{"id":12717,"date":"2024-07-15T12:55:47","date_gmt":"2024-07-15T15:55:47","guid":{"rendered":"https:\/\/www.formularium.com.br\/inform\/?p=12717"},"modified":"2024-08-15T12:51:58","modified_gmt":"2024-08-15T15:51:58","slug":"alternativas-para-o-gerenciamento-da-esclerose-multipla","status":"publish","type":"post","link":"https:\/\/www.formularium.com.br\/inform\/profissionais-da-saude\/alternativas-para-o-gerenciamento-da-esclerose-multipla\/","title":{"rendered":"Alternativas para o gerenciamento da esclerose m\u00faltipla"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><\/div><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1144px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\" style=\"--awb-bg-size:cover;--awb-margin-bottom:0px;width:100%;\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-clearfix\"><\/div><\/div><\/div><div class=\"fusion-text fusion-text-1\"><\/div><\/p>\n<p><span style=\"font-weight: 400;\">Vitaminas, Probi\u00f3ticos e \u00d4mega-3 Promovem A\u00e7\u00e3o Anti-inflamat\u00f3ria e Antioxidante e podem ser <\/span><b>alternativas para o gerenciamento da esclerose m\u00faltipla<\/b><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A Esclerose M\u00faltipla (EM) \u00e9 uma doen\u00e7a autoimune e inflamat\u00f3ria do c\u00e9rebro e medula espinhal, na qual a infiltra\u00e7\u00e3o linfoc\u00edtica focal resulta em danos na mielina e ax\u00f4nio.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Inicialmente, a inflama\u00e7\u00e3o \u00e9 transit\u00f3ria e a remieliniza\u00e7\u00e3o ocorre, mas geralmente n\u00e3o \u00e9 duradoura.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Na frequente EM remitente e recorrente, o curso inicial da doen\u00e7a \u00e9 caracterizado por epis\u00f3dios de disfun\u00e7\u00e3o neurol\u00f3gica que geralmente s\u00e3o readquiridos.<\/span><\/p>\n<h2>Op\u00e7\u00f5es de Suplementos Eficazes na Esclerose M\u00faltipla<\/h2>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>\u00c1cidos Graxos Poli-insaturados (PUFAs)<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>Alguns PUFAs \u00d4mega-3 tem consider\u00e1vel atividade anti-inflamat\u00f3ria, que reduz a secre\u00e7\u00e3o de citocinas pr\u00f3-inflamat\u00f3rias, sugerindo seu papel nos infiltrados inflamat\u00f3rios cerebrais, prevenindo relapsos e atenuando a progress\u00e3o da EM (Schmitz <em>et al<\/em>., 2015).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Vitamina D<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>Possui um papel importante no desenvolvimento do sistema nervoso, e sua forma ativa apresenta extensas fun\u00e7\u00f5es imunomodulat\u00f3rias e anti-inflamat\u00f3rias. Pacientes com EM demonstraram ter n\u00edveis s\u00e9ricos de vitamina D mais baixos em compara\u00e7\u00e3o com aqueles saud\u00e1veis (Kamisli <em>et al<\/em>., 2018).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Vitamina A<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>A vitamina A \u00e9 essencial para m\u00faltiplas fun\u00e7\u00f5es, incluindo manuten\u00e7\u00e3o da integridade do sistema imune. No Sistema Nervoso Central, o \u00e1cido retinoico contribui para regenera\u00e7\u00e3o e plasticidade, enquanto tamb\u00e9m desempenha um papel fundamental no aprimoramento da toler\u00e2ncia e redu\u00e7\u00e3o da resposta inflamat\u00f3ria (Reza Dorosty-Motlagh <em>et al<\/em>., 2016).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Probi\u00f3ticos<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>A microflora intestinal \u00e9 essencial para o bom desenvolvimento e fun\u00e7\u00e3o do sistema imunol\u00f3gico perif\u00e9rico e dist\u00farbios podem prejudicar a toler\u00e2ncia imune e contribuir para o desenvolvimento da EM (Schmitz <em>et al<\/em>., 2015).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h1>Estudos Comprovam Benef\u00edcios da Suplementa\u00e7\u00e3o na Esclerose M\u00faltipla<\/h1>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\u00d8\u00a0 Um estudo comparou a suplementa\u00e7\u00e3o de \u00f4mega-3 e \u00f4mega-6, demonstrou uma melhora na sa\u00fade f\u00edsica e mental ap\u00f3s utiliza\u00e7\u00e3o de \u00f4mega-3 (Schmitz <em>et al<\/em>., 2015).