Bentoa, Márcia Guimarães da Silvab, Silvio Alencar Marquesa, Hélio Amante Miota
a Departamento de Dermatologia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
b Departamento de Patologia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
Lido
4643
Vezes
que se leu este artigo
1441
Total PDF
3202
Total HTML
Compartilhar estatísticas
 array:23 [
  "pii" => "S2666275223001017"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2023.04.002"
  "estado" => "S300"
  "fechaPublicacion" => "2023-09-01"
  "aid" => "755"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:18 [
      "pii" => "S0365059623000867"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2022.08.008"
      "estado" => "S300"
      "fechaPublicacion" => "2023-09-01"
      "aid" => "755"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
        "titulo" => "Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "635"
            "paginaFinal" => "643"
          ]
        ]
        "contieneResumen" => array:1 [
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1203
                "Ancho" => 3341
                "Tamanyo" => 282220
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0035"
                "detalle" => "Figure "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Alpha diversity&#46; Proportion distribution of the 13 most prevalent genera among the groups&#58; PSO &#40;psoriasis&#41;&#44; VEG &#40;vegetarian controls&#41;&#44; OMNI &#40;omnivore controls&#41;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Tatiana Cristina Figueira Polo, Mariana Righetto de R&#233; Lai, Luciane Donida Bartoli Miot, Giovana Fernanda Cosi Bento, M&#225;rcia Guimar&#227;es da Silva, Silvio Alencar Marques, H&#233;lio Amante Miot"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Tatiana Cristina Figueira"
                "apellidos" => "Polo"
              ]
              1 => array:2 [
                "nombre" => "Mariana Righetto de R&#233;"
                "apellidos" => "Lai"
              ]
              2 => array:2 [
                "nombre" => "Luciane Donida Bartoli"
                "apellidos" => "Miot"
              ]
              3 => array:2 [
                "nombre" => "Giovana Fernanda Cosi"
                "apellidos" => "Bento"
              ]
              4 => array:2 [
                "nombre" => "M&#225;rcia Guimar&#227;es da"
                "apellidos" => "Silva"
              ]
              5 => array:2 [
                "nombre" => "Silvio Alencar"
                "apellidos" => "Marques"
              ]
              6 => array:2 [
                "nombre" => "H&#233;lio Amante"
                "apellidos" => "Miot"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275223001017"
          "doi" => "10.1016/j.abdp.2023.04.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001017?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000867?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009800000005/v1_202307281023/S0365059623000867/v1_202307281023/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2666275223001339"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2023.05.010"
    "estado" => "S300"
    "fechaPublicacion" => "2023-09-01"
    "aid" => "768"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Quantifica&#231;&#227;o de pesticidas em amostras de cabelo de pacientes com p&#234;nfigo foli&#225;ceo e p&#234;nfigo vulgar no Sudeste do Brasil"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "644"
          "paginaFinal" => "650"
        ]
      ]
      "contieneResumen" => array:1 [
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Leonardo La Serra, Adriana Martinelli Salathiel, Rafael Lanaro, Bruno de Martinis, Ana Maria Roselino"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Leonardo"
              "apellidos" => "La Serra"
            ]
            1 => array:2 [
              "nombre" => "Adriana Martinelli"
              "apellidos" => "Salathiel"
            ]
            2 => array:2 [
              "nombre" => "Rafael"
              "apellidos" => "Lanaro"
            ]
            3 => array:2 [
              "nombre" => "Bruno"
              "apellidos" => "de Martinis"
            ]
            4 => array:2 [
              "nombre" => "Ana Maria"
              "apellidos" => "Roselino"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059623000995"
        "doi" => "10.1016/j.abd.2022.10.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000995?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001339?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001339/v1_202307310652/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275223001340"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2023.05.011"
    "estado" => "S300"
    "fechaPublicacion" => "2023-09-01"
    "aid" => "766"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
      "titulo" => "Dermatologia hospitalar&#58; an&#225;lise de consultas dermatol&#243;gicas em hospital universit&#225;rio terci&#225;rio"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "tieneResumen" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "620"
          "paginaFinal" => "634"
        ]
      ]
      "contieneResumen" => array:1 [
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1309
              "Ancho" => 2215
              "Tamanyo" => 167774
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fluxo de encaminhamentos de consultas dermatol&#243;gicas hospitalares&#44; de agosto de 2018 a janeiro de 2020</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Iago Gon&#231;alves Ferreira, Camila Saraiva Almeida, Lucas Abascal Bulc&#227;o, Diego Gon&#231;alves Ferreira, Magda Blessmann Weber, Renan Rangel Bonamigo"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Iago Gon&#231;alves"
              "apellidos" => "Ferreira"
            ]
            1 => array:2 [
              "nombre" => "Camila Saraiva"
              "apellidos" => "Almeida"
            ]
            2 => array:2 [
              "nombre" => "Lucas Abascal"
              "apellidos" => "Bulc&#227;o"
            ]
            3 => array:2 [
              "nombre" => "Diego Gon&#231;alves"
              "apellidos" => "Ferreira"
            ]
            4 => array:2 [
              "nombre" => "Magda Blessmann"
              "apellidos" => "Weber"
            ]
            5 => array:2 [
              "nombre" => "Renan Rangel"
              "apellidos" => "Bonamigo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059623000971"
        "doi" => "10.1016/j.abd.2022.08.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623000971?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001340?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001340/v1_202307310652/pt/main.assets"
  ]
  "pt" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
    "titulo" => "Caracteriza&#231;&#227;o do microbioma intestinal de homens adultos brasileiros com psor&#237;ase em compara&#231;&#227;o com controles on&#237;voros e vegetarianos"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "635"
        "paginaFinal" => "643"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Tatiana Cristina Figueira Polo, Mariana Righetto de R&#233; Lai, Luciane Donida Bartoli Miot, Giovana Fernanda Cosi Bento, M&#225;rcia Guimar&#227;es da Silva, Silvio Alencar Marques, H&#233;lio Amante Miot"
        "autores" => array:7 [
          0 => array:4 [
            "nombre" => "Tatiana Cristina Figueira"
            "apellidos" => "Polo"
            "email" => array:1 [
              0 => "tatiana.figueira@yahoo.com.br"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Mariana Righetto de R&#233;"
            "apellidos" => "Lai"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Luciane Donida Bartoli"
            "apellidos" => "Miot"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Giovana Fernanda Cosi"
            "apellidos" => "Bento"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#225;rcia Guimar&#227;es da"
            "apellidos" => "Silva"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Silvio Alencar"
            "apellidos" => "Marques"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "H&#233;lio Amante"
            "apellidos" => "Miot"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Departamento de Dermatologia&#44; Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Patologia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil"
            "etiqueta" => "b"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1232
            "Ancho" => 2175
            "Tamanyo" => 158697
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Compara&#231;&#227;o da mediana da abund&#226;ncia dos g&#234;neros que apresentaram diferen&#231;a entre os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Psor&#237;ase &#233; doen&#231;a cr&#244;nica inflamat&#243;ria sist&#234;mica que afeta entre 1&#37; e 2&#37; da popula&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a> Sua patog&#234;nese &#233; multifatorial&#44; n&#227;o sendo totalmente esclarecida&#44; mas que envolve&#44; al&#233;m de uma base gen&#233;tica e est&#237;mulos ambientais&#44; a ativa&#231;&#227;o do sistema imune &#40;inato e adaptativo&#41;&#44; que desencadeia respostas inflamat&#243;rias locais na pele e articula&#231;&#245;es&#44; assim como promove inflama&#231;&#227;o sist&#234;mica de baixo grau&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Comorbidades como obesidade&#44; hipertens&#227;o arterial&#44; diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; s&#237;ndrome metab&#243;lica&#44; doen&#231;a cardiovascular&#44; dislipidemia e transtornos afetivos &#40;depress&#227;o&#44; ansiedade&#41; s&#227;o frequentes em pacientes com psor&#237;ase&#44; substanciando o processo inflamat&#243;rio sist&#234;mico subjacente&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Microbioma intestinal &#40;MI&#41; consiste em flora inconstante&#44; constitu&#237;da nos primeiros anos de vida&#44; mas que varia conforme est&#237;mulos ambientais&#44; como dieta&#44; estilo de vida &#40;tabagismo&#44; consumo de &#225;lcool&#44; exerc&#237;cios f&#237;sicos&#44; estresse&#44; sono&#41;&#44; higiene&#44; terap&#234;utica com antimicrobianos&#44; localiza&#231;&#227;o geogr&#225;fica&#44; sexo&#44; idade e certas doen&#231;as&#46; Cerca de 57&#37; do MI &#233; influenciado pela dieta&#44; e apenas 12&#37; por fatores gen&#233;ticos&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">4</span></a> No microbioma fecal existem entre uma e 2&#46;000 esp&#233;cies de bact&#233;rias&#44; distribu&#237;das em mais de 50 filos&#46; Cerca de 90&#37; do MI s&#227;o compostos pelos filos <span class="elsevierStyleItalic">Firmicutes</span> e <span class="elsevierStyleItalic">Bacteroidetes</span>&#59; uma propor&#231;&#227;o maior de <span class="elsevierStyleItalic">Firmicutes&#47;Bacteroidetes</span> &#40;F&#47;B&#41; &#233; associada a maior est&#237;mulo inflamat&#243;rio sist&#234;mico&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A disbiose intestinal&#44; caracterizada pelo desequil&#237;brio da composi&#231;&#227;o do MI&#44; pode levar ao aumento da permeabilidade intestinal e a transloca&#231;&#227;o de mediadores inflamat&#243;rios intraluminais&#46; Portanto&#44; a caracteriza&#231;&#227;o do MI pode contribuir na compreens&#227;o sobre a patog&#234;nese de doen&#231;as inflamat&#243;rias sist&#234;micas como psor&#237;ase&#44; doen&#231;a de Crohn&#44; artrite reumatoide e obesidade&#44; pois h&#225; ind&#237;cios de que a composi&#231;&#227;o do MI esteja envolvida no curso das mesmas&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Estudos cl&#237;nicos foram conduzidos para explorar a rela&#231;&#227;o entre MI e a atividade cl&#237;nica da psor&#237;ase&#44; com resultados ainda conflitantes&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">7</span></a> Entretanto&#44; considera&#8208;se a modula&#231;&#227;o do MI por meio de tratamento diet&#233;tico&#44; suplementa&#231;&#245;es com probi&#243;ticos e transplante fecal&#44; com potencial de interferir&#44; al&#233;m da atividade da psor&#237;ase&#44; no curso de comorbidades&#44; al&#233;m de maximizar sua resposta terap&#234;utica&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Lipopolissacar&#237;dio &#40;LPS&#41; &#233; uma endotoxina que comp&#245;e a parede celular de bact&#233;rias gram&#8208;negativas e promove ativa&#231;&#227;o do sistema imune a partir da estimula&#231;&#227;o direta de macr&#243;fagos&#44; mon&#243;citos&#44; c&#233;lulas dendr&#237;ticas e linf&#243;citos B&#44; desencadeando febre&#44; vasodilata&#231;&#227;o &#40;&#243;xido n&#237;trico&#41; e