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Federico A, Rossi A, Caro G, Magri F, Muscianese M, Di Fraia M, Carlesimo M. Are dissecting cellulitis and hidradenitis suppurativa different diseases? Clin Dermatol 2021; 39:496-499. [PMID: 34518010 DOI: 10.1016/j.clindermatol.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although dissecting cellulitis (DC) and hidradenitis suppurativa (HS) are classified separately, they share many clinical, dermatoscopic, pathogenetic, and histologic aspects, as well as therapeutic options. The association between DC, HS, and acne conglobata represents the follicular occlusion triad or follicular occlusion tetrad, which may include a pilonidal sinus. DC, also known as "folliculitis et perifolliculitis capitis abscendes et suffoidens," is classified as a secondary cicatricial and neutrophilic alopecia. It occurs with perifolliculitis of the scalp, dermal abscesses, sinus tract development, and secondary scarring alopecia. HS, sometimes known as acne inversa, is a chronic relapsing inflammatory disease afflicting apocrine gland-rich areas of the body with painful nodules and abscesses, sinus tracts, and scarring. Given the overlap between the clinical features and the pathogenesis of DC and HS, it would be more appropriate to consider these conditions as two different localizations of the same disease rather than two different pathologies, being a follicular occlusion disease occurring on the scalp and on the apocrine gland-rich areas of the body.
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Affiliation(s)
- Alessandro Federico
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
| | - Alfredo Rossi
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Gemma Caro
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Magri
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marta Muscianese
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Di Fraia
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Marta Carlesimo
- Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Dallio M, Romeo M, Gravina AG, Masarone M, Larussa T, Abenavoli L, Persico M, Loguercio C, Federico A. Nutrigenomics and Nutrigenetics in Metabolic- (Dysfunction) Associated Fatty Liver Disease: Novel Insights and Future Perspectives. Nutrients 2021; 13:nu13051679. [PMID: 34063372 PMCID: PMC8156164 DOI: 10.3390/nu13051679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Metabolic- (dysfunction) associated fatty liver disease (MAFLD) represents the predominant hepatopathy and one of the most important systemic, metabolic-related disorders all over the world associated with severe medical and socio-economic repercussions due to its growing prevalence, clinical course (steatohepatitis and/or hepatocellular-carcinoma), and related extra-hepatic comorbidities. To date, no specific medications for the treatment of this condition exist, and the most valid recommendation for patients remains lifestyle change. MAFLD has been associated with metabolic syndrome; its development and progression are widely influenced by the interplay between genetic, environmental, and nutritional factors. Nutrigenetics and nutrigenomics findings suggest nutrition’s capability, by acting on the individual genetic background and modifying the specific epigenetic expression as well, to influence patients’ clinical outcome. Besides, immunity response is emerging as pivotal in this multifactorial scenario, suggesting the interaction between diet, genetics, and immunity as another tangled network that needs to be explored. The present review describes the genetic background contribution to MAFLD onset and worsening, its possibility to be influenced by nutritional habits, and the interplay between nutrients and immunity as one of the most promising research fields of the future in this context.
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Affiliation(s)
- Marcello Dallio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy; (M.R.); (A.G.G.); (C.L.); (A.F.)
- Correspondence: ; Tel.: +39-0815666740
| | - Mario Romeo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy; (M.R.); (A.G.G.); (C.L.); (A.F.)
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy; (M.R.); (A.G.G.); (C.L.); (A.F.)
| | - Mario Masarone
- Department of Medicine and Surgery, University of Salerno, Via Allende, 84081 Baronissi, Italy; (M.M.); (M.P.)
| | - Tiziana Larussa
- Department of Health Sciences, University Magna Graecia, viale Europa, 88100 Catanzaro, Italy; (T.L.); (L.A.)
| | - Ludovico Abenavoli
- Department of Health Sciences, University Magna Graecia, viale Europa, 88100 Catanzaro, Italy; (T.L.); (L.A.)
| | - Marcello Persico
- Department of Medicine and Surgery, University of Salerno, Via Allende, 84081 Baronissi, Italy; (M.M.); (M.P.)
| | - Carmelina Loguercio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy; (M.R.); (A.G.G.); (C.L.); (A.F.)
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via S. Pansini 5, 80131 Naples, Italy; (M.R.); (A.G.G.); (C.L.); (A.F.)