<\/p>\n<p>\u00d8\u00a0 Outro estudo de Sorto-Gomez<em> et al<\/em>. (2016) demonstrou que a administra\u00e7\u00e3o de 4 g ao dia de \u00d4mega-3 promove um menor aumento de Glutationa Redutase comparado ao placebo, sugerindo seu efeito nos mecanismos de defesa antioxidante.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>\u00c1cidos Graxos Poli-insaturados<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\u00d8\u00a0 Laursen <em>et al<\/em>. (2016) observaram que a suplementa\u00e7\u00e3o com 50 \u00b5g a 100 \u00b5g ao dia, variando de acordo com o n\u00edveis s\u00e9ricos de 25(OH)D, em pacientes com SM remitente e recorrente sob uso de terapia padr\u00e3o promoveu corre\u00e7\u00e3o da hipovitaminose D, que foi associada com redu\u00e7\u00e3o da taxa de reca\u00edda anualizada e de EMRR.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Vitamina D<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\u00d8\u00a0 Em um estudo duplo-cego, a suplementa\u00e7\u00e3o com 25.000 UI de vitamina A ao dia na forma de palmitato de retinol, durante 6 meses em pacientes com EMRR reduziu a prolifera\u00e7\u00e3o evocada de glicoprote\u00edna miel\u00ednica oligodendrocit\u00e1ria (MOG) (Schmitz <em>et al<\/em>., 2015).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Vitamina A<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td>\u00d8\u00a0 Kouchaki <em>et al<\/em>. (2017) avaliaram os efeitos da administra\u00e7\u00e3o de probi\u00f3ticos (<em>Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum<\/em> e <em>Lactobacillus fermentum<\/em> 2X10<sup>9<\/sup> UFC cada) em pacientes com EM. Essa suplementa\u00e7\u00e3o demonstrou efeitos favor\u00e1veis no <em>Expanded disability status scale<\/em> (EDSS), par\u00e2metros de sa\u00fade mental, fatores inflamat\u00f3rios, marcadores de resist\u00eancia \u00e0 insulina, HDL e malondialde\u00eddo.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Probi\u00f3ticos<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h1>Formul\u00e1rio Formula\u00e7\u00f5es para Auxiliar no Gerenciamento da Esclerose M\u00faltipla<\/h1>\n<h2>Melhora da Sa\u00fade F\u00edsica e Mental em Pacientes com Esclerose M\u00faltipla<\/h2>\n<table width=\"306\">\n<tbody>\n<tr>\n<td width=\"306\"><strong>C\u00e1psulas de \u00d4mega-3<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"306\">\u00d4mega-3&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.1 g<\/td>\n<\/tr>\n<tr>\n<td width=\"306\">Excipiente qsp&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.1 C\u00e1psula<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Administrar 1 c\u00e1psula de 1 a 4 vezes ao dia ou conforme orienta\u00e7\u00e3o m\u00e9dica.<\/p>\n<p><strong><em>Suplementa\u00e7\u00e3o para Pacientes com EMRR e Hipovitaminose D<\/em><\/strong><\/p>\n<table width=\"307\">\n<tbody>\n<tr>\n<td width=\"307\"><strong>C\u00e1psulas de Vitamina D3<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"307\">Vitamina D3&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;50 a 100 \u00b5g<\/td>\n<\/tr>\n<tr>\n<td width=\"307\">Excipiente qsp&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;1 C\u00e1psula<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Administrar 1 c\u00e1psula ao dia ou conforme orienta\u00e7\u00e3o m\u00e9dica.<\/p>\n<p><strong><em>Redu\u00e7\u00e3o da Prolifera\u00e7\u00e3o de MOG e Redu\u00e7\u00e3o de Escores Funcionais na EMRR<\/em><\/strong><\/p>\n<table width=\"312\">\n<tbody>\n<tr>\n<td width=\"312\"><strong>C\u00e1psulas de Vitamina A<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"312\">Vitamina A (Palmitato de Retinol)..25000 UI<\/td>\n<\/tr>\n<tr>\n<td width=\"312\">Excipiente qsp&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;1 C\u00e1psula<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Administrar 1 c\u00e1psula ao dia ou conforme orienta\u00e7\u00e3o m\u00e9dica.