secre&#231;&#227;o de eicosanoides&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">9</span></a> A prote&#237;na de liga&#231;&#227;o de lipopolissacar&#237;dios &#40;LPB&#41; liga&#8208;se ao LPS e transfere mon&#244;meros de LPS para as c&#233;lulas inflamat&#243;rias atrav&#233;s de CD14&#46; Os n&#237;veis plasm&#225;ticos de LPB s&#227;o influenciados pelas concentra&#231;&#245;es circulantes de LPS&#44; que t&#234;m meia&#8208;vida muito curta&#46; A exposi&#231;&#227;o ao LPS induz um aumento duradouro da produ&#231;&#227;o de LPB no f&#237;gado dentro de 15 a 30 minutos&#44; com n&#237;vel s&#233;rico m&#225;ximo ocorrendo ap&#243;s 24 a 48 horas&#46; O complexo LPS&#8208;LBP&#8208;CD14&#8208;MD2 induz uma resposta pr&#243;&#8208;inflamat&#243;ria pela ativa&#231;&#227;o de NF&#8208;&#954;B mediada pelo receptor <span class="elsevierStyleItalic">Toll&#8208;like</span>&#8208;4 &#40;TLR4&#41; e&#44; como tal&#44; os n&#237;veis circulantes de LPB foram associados &#224; inflama&#231;&#227;o sist&#234;mica&#46; Al&#233;m disso&#44; n&#237;veis plasm&#225;ticos da prote&#237;na C reativa quantitativa ultrassens&#237;vel &#40;PCRqt&#41;&#44; um biomarcador s&#233;rico de inflama&#231;&#227;o sist&#234;mica sintetizado pelo f&#237;gado&#44; est&#227;o associadas ao aumento de LPS&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Na Am&#233;rica do Sul&#44; s&#227;o raros os estudos controlados que caracterizem o MI de pacientes com psor&#237;ase&#46; Assim&#44; o objetivo desta investiga&#231;&#227;o foi caracterizar o MI de homens adultos brasileiros com psor&#237;ase&#44; comparando&#8208;os com controles on&#237;voros e vegetarianos&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todo</span><p id="par0040" class="elsevierStylePara elsevierViewall">Estudo transversal envolvendo 42 homens adultos &#40;21&#8208;65 anos&#41; &#8211; 21 com psor&#237;ase &#40;PSO&#41; e 21 controles sem psor&#237;ase&#44; dos quais 14 on&#237;voros &#40;ONI&#41; e sete vegetarianos &#40;VEG&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Todos os participantes inclu&#237;dos eram n&#227;o tabagistas&#44; n&#227;o etilistas&#44; n&#227;o apresentaram altera&#231;&#245;es na dieta nos &#250;ltimos tr&#234;s meses&#59; n&#227;o usaram antibi&#243;ticos&#44; laxantes&#44; anti&#8208;inflamat&#243;rios&#44; ou referiram altera&#231;&#245;es intestinais na &#250;ltima semana&#44; aus&#234;ncia de doen&#231;a inflamat&#243;ria intestinal&#44; infec&#231;&#245;es&#44; doen&#231;as autoimunes e uso de probi&#243;ticos&#46; A amostra de homens adultos do interior do estado de S&#227;o Paulo foi escolhida para reduzir a variabilidade do MI&#44; que tamb&#233;m &#233; influenciada por sexo&#44; idade e localiza&#231;&#227;o geogr&#225;fica da popula&#231;&#227;o&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">O estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa em Seres Humanos da Faculdade de Medicina de Botucatu &#40;FMB&#47;UNESP&#41; sob o parecer n&#176; 3&#46;743&#46;366&#46; Todos os participante assinaram o Termo de Consentimento Livre e Esclarecido&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A pesquisa foi realizada no Ambulat&#243;rio de Dermatologia da FMB&#44; no per&#237;odo de mar&#231;o de 2020 a fevereiro de 2021&#46; A popula&#231;&#227;o teve origem entre moradores da regi&#227;o de Botucatu &#40;SP&#41;&#44; pacientes com diagn&#243;stico de psor&#237;ase&#44; seus acompanhantes e convidados vegetarianos&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Foram obtidos dados cl&#237;nicos&#44; demogr&#225;ficos&#44; socioecon&#244;micos e diet&#233;ticos por meio de entrevistas presenciais&#59; as avalia&#231;&#245;es antropom&#233;trica e diet&#233;tica foram realizadas por nutricionista experiente &#40;T&#46;C&#46;F&#46;P&#46;&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o diet&#233;tica foi obtida pelo Recordat&#243;rio de 24 horas &#40;R24<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; a partir do relato detalhado do consumo alimentar nas &#250;ltimas 24 horas&#44; com dados sobre os tipos de alimentos e bebidas&#44; al&#233;m do tamanho&#44; por&#231;&#245;es&#44; volume ou medidas caseiras&#46; Posteriormente&#44; os dados foram transformados em gramas&#44; valores de energia&#44; macronutrientes e micronutrientes pelo <span class="elsevierStyleItalic">software</span> NDSR &#40;<span class="elsevierStyleItalic">Nutritional Data System for Research</span>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para estimar a gravidade da doen&#231;a&#44; foi utilizado o escore PASI &#40;<span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#41;&#44; avaliado por dermatologista titulado &#40;L&#46;D&#46;B&#46;M&#46; ou M&#46;R&#46;R&#46;L&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Para avaliar o MI&#44; coletaram&#8208;se amostras de fezes para obten&#231;&#227;o do material gen&#233;tico&#46; Os indiv&#237;duos foram orientados a realizar a coleta de fezes da primeira evacua&#231;&#227;o do dia em tubo espec&#237;fico em sua resid&#234;ncia&#46; Ap&#243;s a coleta&#44; as amostras foram entregues &#224; pesquisadora respons&#225;vel &#40;T&#46;C&#46;F&#46;P&#46;&#41; e transportadas refrigeradas &#40;gelo seco&#58; &#8722;28<span class="elsevierStyleHsp" style=""></span>&#176;C&#41; at&#233; o laborat&#243;rio Biotecnologia Pesquisa e Inova&#231;&#227;o &#40;BPI&#44; Botucatu&#8208;SP&#41;&#44; e armazenadas em freezer &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C at&#233; o momento da extra&#231;&#227;o do DNA&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Para extra&#231;&#227;o do material gen&#233;tico&#44; foram utilizadas al&#237;quotas de 1<span class="elsevierStyleHsp" style=""></span>g e o <span class="elsevierStyleItalic">kit</span> Quick&#8208;DNA Fungal&#47;Bacterial Miniprep &#40;Zymo Research&#41;&#44; de acordo com protocolo descrito pelo fabricante&#46; Posteriormente&#44; o material passou pelo teste de qualidade por meio da quantifica&#231;&#227;o por fluoresc&#234;ncia com a utiliza&#231;&#227;o do equipamento Qubit&#174; 3&#46;0 Fluorometer &#40;Thermo Fisher Scientific&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Para as rea&#231;&#245;es de amplifica&#231;&#227;o da regi&#227;o 16S foram realizadas triplicatas de amostras&#44; tendo como volume final de 20 &#956;L&#44; contendo 10 &#956;L de GoTaq&#174; Colorless Master Mix 2<span class="elsevierStyleHsp" style=""></span>&#215; &#40;Promega&#44; USL&#41;&#44; 0&#44;3 &#956;M de oligonucleot&#237;dio <span class="elsevierStyleItalic">forward</span> e 0&#44;3 &#956;M de oligonucleot&#237;dio <span class="elsevierStyleItalic">reverse</span>&#44; 3 &#956;L de DNA gen&#244;mico e &#225;gua ultrapura est&#233;ril suficiente para completar 20 &#956;L&#46; As rea&#231;&#245;es de amplifica&#231;&#227;o foram conduzidas em termociclador Veriti<span class="elsevierStyleSup">TM</span> Thermal Cycler &#40;Applied Biosystems&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ap&#243;s a rea&#231;&#227;o de amplifica&#231;&#227;o do DNA de cada amostra&#44; a comprova&#231;&#227;o da amplifica&#231;&#227;o foi realizada por eletroforese em gel de agarose 2&#37; corado com gel Red &#40;Uniscience&#41;&#44; aproximadamente 300 bp &#40;tamanho do <span class="elsevierStyleItalic">amplicon</span>&#41;&#46; Submeteu&#8208;se PCR para etapas de purifica&#231;&#227;o utilizando <span class="elsevierStyleItalic">bead</span> magn&#233;tica Agencourt AMPure XP &#40;Beckman Coulter&#41; para remo&#231;&#227;o de fragmentos muito pequenos da popula&#231;&#227;o total de mol&#233;culas e restos de <span class="elsevierStyleItalic">primers</span> da rea&#231;&#227;o&#46; Ap&#243;s essa etapa&#44; foi realizada a quantifica&#231;&#227;o pela metodologia de PCR em tempo real utilizando termociclador QuantStudio 3 Real Time &#40;Applied Biosystems&#41; e <span class="elsevierStyleItalic">kit</span> KAPA&#8208;KK4824 &#40;Library Quantification Kit &#8208; Illumina&#47;Universal&#41;&#44; todos de acordo com protocolo do fabricante&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Foi gerado um <span class="elsevierStyleItalic">pool</span> equimolar de DNA&#44; por meio da normaliza&#231;&#227;o de todas as amostras a 3<span class="elsevierStyleHsp" style=""></span>nM para a realiza&#231;&#227;o do sequenciamento&#44; o qual foi conduzido utilizando o sistema Illumina MiSeq de sequenciamento de nova gera&#231;&#227;o &#40;Illumina Sequencing&#41; e <span class="elsevierStyleItalic">kit</span> MiSeq Reagent Kit V2 Nano 300 ciclos &#8211; leitura de 2 &#215; 150 pb&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Utilizou&#8208;se o banco de dados Greengenes 13&#95;8 99&#37; OTUs from 515F&#47;806R region of sequences para identifica&#231;&#227;o das sequ&#234;ncias de t&#225;xons e foram consideradas apenas sequ&#234;ncias com mais de 97&#37; de analogia &#40;confiabilidade&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">A abund&#226;ncia relativa das unidades taxon&#244;micas &#40;UTN&#41; nas amostras foi explorada a partir de seus componentes extra&#237;dos pelo m&#233;todo <span class="elsevierStyleItalic">Partial Least Squares</span> &#40;PLS&#41;&#44; com dados escalonados pelos desvios&#8208;padr&#227;o&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">As principais vari&#225;veis do estudo s&#227;o a diversidade da flora intestinal identificada em cada MI avaliado&#44; segundo cada categoria de UTN&#58; abund&#226;ncia relativa dos grupos&#44; pelos &#237;ndices de diversidade de Hill &#40;riqueza&#44; Shannon e Simpson&#41;&#44; a rela&#231;&#227;o entre os filos <span class="elsevierStyleItalic">Firmicutes</span>&#47;<span class="elsevierStyleItalic">Bacteroidetes</span>&#44; abund&#226;ncia dos g&#234;neros bacterianos &#40;alfa diversidade&#41; e os componentes dos padr&#245;es PLS &#40;beta diversidade&#41; identificados para os grupos&#46; Define&#8208;se riqueza como n&#250;mero total de UTN identificadas na amostra&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Foram ainda coletadas amostras de 10<span class="elsevierStyleHsp" style=""></span>mL de sangue dos pacientes no ambulat&#243;rio de dermatologia&#44; pela m&#233;dica respons&#225;vel pelo tratamento dos pacientes &#40;M&#46;R&#46;R&#46;L&#46;&#41;&#44; para avalia&#231;&#227;o do LPB e PCRqt s&#233;ricos&#46; Ap&#243;s as coletas&#44; as amostras foram imediatamente levadas sob refrigera&#231;&#227;o para a Unidade de Pesquisa Experimental &#40;UNIPEX&#41; da FMB&#8208;Unesp&#44; para centrifuga&#231;&#227;o e extra&#231;&#227;o do soro&#46; Para a an&#225;lise do LPB&#44; foi utilizado o m&#233;todo ELISA <span class="elsevierStyleItalic">sandwich</span>&#44; conforme as orienta&#231;&#245;es do fabricante do kit &#40;<span class="elsevierStyleItalic">Human LBP DuoSet ELISA &#8208;</span> DY870&#8208;05&#44; R&#38;D Systems&#44; Inc&#46;&#44; Minneapolis&#44; MN&#44; EUA&#41;&#46; As amostras foram dilu&#237;das na fra&#231;&#227;o 1&#58;500&#46; As concentra&#231;&#245;es finais de LPB foram determinadas conforme a curva padr&#227;o&#46; As an&#225;lises do PCRqt foram realizadas pelo m&#233;todo de imunoturbidimetria&#46; Adotaram&#8208;se como valores normais de PCRqt &#8804; 3 mg&#47;dL&#44; e de LPB &#8804; 10 mg&#47;mL&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Vari&#225;veis qualitativas foram representadas pelos percentuais&#46; Vari&#225;veis quantitativas foram representadas como m&#233;dias e desvios&#8208;padr&#227;o&#44; se a normalidade for verificada pelo teste de Shapiro&#8208;Wilk&#44; ou medianas e quartis &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41;&#44; se indicado&#46; As abund&#226;ncias dos g&#234;neros foram comparadas entre os grupos pelo teste de Kruskal&#8208;Wallis&#46; Os &#237;ndices de diversidade ecol&#243;gica foram comparados entre os grupos por modelos lineares generalizados&#44; ajustado pela idade dos participantes&#46; Os modelos foram ajustados para as distribui&#231;&#245;es de probabilidade mais adequadas a cada amostra &#40;p&#46; ex&#46;&#44; gama&#41;&#44; e a corre&#231;&#227;o para m&#250;ltiplas compara&#231;&#245;es foi realizada pelo procedimento de &#352;id&#225;k&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">As cargas dos componentes PLS foram correlacionadas com dados nutricionais&#44; n&#237;veis de LPB e de PCRqt pelo teste de correla&#231;&#227;o de Spearman&#44; e representado como mapa t&#233;rmico&#46; Os dados foram tabulados em Excel 2010 e analisados nos <span class="elsevierStyleItalic">softwares</span> IBM SPSS 25<span class="elsevierStyleHsp" style=""></span>v e Statistica 10<span class="elsevierStyleHsp" style=""></span>v&#46; A signific&#226;ncia estat&#237;stica foi definida como p &#8804; 0&#44;05&#59; bicaudal&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Como se trata de estudo explorat&#243;rio&#44; foi utilizada amostragem por conveni&#234;ncia a fim de se determinar o comportamento global dos grupos e fundamentar a an&#225;lise pormenorizada de amostras <span class="elsevierStyleItalic">a posteriori</span>&#46; Al&#233;m disso&#44; o m&#233;todo PLS n&#227;o exige amostragem m&#237;nima para sua execu&#231;&#227;o&#46; Para as an&#225;lises de correla&#231;&#227;o bivariada&#44; considera&#8208;se suficiente uma amostra de 41 participantes para a detec&#231;&#227;o de correla&#231;&#227;o moderada &#40;rho &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;70&#41;&#44; considerando &#945;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01 e poder de 90&#37;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0135" class="elsevierStylePara elsevierViewall">Os principais dados cl&#237;nicos&#44; demogr&#225;ficos&#44; alimentares&#44; LPB s&#233;rico e PCRqt est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Idade e IMC dos grupos PSO e ONI foram maiores que do grupo VEG&#46; Do ponto de vista alimentar&#44; os grupos PSO e ONI relataram maior consumo de carboidratos e prote&#237;nas que o grupo VEG&#46; Quanto &#224;s fibras alimentares&#44; o grupo PSO relatou menor ingesta de fibras que ONI e que VEG&#46; Os n&#237;veis plasm&#225;ticos de LPB&#44; assim como os n&#237;veis de PCRqt&#44; foram maiores no grupo PSO em rela&#231;&#227;o ao VEG&#44; por&#233;m&#44; PCRqt foi maior no PSO em rela&#231;&#227;o ao ONI&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Nenhum controle VEG nem ONI eutr&#243;ficos apresentou valores elevados de LPB&#59; por&#233;m&#44; um ONI obeso&#44; um PSO eutr&#243;fico e dois PSO obesos apresentaram LPB &#62;<span class="elsevierStyleHsp" style=""></span>10 mg&#47;mL&#46; Do mesmo modo&#44; nenhum controle VEG nem ONI eutr&#243;ficos apresentou valores elevados de PCRqt&#44; por&#233;m dois ONI obesos&#44; quatro PSO eutr&#243;ficos e tr&#234;s PSO obesos apresentaram PCR<span class="elsevierStyleHsp" style=""></span>&#62; 3 mg&#47;mL&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Entre os pacientes com psor&#237;ase&#44; oito &#40;32&#37;&#41; apresentavam doen&#231;a articular&#44; seis &#40;24&#37;&#41; eram tratados exclusivamente com t&#243;picos&#44; seis &#40;24&#37;&#41; utilizavam metotrexato&#44; oito &#40;32&#37;&#41; utilizavam acitretina e cinco &#40;20&#37;&#41; utilizavam secuquinumabe&#46; O PASI variou entre 1 e 18&#44; com mediana &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41; de 4 &#40;1&#8208;7&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Quanto &#224;s comorbidades&#44; entre os pacientes com psor&#237;ase encontraram&#8208;se dois &#40;17&#37;&#41; com diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; tr&#234;s &#40;25&#37;&#41; com hipertens&#227;o arterial e cinco &#40;42&#37;&#41; com dislipidemia&#46; Entre os on&#237;voros&#44; dois &#40;13&#37;&#41; eram diab&#233;ticos&#44; quatro &#40;28&#37;&#41; hipertensos e seis &#40;43&#37;&#41; com dislipidemia&#46; Nenhum dos vegetarianos apresentava comorbidades&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">A an&#225;lise do MI dos participantes resultou na identifica&#231;&#227;o de 1&#46;496 diferentes UTN&#44; reunidos em 94 g&#234;neros &#40;tabela suplementar 1&#41;&#46; Os &#237;ndices de diversidade ecol&#243;gica do MI diferiram entre os grupos e est&#227;o representados na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Quando ajustado pela idade e IMC&#44; o filo <span class="elsevierStyleItalic">Firmicutes</span> foi menos abundante em VEG&#44; e a rela&#231;&#227;o F&#47;B foi maior no grupo PSO que no VEG&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Quando comparados os obesos com psor&#237;ase e controles obesos&#44; a rela&#231;&#227;o F&#47;B n&#227;o apresentou diferen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;078&#41;&#46; Entretanto&#44; quando s&#227;o comparados eutr&#243;ficos com psor&#237;ase e controles eutr&#243;ficos&#44; os portadores de psor&#237;ase apresentaram maiores valores m&#233;dios &#40;DP&#41; da rela&#231;&#227;o F&#47;B &#40;12&#44;1 &#91;2&#44;9&#93; <span class="elsevierStyleItalic">vs</span>&#46; 2&#44;0 &#91;1&#44;0&#93;&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o &#224; alfa&#8208;diversidade&#44; entre os 13 g&#234;neros mais prevalentes nos tr&#234;s grupos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; foi identificada maior propor&#231;&#227;o do g&#234;nero <span class="elsevierStyleItalic">Prevotella</span> &#40;36&#37;&#41; no grupo VEG e <span class="elsevierStyleItalic">Blautia</span> em PSO &#40;14&#37;&#41; e ONI &#40;18&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0170" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o ao grupo PSO&#44; houve diferen&#231;a na abund&#226;ncia dos g&#234;neros <span class="elsevierStyleItalic">Prevotella</span>&#44; <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Dorea</span>&#44; <span class="elsevierStyleItalic">Bifidobacterium e Coprococcus</span>&#44; quando compararados com VEG<span class="elsevierStyleItalic">&#46;</span> J&#225; os g&#234;neros <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Collinsella</span>&#44; <span class="elsevierStyleItalic">Desulfovibrio</span> diferiram entre os grupos PSO e ONI &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">Quanto &#224; beta&#8208;diversidade&#44; dois componentes PLS representaram at&#233; 79&#44;5&#37; da vari&#226;ncia dos subgrupos&#46; A <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a> apresenta a proje&#231;&#227;o dos casos de acordo com a carga de seus componentes&#44; individualizando&#8208;os em quadrantes distintos&#46; O padr&#227;o plsPSO pode ser compreendido como os carregamentos negativos de PLS1 e 2 &#40;plsPSO<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;PLS1&#8722;PLS2&#41;&#59; inversamente&#44; o padr&#227;o plsVEG pode ser representado pelos carregamentos positivos de PLS1 e 2 &#40;plsPVEG<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>PLS1&#43;PLS2&#41;&#59; j&#225; o padr&#227;o plsONI pode ser representado pelo carregamento positivo de PS1 e negativo de PS2 &#40;plsONI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>PLS1<span class="elsevierStyleItalic">&#8208;</span>PLS2&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0180" class="elsevierStylePara elsevierViewall">Os carregamentos das UTN segundo PLS1 e PLS2 est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#sec0050">figura suplementar 1</a>&#46; Segundo os componentes plsPSO&#44; as bact&#233;rias com maior carregamento do padr&#227;o de MI do grupo PSO foram do g&#234;nero <span class="elsevierStyleItalic">Coprococcus</span>&#44; <span class="elsevierStyleItalic">Lachnospira</span>&#44; <span class="elsevierStyleItalic">Paraprevotella</span>&#44; e as esp&#233;cies <span class="elsevierStyleItalic">Faecalibacterium prausnitzii</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Prevotella stercorea</span> sp&#46;&#44; <span class="elsevierStyleItalic">Prevotella copri</span> sp&#46; e <span class="elsevierStyleItalic">Ruminococcus callidus</span> sp&#46; J&#225; as com menor carregamento foram dos g&#234;neros <span class="elsevierStyleItalic">Lactobacillus</span>&#44; <span class="elsevierStyleItalic">Streptococcus</span>&#44; <span class="elsevierStyleItalic">Dialister</span>&#44; <span class="elsevierStyleItalic">Megasphera</span>&#44; <span class="elsevierStyleItalic">Slackia</span>&#44; e as esp&#233;cies <span class="elsevierStyleItalic">Bacteroides</span><span class="elsevierStyleItalic">fragilis</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Bacteroides uniformis</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Blautia producta</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; <span class="elsevierStyleItalic">Butyricoccus pullicaerum</span> sp<span class="elsevierStyleItalic">&#46; e Parabacteroides distasonis</span> sp&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#fig0020">figura 4</a> apresenta as correla&#231;&#245;es entre os n&#237;veis de LPB&#44; PCRqt&#44; ingesta nutricional e os padr&#245;es de MI&#58; PSO&#44; ONI&#44; e VEG&#46; Os n&#237;veis de LPB se correlacionaram inversamente com a ingesta de fibras &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#8208;</span>0&#44;53&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; por&#233;m&#44; positivamente com o componente do padr&#227;o de MI dos pacientes com psor&#237;ase &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;39&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; O comportamento do PCRqt n&#227;o se associou ao componente do padr&#227;o plsPSO &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;28&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;11&#41;&#44; mas com a ingesta de carboidratos &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;41&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; e com os n&#237;veis de LPB &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;46&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Do ponto de vista alimentar&#44; o componente do padr&#227;o de MI plsPSO se correlacionou de maneira fortemente negativa com a ingesta de fibras &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#8208;</span>0&#44;71&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; assim como a menor ingesta de fibras se associou a maiores n&#237;veis de LPB e PCRqt&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0190" class="elsevierStylePara elsevierViewall">Nosso estudo indicou que caracter&#237;sticas do MI de homens adultos com psor&#237;ase diferiram dos controles on&#237;voros e vegetarianos residentes de uma mesma regi&#227;o do Brasil&#46; Aspectos et&#225;rios&#44; alimentares e de composi&#231;&#227;o corporal tamb&#233;m podem contribuir por parte dessas diferen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">11</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Nessa amostra&#44; o grupo PSO apresentou maior ingesta de carboidratos&#44; por&#233;m baixa ingesta de fibras&#44; mostrando ainda maior rela&#231;&#227;o F&#47;B no MI que o grupo VEG&#44; que contou com maior ingesta de fibras e menor abund&#226;ncia de <span class="elsevierStyleItalic">Firmicutes</span>&#46; Al&#233;m disso&#44; os h&#225;bitos alimentares dos pacientes com psor&#237;ase mostraram&#8208;se desequilibrados&#44; pois tamb&#233;m foram identifcados aumento de gorduras de baixa qualidade e alta densidade cal&#243;rica&#44; caracter&#237;sticas da dieta ocidental que &#233; associada &#224; disbiose intestinal e redu&#231;&#227;o de diversidade bacteriana&#46; Tais h&#225;bitos diet&#233;ticos podem se correlacionar com a gravidade da doen&#231;a e das comorbidades&#44; j&#225; que gorduras saturadas&#44; a&#231;&#250;cares&#44; carne bovina e &#225;lcool interferem no <span class="elsevierStyleItalic">status</span> inflamat&#243;rio sist&#234;mico&#44; enquanto a ingesta de fibras alimentares pode contribuir com a supress&#227;o de certas vias inflamat&#243;rias e na indu&#231;&#227;o de c&#233;lulas&#8208;T reguladoras&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">12&#8211;14</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">A disbiose intestinal tamb&#233;m atua no desequil&#237;brio dos &#225;cidos graxos de cadeia curta &#40;AGCC&#41;&#44; dos quais butirato e acetato s&#227;o os mais estudados&#44; e s&#227;o produzidos a partir da fermenta&#231;&#227;o de fibras pelas bact&#233;rias intestinais&#46; Acetato &#233; associado &#224; produ&#231;&#227;o de grelina&#44; que controla o apetite e a resist&#234;ncia &#224; insulina&#59; j&#225; o butirato &#233; fonte de energia para c&#233;lulas intestinais&#44; associado com preven&#231;&#227;o e redu&#231;&#227;o da inflama&#231;&#227;o sist&#234;mica e aumento da diversidade bacteriana&#44; favorecendo a prolifera&#231;&#227;o de bact&#233;rias do filo <span class="elsevierStyleItalic">Bacteroidetes</span>&#46; Dietas com alto teor de fibras&#44; vegetais e frutas promovem aumento de <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; e por consequ&#234;ncia maior diversidade bacteriana&#46; Por outro lado&#44; dietas com excesso de frituras&#44; s&#243;dio&#44; prote&#237;na e gordura animal podem propiciar maior ativa&#231;&#227;o pr&#243;&#8208;inflamat&#243;ria sist&#234;mica e propor&#231;&#227;o F&#47;B no