<\/p>\n<ul>\n<li>A suplementa\u00e7\u00e3o com retinil palmitato (25.000 UI\/dia) por 6 meses, seguida da administra\u00e7\u00e3o de 10.000 UI\/dia por mais 6 meses promoveu redu\u00e7\u00e3o do MSFC (<em>Multiple Sclerosis Functional Composite<\/em>) em pacientes com esclerose m\u00faltipla caracterizada por relapso\/remiss\u00e3o (Bitarafan<em>et al<\/em>., 2015).<\/li>\n<\/ul>\n<h1>Outras Formula\u00e7\u00f5es para Pacientes com EM<\/h1>\n<h2>Melhora dos Par\u00e2metros Relacionados \u00e0 Incapacidade, Sa\u00fade Mental, HDL, Insulina e MDA<\/h2>\n<p><strong><em>\u00a0<\/em><\/strong><\/p>\n<table width=\"309\">\n<tbody>\n<tr>\n<td width=\"309\"><strong>C\u00e1psulas Probi\u00f3ticas<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"309\"><em>Lactobacillus acidophilus&#8230;&#8230;&#8230;.<\/em>2X10<sup>9<\/sup> UFC<\/td>\n<\/tr>\n<tr>\n<td width=\"309\"><em>Lactobacillus casei&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/em> 2X10<sup>9<\/sup> UFC<\/td>\n<\/tr>\n<tr>\n<td width=\"309\"><em>Bifidobacterium bifidum&#8230;&#8230;&#8230;..<\/em> 2X10<sup>9<\/sup> UFC<\/td>\n<\/tr>\n<tr>\n<td width=\"309\"><em>Lactobacillus fermentum&#8230;&#8230;&#8230;.<\/em> 2X10<sup>9<\/sup> UFC<\/td>\n<\/tr>\n<tr>\n<td width=\"309\">Excipiente qsp&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;..1 C\u00e1psulas<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Administrar 1 c\u00e1psula ao dia ou conforme orienta\u00e7\u00e3o m\u00e9dica.<\/p>\n<p><strong><em>\u00a0<\/em><\/strong><\/p>\n<p><strong><em>Redu\u00e7\u00e3o da Fadiga e Depress\u00e3o na Esclerose M\u00faltipla<\/em><\/strong><\/p>\n<table width=\"306\">\n<tbody>\n<tr>\n<td width=\"306\"><strong>C\u00e1psulas de Coenzima Q10<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"306\">Coenzima Q10&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.500 mg<\/td>\n<\/tr>\n<tr>\n<td width=\"306\">Excipiente qsp&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.1 C\u00e1psula<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Administrar 1 c\u00e1psula ao dia ou conforme orienta\u00e7\u00e3o m\u00e9dica.<\/p>\n<p>Sanoobar <em>et al<\/em>. (2015) avaliaram os efeitos da coenzima Q10 sobre os escores de depress\u00e3o e fadiga em pacientes com esclerose m\u00faltipla.<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"167\"><strong>Par\u00e2metro<\/strong><\/td>\n<td width=\"149\"><strong>Coenzima Q10<\/strong><\/td>\n<td width=\"159\"><strong>Placebo<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"167\"><strong>FSS<\/strong><\/td>\n<td width=\"149\">Decr\u00e9scimo<\/td>\n<td width=\"159\">Aumento<\/td>\n<\/tr>\n<tr>\n<td width=\"167\"><strong>BDI<\/strong><\/td>\n<td width=\"149\">Decr\u00e9scimo<\/td>\n<td width=\"159\">&#8211;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Conclus\u00e3o.<\/p>\n<p><strong><em>\u00a0<\/em><\/strong><strong><em>\u00a0Este estudo permitiu concluir que a administra\u00e7\u00e3o de coenzima Q10 \u00e9 uma estrat\u00e9gia segura e eficaz para manejo de sintomas associados \u00e0 fadiga e \u00e0 depress\u00e3o, comuns em pacientes com esclerose m\u00faltipla, e que podem afetar de maneira significativa a qualidade de vida dos mesmos.<\/em><\/strong><\/p>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Refer\u00eancia<\/strong><\/p>\n<p>Schmitz K1, Barthelmes J1, Stolz L1, Beyer S1, Diehl O1, Tegeder I2. &#8220;Disease modifying nutricals&#8221; for multiple sclerosis. Pharmacol Ther. 2015 Apr;148:85-113. doi: 10.1016\/j.pharmthera.2014.11.015. Epub 2014 Nov 27.<\/p>\n<p>Laursen JH1, S\u00f8ndergaard HB2, S\u00f8rensen PS2, Sellebjerg F2, Oturai AB2. Vitamin D supplementation reduces relapse rate in relapsing-remitting multiple sclerosis patients treated with natalizumab. Mult Scler Relat Disord. 2016 Nov;10:169-173. doi: 10.1016\/j.msard.2016.10.005. Epub 2016 Oct 26.<\/p>\n<p>Kouchaki E1, Tamtaji OR2, Salami M3, Bahmani F4, Daneshvar Kakhaki R5, Akbari E2, Tajabadi-Ebrahimi M6, Jafari P7, Asemi Z8. Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2017 Oct;36(5):1245-1249. doi: 10.1016\/j.clnu.2016.08.015. Epub 2016 Sep 16.