MI&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">15</span></a> Al&#233;m disso&#44; os AGCC s&#227;o moduladores diretos da s&#237;ntese de interleucina 17 &#40;IL&#8208;17&#41; por linf&#243;citos&#8208;T&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">16</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">A disbiose intestinal pode promover o aumento intraluminal de LPS&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> e dietas com baixa qualidade nutricional &#40;p&#46; ex&#46;&#44; dieta ocidental&#41;&#44; estresse f&#237;sico e psicol&#243;gico&#44; certos medicamentos &#40;p&#46; ex&#46;&#44; antimicrobianos&#41; s&#227;o fatores que favorecem o aumento da permeabilidade intestinal&#46; Um intestino mais perme&#225;vel propicia a transloca&#231;&#227;o de LPS para a corrente sangu&#237;nea &#40;endotoxemia metab&#243;lica&#41;&#44; favorecendo resist&#234;ncia &#224; insulina&#44; inflama&#231;&#227;o no tecido adiposo&#44; infiltra&#231;&#227;o tecidual de mon&#243;citos&#47;macr&#243;fagos&#44; que aumentam o risco de doen&#231;as como esteatose hep&#225;tica&#44; obesidade&#44; diabetes&#46; Assim&#44; parte da resposta inflamat&#243;ria sist&#234;mica pode ser atribu&#237;da &#224; composi&#231;&#227;o do MI&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">Em modelo murino de psor&#237;ase induzida por imiquimode&#44; a administra&#231;&#227;o oral de <span class="elsevierStyleItalic">Staphylococcus aureus</span> e <span class="elsevierStyleItalic">Streptococcus danieliae</span> levou &#224; inflama&#231;&#227;o cut&#226;nea e ao aumento da express&#227;o de TNF e IL17&#44; subsidiando a hip&#243;tese de que a disbiose intestinal possa levar &#224; piora cl&#237;nica da doen&#231;a&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Este estudo investigou&#44; de maneira original&#44; rela&#231;&#245;es entre n&#237;veis plasm&#225;ticos de LPB&#44; PCRqt&#44; e padr&#227;o alimentar em on&#237;voros&#44; vegetarianos e pacientes com psor&#237;ase&#44; demonstrando que os n&#237;veis de LPB se correlacionaram inversamente com o consumo de fibras&#46; Nessa amostra&#44; os participantes com psor&#237;ase apresentaram n&#237;veis de LPB maiores que os vegetarianos&#44; levando &#224; hip&#243;tese de que a modula&#231;&#227;o do MI &#40;p&#46; ex&#46;&#44; pode meio da dieta&#41; contribua com a redu&#231;&#227;o dos n&#237;veis de LPB s&#233;ricos&#59; portanto&#44; esses achados subsidiam que a sa&#250;de intestinal pode ser modulada por meio de escolhas alimentares&#46; Al&#233;m disso&#44; os n&#237;veis de PCRqt foram maiores em PSO&#44; associados &#224; ingesta de carboidratos e LPB&#46; Apesar de a permeabilidade intestinal n&#227;o ser avaliada de maneira direta&#44; os n&#237;veis elevados de LPB e PCRqt podem indicar maior permeabilidade intestinal em pacientes com psor&#237;ase&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Pesquisas com n&#237;veis s&#233;ricos de LPB em humanos s&#227;o escassas&#44; mas existem evid&#234;ncias de que o LPB esteja elevado em pacientes com psor&#237;ase&#44; havendo correla&#231;&#227;o com os n&#237;veis de PCRqt&#46; Desse modo&#44; LPB pode ser um indicador de inflama&#231;&#227;o sist&#234;mica e progress&#227;o para s&#237;ndrome metab&#243;lica em pacientes com psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">21</span></a> &#201; importante ressaltar que&#44; recentemente&#44; o LPB revelou&#8208;se um biomarcador para a permeabilidade intestinal em adultos&#44; independentemente de idade&#44; IMC e g&#234;nero&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">22</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Em estudos controlados que analisaram o MI de pacientes com psor&#237;ase&#44; utilizando grupos populacionais diversos&#44; foram encontrados achados diferentes&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a> Em um estudo israelense que avaliou a diversidade beta em pacientes com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41; em compara&#231;&#227;o com controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41; sem psor&#237;ase&#44; pareados por idade&#44; IMC e comorbidades&#44; identificou&#8208;se aumento significante em <span class="elsevierStyleItalic">Ruminoccocus gnavus</span>&#44; <span class="elsevierStyleItalic">Dorea formicigenerans</span> e <span class="elsevierStyleItalic">Collinsella aerofaciens</span> no MI da psor&#237;ase&#44; enquanto <span class="elsevierStyleItalic">Prevotella copri</span> e <span class="elsevierStyleItalic">Parabacteroides distasonis</span> foram significantemente menores em compara&#231;&#227;o com os controles<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a> &#8211; um padr&#227;o algo diverso da estrutura de MI encontrada em nossa amostra&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Outro estudo conduzido na China evidenciou que pacientes com psor&#237;ase t&#234;m perfis de MI significantemente perturbados&#44; pois ao analisar o MI de 35 pacientes com psor&#237;ase e 27 controles&#44; mostrou diferen&#231;a nas abund&#226;ncias relativas de <span class="elsevierStyleItalic">Firmicutes</span> e <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; com aumento de <span class="elsevierStyleItalic">Bacteroides</span>&#44; <span class="elsevierStyleItalic">Actinobacteria</span> e redu&#231;&#227;o de <span class="elsevierStyleItalic">Firmicutes</span>&#44; <span class="elsevierStyleItalic">Proteobacteria</span> e <span class="elsevierStyleItalic">Bifidobacterium&#46;</span><a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a> Em contrapartida&#44; um estudo espanhol de pacientes com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&#44; em compara&#231;&#227;o com um grupo controle saud&#225;vel &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; mostrou menor diversidade bacteriana e diferente abund&#226;ncia relativa de certos t&#225;xons bacterianos em pacientes com psor&#237;ase&#44; com aumento de <span class="elsevierStyleItalic">Actinobacteria</span>&#44; <span class="elsevierStyleItalic">Firmicutes</span> e redu&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span>&#44; <span class="elsevierStyleItalic">Proteobacterias</span> e <span class="elsevierStyleItalic">Fecalibacterium</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">Em uma an&#225;lise do MI de 52 pacientes com psor&#237;ase &#40;PASI &#8805; 6&#41; em compara&#231;&#227;o com popula&#231;&#227;o saud&#225;vel &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>300&#41;&#44; evidenciou&#8208;se maior frequ&#234;ncia do padr&#227;o chamado enter&#243;tipo 2&#44; com tend&#234;ncia a apresentar transloca&#231;&#227;o bacteriana mais frequente e maior estado inflamat&#243;rio &#40;71&#37;&#41; do que outros enter&#243;tipos&#44; havendo predom&#237;nio de <span class="elsevierStyleItalic">Akkermansia</span>&#44; <span class="elsevierStyleItalic">Faecalibacterium</span>&#44; <span class="elsevierStyleItalic">Ruminococcus</span> e menor propor&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a> Nossa amostra tamb&#233;m indicou maiores propor&#231;&#245;es de <span class="elsevierStyleItalic">Faecalibacterium</span> e <span class="elsevierStyleItalic">Ruminococcus</span>&#44; al&#233;m de menores &#237;ndices de <span class="elsevierStyleItalic">Bactroidetes</span> no perfil &#40;PLS&#41; dos pacientes com psor&#237;ase&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Recentemente&#44; um estudo conduzido na Argentina demonstrou mudan&#231;as na composi&#231;&#227;o do MI dependendo do <span class="elsevierStyleItalic">status</span> da psor&#237;ase&#44; com aumento de <span class="elsevierStyleItalic">Firmicutes</span> e deple&#231;&#227;o de <span class="elsevierStyleItalic">Bacteroidetes</span> em 55 pacientes com psor&#237;ase&#44; em compara&#231;&#227;o com 27 controles&#46; Al&#233;m disso&#44; os g&#234;neros <span class="elsevierStyleItalic">Faecalibacterium</span> e <span class="elsevierStyleItalic">Blautia</span> foram maiores em pacientes com psor&#237;ase&#44; enquanto <span class="elsevierStyleItalic">Bacteroides</span> e <span class="elsevierStyleItalic">Paraprevotella</span> foram maiores em controles sem psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">28</span></a> Como nossos pacientes estavam em tratamento e a maior parte com PASI &#60;<span class="elsevierStyleHsp" style=""></span>4&#44; n&#227;o foi poss&#237;vel estratificar o MI de acordo com a gravidade da doen&#231;a&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">Outro estudo de caso&#8208;controle na &#193;sia Central&#44; com pacientes entre 30 e 45 anos&#44; com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41; e controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; pareados por idade e sexo&#44; encontrou associa&#231;&#227;o com psor&#237;ase e n&#237;veis elevados de <span class="elsevierStyleItalic">Firmicutes</span>&#44; <span class="elsevierStyleItalic">Faecalibacterium</span> e abund&#226;ncia reduzida de <span class="elsevierStyleItalic">Oscillibacter</span> e <span class="elsevierStyleItalic">Roseburia</span>&#44; mas n&#227;o houve diferen&#231;a na diversidade e rela&#231;&#227;o F&#47;B&#44; bastante alinhado com nossos resultados&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">29</span></a></p><p id="par0250" class="elsevierStylePara elsevierViewall">Um estudo brasileiro mostrou menor diversidade no MI de mulheres com psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41; em compara&#231;&#227;o com controles &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&#44; identificando aumento do g&#234;nero <span class="elsevierStyleItalic">Dialister</span> e da esp&#233;cie <span class="elsevierStyleItalic">Prevotella copri</span> sp<span class="elsevierStyleItalic">&#46;</span>&#44; mas redu&#231;&#227;o nos g&#234;neros <span class="elsevierStyleItalic">Ruminococcus</span>&#44; <span class="elsevierStyleItalic">Lachnospira</span>&#44; <span class="elsevierStyleItalic">Blautia</span> e nas esp&#233;cies <span class="elsevierStyleItalic">Akkermansia muciniphila</span> sp&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30</span></a></p><p id="par0255" class="elsevierStylePara elsevierViewall">No presente estudo&#44; o perfil de MI encontrado nos homens adultos portadores de psor&#237;ase foi associado aos descritos em outras comorbidades&#44; como na s&#237;ndrome metab&#243;lica&#44; obesidade e doen&#231;as afetivas&#44; o que pode decorrer do estilo de vida ocidental&#46; Ainda de acordo com a literatura&#44; o <span class="elsevierStyleItalic">Coprococcus</span> foi associado a doen&#231;as afetivas como depress&#227;o&#44; obesidade e m&#225; qualidade do sono&#59;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">31</span></a><span class="elsevierStyleItalic">Lachnospira</span> foi associado ao desenvolvimento de diabetes <span class="elsevierStyleItalic">mellitus</span>&#59;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">32</span></a> e <span class="elsevierStyleItalic">Paraprevotella</span> com maior ingest&#227;o de gorduras&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">33</span></a> Apesar de haver associa&#231;&#227;o com dietas vegetarianas&#44; <span class="elsevierStyleItalic">Prevotella</span> tamb&#233;m &#233; relacionada &#224; elevada ingesta de carboidratos&#44; e como apresenta alta diversidade gen&#233;tica dentro e entre esp&#233;cies&#44; podem explicar sua descri&#231;&#227;o tanto em MI saud&#225;veis como em disbi&#243;ticos&#59; uma carga elevada de <span class="elsevierStyleItalic">Prevotella</span> no MI foi associada &#224; obesidade&#44; resist&#234;ncia &#224; insulina&#44; hipertens&#227;o e doen&#231;a hep&#225;tica gordurosa n&#227;o alco&#243;lica&#46;<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">34</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">A composi&#231;&#227;o do MI de psor&#237;ase encontrado nessa amostra se op&#244;s &#224; encontrada nos vegetarianos&#44; ricos em <span class="elsevierStyleItalic">Bacteroides</span> e <span class="elsevierStyleItalic">Lactobacillus</span>&#44; associados &#224; menor permeabilidade intestinal&#46; De fato&#44; a preval&#234;ncia de psor&#237;ase em vegetarianos &#233; excepcional&#44; e a dieta vegetariana leva &#224; melhora de les&#245;es cut&#226;neas da psor&#237;ase&#44; o que sugere que a modula&#231;&#227;o do MI possa subsidiar o desenvolvimento de doen&#231;as inflamat&#243;rias como a psor&#237;ase&#46;<a class="elsevierStyleCrossRefs" href="#bib0375"><span class="elsevierStyleSup">35&#44;36</span></a></p><p id="par0265" class="elsevierStylePara elsevierViewall">Estudos metagen&#244;micos do MI apresentam alta variabilidade de resultados entre as publica&#231;&#245;es&#46; Diferen&#231;as populacionais &#233;tnicas&#44; culturais e alimentares podem explicar os resultados controversos entre os estudos que caracterizaram MI em psor&#237;ase&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Assim&#44; ainda n&#227;o foi definido o que constitui um MI saud&#225;vel&#44; quando exclu&#237;das as bact&#233;rias sabidamente patog&#234;nicas&#46; Por isso&#44; &#233; essencial destacar que as esp&#233;cies comensais n&#227;o devem ser consideradas absolutamente &#8220;boas&#8221; ou &#8220;ruins&#8221;&#44; j&#225; que todas desempenham fun&#231;&#245;es no ecossistema intestinal&#46; A problem&#225;tica emerge do desequil&#237;brio&#44; ou seja&#44; a predomin&#226;ncia de grupos de esp&#233;cies comensais que promovem altera&#231;&#245;es na permeabilidade intestinal&#46; Al&#233;m disso&#44; quando se caracteriza o MI de um grupo&#44; pretende&#8208;se entender o padr&#227;o de desequil&#237;brio&#44; apesar de a composi&#231;&#227;o do MI ser &#250;nica em cada indiv&#237;duo&#44; adquirida nos primeiros anos de vida e moldada pelas caracter&#237;sticas ambientais&#44; como os h&#225;bitos alimentares&#44; ao longo da vida&#46;<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">37&#8211;39</span></a></p><p id="par0275" class="elsevierStylePara elsevierViewall">Este estudo apresenta limita&#231;&#245;es ligadas &#224; amostra modesta&#44; n&#227;o aleatorizada&#44; o que n&#227;o impediu a identifica&#231;&#227;o de padr&#245;es de MI entre os grupos&#59; al&#233;m disso&#44; a origem comum quanto ao grupo populacional maximiza a homogeneidade da amostra&#46; O efeito dos tratamentos da psor&#237;ase no MI &#233; tema a ser investigado&#44; e nossos participantes utilizaram diversos medicamentos diferentes&#59; entretanto&#44; o uso de adalimumabe n&#227;o mostrou modificar o padr&#227;o de MI em 10 pacientes&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a> Nossos participantes ainda apresentavam escores de PASI baixos&#44; decorrente do controle da doen&#231;a com a terap&#234;utica estabelecida&#46; Na verdade&#44; s&#227;o necess&#225;rios estudos de MI com pacientes com psor&#237;ase sem tratamento sist&#234;mico&#46; Outro aspecto se refere &#224; amostragem do microbioma fecal&#44; que consiste na flora transit&#243;ria do c&#243;lon&#44; em contrapartida &#224; flora permanente que &#233; ligada &#224; mucosa&#44; menos sujeita a varia&#231;&#227;o&#46; Finalmente&#44; LPB &#233; utilizado como <span class="elsevierStyleItalic">proxy</span> da medida de LPS&#44; em decorr&#234;ncia de sua labilidade&#46; As varia&#231;&#245;es alimentares podem dificultar as compara&#231;&#245;es entre os grupos&#44; visto que mesmo dentro dos grupos on&#237;voros&#44; vegetarianos e psor&#237;ase&#44; existem alimentos que podem atuar de maneira diferente no MI&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Estudos cl&#237;nicos controlados em psor&#237;ase que visem a manipula&#231;&#227;o do MI&#44; quer com transplante de fezes&#44; interven&#231;&#245;es diet&#233;ticas &#40;p&#46; ex&#46;&#44; adequa&#231;&#227;o de fibras&#41;&#44; pr&#243;&#47;pr&#233;&#8208;bi&#243;ticos ou sais biliares&#44; devem ser conduzidos para melhor compreens&#227;o do papel do MI na atividade cl&#237;nica da psor&#237;ase&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclus&#227;o</span><p id="par0285" class="elsevierStylePara elsevierViewall">Identificou&#8208;se diferen&#231;a no MI de homens adultos brasileiros com psor&#237;ase em rela&#231;&#227;o a on&#237;voros e vegetarianos saud&#225;veis&#46; O padr&#227;o de MI encontrado correlacionou&#8208;se com a ingesta de fibras alimentares&#44; com os n&#237;veis s&#233;ricos de LPB&#46; Mudan&#231;as nos h&#225;bitos alimentares podem remodelar o MI&#44; e por consequ&#234;ncia&#44; auxiliar no controle cl&#237;nico da psor&#237;ase&#46; Ressalta&#8208;se a necessidade de conscientiza&#231;&#227;o da import&#226;ncia nutricional no tratamento da doen&#231;a e no manejo das comorbidades&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suporte financeiro</span><p id="par0290" class="elsevierStylePara elsevierViewall">FUNADERM &#8208; Fundo de Apoio &#224; Dermatologia&#44; da Sociedade Brasileira de Dermatologia&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Contribui&#231;&#227;o dos autores</span><p id="par0295" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; Concep&#231;&#227;o do estudo&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0300" class="elsevierStylePara elsevierViewall">Tatiana Cristina Figueira Polo&#58; Concep&#231;&#227;o do estudo&#59; coleta de dados&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">Mariana Righetto de R&#233; Lai&#58; Concep&#231;&#227;o do estudo&#59; coleta de dados&#59; an&#225;lise dos resultados&#59; escrita do texto&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0310" class="elsevierStylePara elsevierViewall">Luciane Donida Bartoli Miot&#58; Coleta de dados&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0315" class="elsevierStylePara elsevierViewall">Giovana Fernanda Cosi Bento&#58; An&#225;lise dos resultados&#59; revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0320" class="elsevierStylePara elsevierViewall">M&#225;rcia Guimar&#227;es da Silva&#58; Revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p><p id="par0325" class="elsevierStylePara elsevierViewall">Silvio Alencar Marques&#58; Revis&#227;o e aprova&#231;&#227;o do texto final&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflito de interesses</span><p id="par0330" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1940764"
          "titulo" => "Resumo"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Fundamentos"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objetivo"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "M&#233;todo"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Resultados"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Limita&#231;&#245;es do estudo"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Conclus&#227;o"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1672270"
          "titulo" => "Palavras&#8208;chave"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introdu&#231;&#227;o"
        ]
        3 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "M&#233;todo"
        ]
        4 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Resultados"
        ]
        5 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discuss&#227;o"
        ]
        6 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclus&#227;o"
        ]
        7 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Suporte financeiro"
        ]
        8 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        9 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Conflito de interesses"
        ]
        10 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-05-02"
    "fechaAceptado" => "2022-08-09"
    "PalabrasClave" => array:1 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras&#8208;chave"
          "identificador" => "xpalclavsec1672270"
          "palabras" => array:7 [
            0 => "Dieta"
            1 => "Dieta ocidental"
            2 => "Dieta vegetariana"
            3 => "Microbioma gastrintestinal"
            4 => "Microbiota"
            5 => "Obesidade"
            6 => "Psor&#237;ase"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Psor&#237;ase &#233; doen&#231;a inflamat&#243;ria cr&#244;nica associada &#224; inflama&#231;&#227;o sist&#234;mica e comorbidades&#46; Altera&#231;&#245;es na composi&#231;&#227;o do microbioma intestinal est&#227;o envolvidas na patog&#234;nese de doen&#231;as inflamat&#243;rias e s&#237;ndrome metab&#243;lica&#46; Caracterizar o microbioma intestinal de pacientes com psor&#237;ase pode ser relevante no entendimento do seu curso cl&#237;nico e na preven&#231;&#227;o de comorbidades&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Caracterizar o microbioma intestinal de homens com psor&#237;ase em compara&#231;&#227;o a controles &#40;sem psor&#237;ase&#41; on&#237;voros e vegetarianos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal envolvendo 42 homens adultos&#58; 21 com psor&#237;ase on&#237;voros&#44; 14 controles on&#237;voros e 7 controles vegetarianos&#46; A caracteriza&#231;&#227;o do microbioma intestinal foi realizada por an&#225;lise metagen&#244;mica&#46; Avaliaram&#8208;se os n&#237;veis s&#233;ricos da prote&#237;na ligadora de lipopolissacar&#237;dio &#40;LPB&#41; e prote&#237;na C reativa &#40;PCR&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Os grupos diferiram entre si quanto aos aspectos nutricionais e do microbioma&#46; Pacientes com psor&#237;ase apresentaram maior consumo de prote&#237;nas e menor de fibras&#46; N&#237;veis de LPB&#44; PCR e a rela&#231;&#227;o <span class="elsevierStyleItalic">Firmicutes&#47;Bacteroidetes</span> foram maiores no grupo com psor&#237;ase que no grupo controle vegetariano &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Os g&#234;neros <span class="elsevierStyleItalic">Prevotella<span class="elsevierStyleBold">&#44;</span> Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Dorea</span>&#44; <span class="elsevierStyleItalic">Bifidobacterium</span> e <span class="elsevierStyleItalic">Coprococcus</span> diferiram no grupo com psor&#237;ase em compara&#231;&#227;o com vegetarianos&#59; j&#225; os g&#234;neros <span class="elsevierStyleItalic">Mogibacterium</span>&#44; <span class="elsevierStyleItalic">Collinsella</span> e <span class="elsevierStyleItalic">Desulfovibrio</span> diferiram dos on&#237;voros&#46; Identificou&#8208;se padr&#227;o de microbioma ligado &#224; psor&#237;ase &#40;plsPSO&#41; que se associou a maiores n&#237;veis de LPB &#40;rho &#61; 0&#44;39&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; e menor ingesta de fibras diet&#233;ticas &#40;rho<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;71&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Apenas homens adultos foram avaliados&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Houve diferen&#231;a no microbioma intestinal de homens adultos com psor&#237;ase em rela&#231;&#227;o a on&#237;voros e vegetarianos saud&#225;veis&#46; O padr&#227;o de microbioma encontrado correlacionou&#8208;se com a ingesta de fibras alimentares e com os n&#237;veis s&#233;ricos de LPB&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Fundamentos"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todo"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Limita&#231;&#245;es do estudo"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclus&#227;o"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Como citar este artigo&#58; Polo TCF&#44; Lai MRR&#44; Miot LDB&#44; Bento GFC&#44; Silva MG&#44; Marques SA&#44; Miot HA&#46; Intestinal microbiome characterization of adult Brazilian men with psoriasis compared to omnivore and vegetarian controls&#46; An Bras Dermatol&#46; 2023&#59;98&#58;635&#8211;43&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Trabalho realizado no Departamento de Dermatologia&#44; Faculdade de Medicina de Botucatu&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0340" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Material suplementar"
            "identificador" => "sec0050"
          ]
        ]
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1203
            "Ancho" => 3341
            "Tamanyo" => 271716
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Distribui&#231;&#227;o da propor&#231;&#227;o dos 13 g&#234;neros mais prevalentes entre os grupos PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1232
            "Ancho" => 2175
            "Tamanyo" => 158697
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Alfa&#8208;diversidade&#46; Compara&#231;&#227;o da mediana da abund&#226;ncia dos g&#234;neros que apresentaram diferen&#231;a entre os grupos &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; PSO &#40;psor&#237;ase&#41;&#44; VEG &#40;controles vegetarianos&#41; e ONI &#40;controles on&#237;voros&#41;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1383
            "Ancho" => 1675
            "Tamanyo" => 88054
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Carregamento dos participantes segundo os componentes PLS &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;&#46; Em destaque&#44; composi&#231;&#245;es que discriminam os grupos</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">PLS&#44; componente partial least squares&#59; ONI&#44; controles on&#237;voros&#59; VEG&#44; controles vegetarianos&#59; PSO&#44; psor&#237;ase&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1921