<\/p>\n<p>Sorto-Gomez TE1, Ortiz GG1, Pacheco-Moises FP2, Torres-Sanchez ED1, Ramirez-Ramirez V1, Macias-Islas MA3, de la Rosa AC4, Vel\u00e1zquez-Brizuela IE5. Effect of fish oil on glutathione redox system in multiple sclerosis. Am J Neurodegener Dis. 2016 Jun 1;5(2):145-51. eCollection 2016.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Refer\u00eancia<\/strong><\/p>\n<p>Reza Dorosty-Motlagh A1, Mohammadzadeh Honarvar N2, Sedighiyan M3, Abdolahi M4. The Molecular Mechanisms of Vitamin A Deficiency in Multiple Sclerosis. J Mol Neurosci. 2016 Sep;60(1):82-90. doi: 10.1007\/s12031-016-0781-0. Epub 2016 Jun 29.<\/p>\n<p>Kamisli O1, Acar C2, Sozen M3, Tecellioglu M4, Y\u00fccel FE5, Vaizoglu D6, \u00d6zcan C7. The association between vitamin D receptor polymorphisms and multiple sclerosis in a Turkish population. Mult Scler Relat Disord. 2018 Jan 9;20:78-81. doi: 10.1016\/j.msard.2018.01.002. [Epub ahead of print]<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"100%\">\n<tbody>\n<tr>\n<td><strong>Refer\u00eancia<\/strong><\/p>\n<p>Kouchaki E1, Tamtaji OR2, Salami M3, Bahmani F4, Daneshvar Kakhaki R5, Akbari E2, Tajabadi-Ebrahimi M6, Jafari P7, Asemi Z8. Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled trial. Clin Nutr. 2017 Oct;36(5):1245-1249. doi: 10.1016\/j.clnu.2016.08.015. Epub 2016 Sep 16.<\/p>\n<p>Sanoobar M, Dehghan P, Khalili M, Azimi A, Seifar F. Coenzyme Q10 as a treatment for fatigue and depression in multiple sclerosis patients: A double blind randomized clinical trial. Nutr Neurosci. 2015 Jan 20. [Epub ahead of print]<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong><em>\u00a0<\/em><\/strong><\/p>\n<p><strong><em> <a href=\"https:\/\/www.formularium.com.br\/contato.php\"><img decoding=\"async\" class=\"lazyload aligncenter size-full wp-image-20274\" src=\"https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2.png\" data-orig-src=\"https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2.png\" alt=\"\" width=\"1000\" height=\"300\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%271000%27%20height%3D%27300%27%20viewBox%3D%270%200%201000%20300%27%3E%3Crect%20width%3D%271000%27%20height%3D%27300%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-200x60.png 200w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-300x90.png 300w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-400x120.png 400w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-600x180.png 600w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-768x230.png 768w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2-800x240.png 800w, https:\/\/www.formularium.com.br\/inform\/wp-content\/uploads\/2024\/08\/Formulariu-Blog-002-Lavi-V2.png 1000w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/a><\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vitaminas, Probi\u00f3ticos e \u00d4mega-3 Promovem A\u00e7\u00e3o Anti-inflamat\u00f3ria e Antioxidante e podem ser alternativas para o gerenciamento da esclerose m\u00faltipla. A Esclerose M\u00faltipla (EM) \u00e9 uma doen\u00e7a autoimune e inflamat\u00f3ria do c\u00e9rebro e medula espinhal, na qual a infiltra\u00e7\u00e3o linfoc\u00edtica focal resulta em danos na mielina e ax\u00f4nio. Inicialmente, a inflama\u00e7\u00e3o \u00e9 transit\u00f3ria e a remieliniza\u00e7\u00e3o ocorre,  [&#8230;]<\/p>\n","protected":false},"author":8,"featured_media":12718,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"_joinchat":[],"footnotes":""},"categories":[45],"tags":[],"class_list":["post-12717","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-profissionais-da-saude"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/posts\/12717","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/comments?post=12717"}],"version-history":[{"count":0,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/posts\/12717\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/media\/12718"}],"wp:attachment":[{"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/media?parent=12717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/categories?post=12717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.formularium.com.br\/inform\/wp-json\/wp\/v2\/tags?post=12717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}