            "Ancho" => 2175
            "Tamanyo" => 213640
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mapa t&#233;rmico com as correla&#231;&#245;es bivariadas entre os n&#237;veis de LPB&#44; PCR&#44; caracter&#237;sticas nutricionais da dieta e o padr&#227;o de microbioma intestinal dos pacientes com psor&#237;ase&#46;</p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">LPB&#44; n&#237;vel s&#233;rico da prote&#237;na de liga&#231;&#227;o de Lipopolissacar&#237;deos&#59; PCRqt&#44; n&#237;vel s&#233;rico da prote&#237;na C reativa ultrassens&#237;vel &#40;teste quantitativo&#41;&#59; CHg&#44; carboidratos &#40;em gramas&#41;&#59; PRg&#44; prote&#237;nas &#40;em gramas&#41;&#59; LIPg&#44; lip&#237;dios &#40;em gramas&#41;&#59; FIBg&#44; fibras &#40;em gramas&#41;&#59; plsPSO&#44; componente PLS do microbioma intestinal dos participantes com psor&#237;ase</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">IMC&#44; &#237;ndice de massa corporal&#59; LPB&#44; prote&#237;na ligadora de polissacar&#237;dios&#59; PCRqt&#44; prote&#237;na C reativa ultrassens&#237;vel&#44; teste quantitativo&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles on&#237;voros &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles vegetarianos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Psor&#237;ase &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Idade &#40;anos&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#44;6 &#40;11&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;4 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#44;1 &#40;11&#44;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">IMC &#40;kg&#47;m</span><a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup"><span class="elsevierStyleBold">2</span></span></a><span class="elsevierStyleBold">&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;1 &#40;9&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;4 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;5 &#40;6&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Energia &#40;cal&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;859&#44;4 &#40;1297&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;314&#44;3 &#40;129&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;058&#44;0 &#40;512&#44;0&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Carboidratos &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">539&#44;5 &#40;185&#44;7&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">362&#44;2 &#40;22&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">466&#44;9 &#40;86&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Prote&#237;nas &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">198&#44;9 &#40;76&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#44;4 &#40;21&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&#44;4 &#40;39&#44;3&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Lip&#237;dios &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#44;2 &#40;45&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#44;0 &#40;9&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#44;9 &#40;23&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Fibras &#40;g&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;1 &#40;9&#44;3&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;4 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;8 &#40;7&#44;4&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">LPB &#40;mg&#47;mL&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;1 &#40;2&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8 &#40;1&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;6 &#40;2&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;007&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">PCRqt &#40;mg&#47;dL&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6 &#40;3&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;2 &#40;9&#44;2&#41;<a class="elsevierStyleCrossRefs" href="#tblfn0010"><span class="elsevierStyleSup">a&#44;b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3233293.png"
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">M&#233;dia &#40;desvio&#8211;padr&#227;o&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">p &#8804; 0&#44;05 &#8211; comparado ao vegetariano&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">p &#8804; 0&#44;05 &#8211; comparado ao on&#237;voro&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Principais dados demogr&#225;ficos&#44; alimentares&#44; LPB e PCRqt s&#233;ricos dos participantes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">F&#47;B&#44; Firmicutes&#47;Bacteroidetes&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles on&#237;voros&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles vegetarianos&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Psor&#237;ase&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abund&#226;ncia relativa &#40;10<span class="elsevierStyleSup">3</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#44;0 &#40;12&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;7 &#40;13&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#44;6 &#40;11&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diversidade de Hill<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0 &#40;Riqueza&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">141&#44;2 &#40;53&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">136&#44;6 &#40;21&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">138&#44;5 &#40;49&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;353&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1 &#40;Shannon&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#44;0 &#40;18&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;6 &#40;15&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;4 &#40;18&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;507&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>q<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3 &#40;Simpson&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;4 &#40;6&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;8 &#40;7&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;5 &#40;7&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abund&#226;ncia segundo o filo<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">c</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Firmicutes</span> &#40;10<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#44;1 &#40;37&#44;9&#8208;46&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;1 &#40;29&#44;6&#8208;37&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;1 &#40;33&#44;1&#8208;48&#44;8&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;049</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Bacteroidetes</span> &#40;10<span class="elsevierStyleSup">3</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;7 &#40;6&#44;5&#8208;23&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;0 &#40;10&#44;9&#8208;40&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;1 &#40;6&#44;8&#8208;23&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;335&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rela&#231;&#227;o F&#47;B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5 &#40;1&#44;8&#8208;6&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0 &#40;0&#44;9&#8208;3&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1 &#40;2&#44;2&#8208;5&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">d</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;045</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3233294.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">p&#8208;valor ajustado para idade e &#237;ndice de massa corporal&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">M&#233;dia &#40;desvio&#8208;padr&#227;o&#41;&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Mediana &#40;P<span class="elsevierStyleInf">25</span>&#8208;P<span class="elsevierStyleInf">75</span>&#41;&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">p &#8804; 0&#44;05 &#8211; comparado aos vegetarianos&#59;</p> <p class="elsevierStyleNotepara" id="npar0040"><span class="elsevierStyleSup">b</span> p &#8804; 0&#44;05 &#8211; comparado aos on&#237;voros&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">&#205;ndices de diversidade ecol&#243;gica do microbioma intestinal entre os grupos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>42&#41;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.zip"
          "ficheroTamanyo" => 413232
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:40 [
            0 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of psoriasis in Brazil &#8208; a geographical survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Romiti"
                            1 => "M&#46; Arnone"
                            2 => "A&#46; Menter"
                            3 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2017"
                        "volumen" => "56"
                        "paginaInicial" => "167"
                        "paginaFinal" => "168"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "National&#44; regional&#44; and worldwide epidemiology of psoriasis&#58; systematic analysis and modelling study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Parisi"
                            1 => "I&#46;Y&#46;K&#46; Iskandar"
                            2 => "E&#46; Kontopantelis"
                            3 => "M&#46; Augustin"
                            4 => "C&#46;E&#46;M&#46; Griffiths"
                            5 => "D&#46;M&#46; Ashcroft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ&#46;"
                        "fecha" => "2020"
                        "volumen" => "8247"
                        "paginaInicial" => "1590"
                        "paginaFinal" => "1605"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic and therapeutic guidelines for plaque psoriasis &#8208; Brazilian Society of Dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Arnone"
                            1 => "M&#46;D&#46;F&#46; Takahashi"
                            2 => "A&#46;V&#46;E&#46; Carvalho"
                            3 => "W&#46;M&#46; Bernardo"
                            4 => "A&#46;L&#46; Bressan"
                            5 => "A&#46;M&#46;C&#46; Ramos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/abd1806-4841.2019940211"
                      "Revista" => array:7 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "94"
                        "paginaInicial" => "76"
                        "paginaFinal" => "107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31166402"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1808869416301033"
                          "estado" => "S300"
                          "issn" => "18088694"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of Oral and Gut Microbiota in Patients with psoriatic diseases&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Todberg"
                            1 => "H&#46; Kaiser"
                            2 => "C&#46; Zachariae"
                            3 => "A&#46; Egeberg"
                            4 => "A&#46; Halling"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "2021"
                        "volumen" => "30"
                        "paginaInicial" => "101"
                        "paginaFinal" => "107"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The firmicutes&#47;bacteroidetes ratio&#58; a relevant marker of gut dysbiosis in obese patients&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Magne"
                            1 => "M&#46; Gotteland"
                            2 => "L&#46; Gauthier"
                            3 => "A&#46; Zazueta"
                            4 => "S&#46; Pesoa"
                            5 => "P&#46; Navarrete"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu12051474"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2020"
                        "volumen" => "12"
                        "paginaInicial" => "1474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32438689"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota and metabolic specificity in ulcerative colitis and crohn&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Sankarasubramanian"
                            1 => "R&#46; Ahmad"
                            2 => "N&#46; Avuthu"
                            3 => "A&#46;B&#46; Singh"
                            4 => "C&#46; Guda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Front Med&#46;"
                        "fecha" => "2020"
                        "volumen" => "7"
                        "paginaInicial" => "606298"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systematic review&#58; the gut microbiome and its potential clinical application in inflammatory bowel disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Aldars-Garc&#237;a"
                            1 => "M&#46; Chaparro"
                            2 => "J&#46;P&#46; Gisbert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/microorganisms9050977"
                      "Revista" => array:5 [
                        "tituloSerie" => "Microorganisms&#46;"
                        "fecha" => "2021"
                        "volumen" => "9"
                        "paginaInicial" => "977"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33946482"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriasis and gut microbiome &#8211; current state of art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Polak"
                            1 => "B&#46; Bergler-Czop"
                            2 => "M&#46; Szczepanek"
                            3 => "K&#46; Wojciechowska"
                            4 => "A&#46; Fr&#261;tczak"
                            5 => "N&#46; Kiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2021"
                        "volumen" => "22"
                        "paginaInicial" => "4529"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metabolic endotoxemia initiates obesity and insulin resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;D&#46; Cani"
                            1 => "J&#46; Amar"
                            2 => "M&#46;A&#46; Iglesias"
                            3 => "M&#46; Poggi"
                            4 => "C&#46; Knauf"
                            5 => "D&#46; Bastelica"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2337/db06-1491"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetes&#46;"
                        "fecha" => "2007"
                        "volumen" => "56"
                        "paginaInicial" => "1761"
                        "paginaFinal" => "1772"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17456850"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "ncbi&#46;nlm &#91;Internet&#93;&#46; Gonzalez&#8208;Quintela A&#44; Alonso M&#44; Campos J&#44; Vizcaino L&#44; Loidi L&#44; Gude F&#44; et al&#46; Determinants of serum concentrations of lipopolysaccharide&#8208;binding protein &#40;LBP&#41; in the adult population&#58; the role of obesity&#46; PLoS ONE&#46; 2013&#59;8&#58;e54600&#46; &#91;citado em 20 jul&#46; 2022&#93;&#46; Dispon&#237;vel em&#58; https&#58;&#47;&#47;www&#46;ncbi&#46;nlm&#46;nih&#46;gov&#47;pmc&#47;articles&#47;PMC3551812&#47;&#35;&#58;&#8764;&#58;text<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Serum&#37;20LBP&#37;20concentrations&#37;20increased&#37;20with&#37;20age&#46;&#44;in&#37;20these&#37;20inflammatory&#37;2C&#37;20metabolic&#37;20abnormalities&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characterization of the intestinal microbiome in eutrophic&#44; obese omnivores&#44; and vegetarians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;C&#46;F&#46; Polo"
                            1 => "M&#46;R&#46; de R&#233; Lai"
                            2 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Nutrire&#46;"
                        "fecha" => "2022"
                        "volumen" => "47"
                        "paginaInicial" => "2"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nutrition and Psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Kanda"
                            1 => "T&#46; Hoashi"
                            2 => "H&#46; Saeki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijms21155405"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "5405"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32751360"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1575092210000446"
                          "estado" => "S300"
                          "issn" => "15750922"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evolution of the human diet and its impact on gut microbiota&#44; immune responses&#44; and brain health"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "B&#46;M&#46; Gonz&#225;lez Olmo"
                            1 => "M&#46;J&#46; Butler"
                            2 => "R&#46;M&#46; Barrientos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13010196"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33435203"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microbiota intestinal humana y dieta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;A&#46; Padr&#243;n Pereira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cienc Tecnol&#46;"
                        "fecha" => "2019"
                        "volumen" => "12"
                        "paginaInicial" => "31"
                        "paginaFinal" => "42"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dietary fiber intervention on gut microbiota composition in healthy adults&#58; a systematic review and meta&#8208;analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; So"
                            1 => "K&#46; Whelan"
                            2 => "M&#46; Rossi"
                            3 => "M&#46; Morrison"
                            4 => "G&#46; Holtmann"
                            5 => "J&#46;T&#46; Kelly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/ajcn/nqy041"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Nutr&#46;"
                        "fecha" => "2018"
                        "volumen" => "107"
                        "paginaInicial" => "965"
                        "paginaFinal" => "983"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29757343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota&#8208;derived short&#8208;chain fatty acids regulate IL&#8208;17 production by mouse and human intestinal &#947;&#948; T cells"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Dupraz"
                            1 => "A&#46; Magniez"
                            2 => "N&#46; Rolhion"
                            3 => "M&#46;L&#46; Richard"
                            4 => "G&#46; Da Costa"
                            5 => "S&#46; Touch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.celrep.2021.109332"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cell Rep&#46;"
                        "fecha" => "2021"
                        "volumen" => "36"
                        "paginaInicial" => "109332"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34233192"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short&#8208;Chain fatty acids and lipopolysaccharide as mediators between gut dysbiosis and amyloid pathology in alzheimer&#39;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Marizzoni"
                            1 => "A&#46; Cattaneo"
                            2 => "P&#46; Mirabelli"
                            3 => "C&#46; Festari"
                            4 => "N&#46; Lopizzo"
                            5 => "V&#46; Nicolosi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3233/JAD-200306"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Alzheimers Dis&#46;"
                        "fecha" => "2020"
                        "volumen" => "78"
                        "paginaInicial" => "683"
                        "paginaFinal" => "697"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33074224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The gut microbiome in psoriasis and psoriatic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Myers"
                            1 => "N&#46; Brownstone"
                            2 => "V&#46; Reddy"
                            3 => "S&#46; Chan"
                            4 => "Q&#46; Thibodeaux"
                            5 => "A&#46; Truong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.berh.2020.101494"
                      "Revista" => array:5 [
                        "tituloSerie" => "Best Pract Res Clin Rheumatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "33"
                        "paginaInicial" => "101494"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32360228"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genomic alterations driving psoriasis pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Singh"
                            1 => "D&#46; Pradhan"
                            2 => "P&#46; Puri"
                            3 => "V&#46; Ramesh"
                            4 => "S&#46; Aggarwal"
                            5 => "A&#46; Nayek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gene&#46;"
                        "fecha" => "2019"
                        "volumen" => "683"
                        "paginaInicial" => "61"
                        "paginaFinal" => "71"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of gut microbiome in psoriasis&#58; oral administration of staphylococcus aureus and streptococcus danieliae exacerbates skin inflammation of imiquimod&#8208;induced psoriasis&#8208;like dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Okada"
                            1 => "Y&#46; Matsushima"
                            2 => "K&#46; Mizutani"
                            3 => "K&#46; Yamanaka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijms21093303"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Mol Sci&#46;"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "3303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32392785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lipopolysaccharide&#8208;binding protein is increased in patients with psoriasis with metabolic syndrome and correlates with C&#8208;reactive protein&#58; lipopolysaccharide&#8208;binding protein in patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Roman&#237;"
                            1 => "A&#46; Caix&#224;s"
                            2 => "X&#46; Escot&#233;"
                            3 => "J&#46;M&#46; Carrascosa"
                            4 => "M&#46; Ribera"
                            5 => "M&#46; Rigla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ced.12007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol&#46;"
                        "fecha" => "2013"
                        "volumen" => "38"
                        "paginaInicial" => "81"
                        "paginaFinal" => "84"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23082944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Biomarkers for assessment of intestinal permeability in clinical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Seethaler"
                            1 => "M&#46; Basrai"
                            2 => "A&#46;M&#46; Neyrinck"
                            3 => "J&#46;A&#46; Nazare"
                            4 => "J&#46; Walter"
                            5 => "N&#46;M&#46; Delzenne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Physiol&#8208;Gastrointest Liver Physiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "321"
                        "paginaInicial" => "11"
                        "paginaFinal" => "17"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of gut microbiome in inflammatory skin disorders&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Widhiati"
                            1 => "D&#46; Purnomosari"
                            2 => "T&#46; Wibawa"
                            3 => "H&#46; Soebono"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Dermatol Rep&#46;"
                        "fecha" => "2021"
                        "volumen" => "14"
                        "paginaInicial" => "9188"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriatic patients have a distinct structural and functional fecal microbiota compared with controls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Shapiro"
                            1 => "N&#46;A&#46; Cohen"
                            2 => "V&#46; Shalev"
                            3 => "A&#46; Uzan"
                            4 => "O&#46; Koren"
                            5 => "N&#46; Maharshak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.14933"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "46"
                        "paginaInicial" => "595"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31141234"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dysbiosis of gut microbiota was closely associated with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Huang"
                            1 => "R&#46; Gao"
                            2 => "N&#46; Yu"
                            3 => "Y&#46; Zhu"
                            4 => "Y&#46; Ding"
                            5 => "H&#46; Qin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11427-018-9376-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Sci China Life Sci&#46;"
                        "fecha" => "2019"
                        "volumen" => "62"
                        "paginaInicial" => "807"
                        "paginaFinal" => "815"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30264198"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbiota dysbiosis in a cohort of patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Hidalgo-Cantabrana"
                            1 => "J&#46; G&#243;mez"
                            2 => "S&#46; Delgado"
                            3 => "S&#46; Requena-L&#243;pez"
                            4 => "R&#46; Queiro-Silva"
                            5 => "A&#46; Margolles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "181"
                        "paginaInicial" => "1287"
                        "paginaFinal" => "1295"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut microbial composition in patients with psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;M&#46; Codo&#241;er"
                            1 => "A&#46; Ram&#237;rez-Bosca"
                            2 => "E&#46; Climent"
                            3 => "M&#46; Carri&#243;n-Gutierrez"
                            4 => "M&#46; Guerrero"
                            5 => "J&#46;M&#46; P&#233;rez-Orqu&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-018-22125-y"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep&#46;"
                        "fecha" => "2018"
                        "volumen" => "8"
                        "paginaInicial" => "3812"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29491401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Metagenomic analysis of gut microbiota in non&#8208;treated plaque psoriasis patients stratified by disease severity&#58; development of a new psoriasis&#8208;microbiome index"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Dei-Cas"
                            1 => "F&#46; Giliberto"
                            2 => "L&#46; Luce"
                            3 => "H&#46; Dopazo"
                            4 => "A&#46; Penas-Steinhardt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-020-69537-3"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep&#46;"
                        "fecha" => "2020"
                        "volumen" => "10"
                        "paginaInicial" => "12754"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32728075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psoriasis is associated with elevated gut IL&#8208;1&#945; and intestinal microbiome alterations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Yegorov"
                            1 => "D&#46; Babenko"
                            2 => "S&#46; Kozhakhmetov"
                            3 => "L&#46; Akhmaltdinova"
                            4 => "I&#46; Kadyrova"
                            5 => "A&#46; Nurgozhina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fimmu.2020.571319"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol&#46;"
                        "fecha" => "2020"
                        "volumen" => "11"
                        "paginaInicial" => "571319"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33117362"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The gut microbiota profile in psoriasis&#58; a Brazilian case&#8208;control study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Schade"
                            1 => "D&#46; Mesa"
                            2 => "A&#46;R&#46; Faria"
                            3 => "J&#46;R&#46; Santamaria"
                            4 => "C&#46;A&#46; Xavier"
                            5 => "D&#46; Ribeiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/lam.13630"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lett Appl Microbiol&#46;"
                        "fecha" => "2022"
                        "volumen" => "74"
                        "paginaInicial" => "498"
                        "paginaFinal" => "504"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34897759"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut Microbiome composition associated with major depressive disorder and sleep quality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Q&#46; Zhang"
                            1 => "Y&#46; Yun"
                            2 => "H&#46; An"
                            3 => "W&#46; Zhao"
                            4 => "T&#46; Ma"
                            5 => "Z&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fpsyt.2021.645045"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Psychiatry&#46;"
                        "fecha" => "2021"
                        "volumen" => "12"
                        "paginaInicial" => "645045"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34093266"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intestinal colonization by a lachnospiraceae bacterium contributes to the development of diabetes in obese mice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46; Kameyama"
                            1 => "K&#46; Itoh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1264/jsme2.ME14054"
                      "Revista" => array:6 [
                        "tituloSerie" => "Microbes Environ&#46;"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "427"
                        "paginaFinal" => "430"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25283478"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations between maternal diet&#44; body composition and gut microbial ecology in pregnancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;L&#46; Ruebel"
                            1 => "S&#46;P&#46; Gilley"
                            2 => "C&#46;R&#46; Sims"
                            3 => "Y&#46; Zhong"
                            4 => "D&#46; Turner"
                            5 => "S&#46;V&#46; Chintapalli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13093295"
                      "Revista" => array:5 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "3295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34579172"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gut Prevotella as a possible biomarker of diet and its eubiotic versus dysbiotic roles&#58; a comprehensive literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Precup"
                            1 => "D&#46;C&#46; Vodnar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br J Nutr&#46;"
                        "fecha" => "2019"
                        "volumen" => "122"
                        "paginaInicial" => "131"
                        "paginaFinal" => "140"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Wolters"
                            1 => "Diet"
                            2 => "psoriasis&#58; experimental data"
                            3 => "evidence&#46; clinical"
                            4 => "J&#46; Br"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dermatol"
                        "fecha" => "2005"
                        "volumen" => "153"
                        "paginaInicial" => "706"
                        "paginaFinal" => "714"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A fasting and vegetarian diet treatment trial on chronic inflammatory disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Lithell"
                            1 => "A&#46; Bruce"
                            2 => "I&#46;B&#46; Gustafsson"
                            3 => "N&#46;J&#46; H&#246;glund"
                            4 => "B&#46; Karlstr&#246;m"
                            5 => "K&#46; Ljunghall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "1983"
                        "volumen" => "63"
                        "paginaInicial" => "397"
                        "paginaFinal" => "403"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6197838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High&#8208;fat diet&#8211;induced colonocyte dysfunction escalates microbiota&#8208;derived trimethylamine N&#8208;oxide"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Yoo"
                            1 => "J&#46;K&#46; Zieba"
                            2 => "N&#46;J&#46; Foegeding"
                            3 => "T&#46;P&#46; Torres"
                            4 => "C&#46;D&#46; Shelton"
                            5 => "N&#46;G&#46; Shealy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1126/science.aba3683"
                      "Revista" => array:6 [
                        "tituloSerie" => "Science&#46;"
                        "fecha" => "2021"
                        "volumen" => "373"
                        "paginaInicial" => "813"
                        "paginaFinal" => "818"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34385401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The crosstalk between gut bacteria and host immunity in intestinal inflammation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Q&#46; Yang"
                            1 => "Y&#46; Wang"
                            2 => "A&#46; Jia"
                            3 => "Y&#46; Wang"
                            4 => "Y&#46; Bi"
                            5 => "G&#46; Liu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jcp.30024"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cell Physiol&#46;"
                        "fecha" => "2021"
                        "volumen" => "236"
                        "paginaInicial" => "2239"
                        "paginaFinal" => "2254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32853458"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Microbiota in health and disease &#8208; potential clinical applications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Laudes"
                            1 => "C&#46; Geisler"
                            2 => "N&#46; Rohmann"
                            3 => "J&#46; Bouwman"
                            4 => "T&#46; Pischon"
                            5 => "K&#46; Schlicht"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/nu13020386"
                      "Revista" => array:6 [
                        "tituloSerie" => "Nutrients&#46;"
                        "fecha" => "2021"
                        "volumen" => "13"
                        "paginaInicial" => "386"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33513722"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful treatment of psoriasis with adalimumab induced no changes in the gut microbiota"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46; Todberg"
                            1 => "A&#46; Egeberg"
                            2 => "C&#46; Zachariae"
                            3 => "N&#46; S&#248;rensen"
                            4 => "O&#46; Pedersen"
                            5 => "L&#46; Skov"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2022"
                        "volumen" => "36"
                        "paginaInicial" => "464"
                        "paginaFinal" => "467"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/26662752/0000009800000005/v1_202307310652/S2666275223001017/v1_202307310652/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "89618"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Artigo Original"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009800000005/v1_202307310652/S2666275223001017/v1_202307310652/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275223001017?idApp=UINPBA00008Z"
]
Informação do artigo
ISSN: 26662752
Idioma original: Português
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 28 5 33
2024 Outubro 198 64 262
2024 Setembro 219 106 325
2024 Agosto 242 145 387
2024 Julho 222 100 322
2024 Junho 167 70 237
2024 Maio 156 62 218
2024 Abril 241 96 337
2024 Março 230 83 313
2024 Fevereiro 230 106 336
2024 Janeiro 181 58 239
2023 Dezembro 136 68 204
2023 Novembro 221 105 326
2023 Outubro 185 91 276
2023 Setembro 183 117 300
2023 Agosto 187 67 254
2023 Julho 83 37 120
2023 Junho 80 55 135
2023 Maio 13 6 19
Mostrar tudo

Siga este link para acessar o texto completo do artigo

Idiomas
Anais Brasileiros de Dermatologia (Portuguese)
en pt
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.