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Federico A, Rosato V, Masarone M, Torre P, Dallio M, Romeo M, Persico M. The Role of Fructose in Non-Alcoholic Steatohepatitis: Old Relationship and New Insights. Nutrients 2021; 13:1314. [PMID: 33923525 PMCID: PMC8074203 DOI: 10.3390/nu13041314] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/22/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents the result of hepatic fat overload not due to alcohol consumption and potentially evolving to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Fructose is a naturally occurring simple sugar widely used in food industry linked to glucose to form sucrose, largely contained in hypercaloric food and beverages. An increasing amount of evidence in scientific literature highlighted a detrimental effect of dietary fructose consumption on metabolic disorders such as insulin resistance, obesity, hepatic steatosis, and NAFLD-related fibrosis as well. An excessive fructose consumption has been associated with NAFLD development and progression to more clinically severe phenotypes by exerting various toxic effects, including increased fatty acid production, oxidative stress, and worsening insulin resistance. Furthermore, some studies in this context demonstrated even a crucial role in liver cancer progression. Despite this compelling evidence, the molecular mechanisms by which fructose elicits those effects on liver metabolism remain unclear. Emerging data suggest that dietary fructose may directly alter the expression of genes involved in lipid metabolism, including those that increase hepatic fat accumulation or reduce hepatic fat removal. This review aimed to summarize the current understanding of fructose metabolism on NAFLD pathogenesis and progression.
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Affiliation(s)
- Alessandro Federico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.D.); (M.R.)
| | - Valerio Rosato
- Internal Medicine and Hepatology Division, Department of Medicine, Surgery and Odontostomatology, “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.R.); (M.M.); (P.T.); (M.P.)
- Liver Unit, Ospedale Evangelico Betania, 80147 Naples, Italy
| | - Mario Masarone
- Internal Medicine and Hepatology Division, Department of Medicine, Surgery and Odontostomatology, “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.R.); (M.M.); (P.T.); (M.P.)
| | - Pietro Torre
- Internal Medicine and Hepatology Division, Department of Medicine, Surgery and Odontostomatology, “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.R.); (M.M.); (P.T.); (M.P.)
| | - Marcello Dallio
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.D.); (M.R.)
| | - Mario Romeo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy; (M.D.); (M.R.)
| | - Marcello Persico
- Internal Medicine and Hepatology Division, Department of Medicine, Surgery and Odontostomatology, “Scuola Medica Salernitana”, University of Salerno, 84084 Salerno, Italy; (V.R.); (M.M.); (P.T.); (M.P.)
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Izzo L, Santonastaso A, Cotticelli G, Federico A, Pacifico S, Castaldo L, Colao A, Ritieni A. An Italian Survey on Dietary Habits and Changes during the COVID-19 Lockdown. Nutrients 2021; 13:1197. [PMID: 33916384 PMCID: PMC8065756 DOI: 10.3390/nu13041197] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/26/2021] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
The World Health Organization has declared the coronavirus outbreak a Public Health Emergency of International Concern; the outbreak has led to lockdowns in several parts of the world, and sudden changes in people's lifestyles. This study explores the impact of the first coronavirus disease 2019 (COVID-19) pandemic period on dietary habits, lifestyle changes, and adherence to the Mediterranean diet among the Italian population, through an online questionnaire, conducted from April to May 2020, involving 1519 participants. The 14-point Mediterranean Diet Adherence Screener (MEDAS) highlighted a medium Mediterranean diet adherence in 73.5% of responders, which principally included the younger population, aged 18-30 years (p < 0.05). In regards to changes in eating habits, 33.5% of responders declared an influence of the pandemic period on nutritional practice. A decrease in alcohol consumption was reported by 81% of responders, while an increase in frozen food consumption was reported by 81.3% of responders. In addition, 58.8% reported positive weight modification (40.8%, +1-3 kg); physical activity reduction was reported for 70.5% of responders. Our study contributes toward amplifying the investigation on the dietary habits and changes of the Italian population during the COVID-19 lockdown, although the pandemic is ongoing. Similar studies should be performed around the world to understand how the emergency has impacted people's habits.
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Affiliation(s)
- Luana Izzo
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
| | - Antonio Santonastaso
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Gaetano Cotticelli
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Alessandro Federico
- Department of Precision Medicine, Hepatogastroenterology Division, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy; (A.S.); (G.C.); (A.F.)
| | - Severina Pacifico
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Via Vivaldi 43, 81100 Caserta, Italy;
| | - Luigi Castaldo
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Unit of Endocrinology, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy;
- UNESCO Chair on Health Education and Sustainable Development, “Federico II” University, 80131 Naples, Italy
| | - Alberto Ritieni
- Department of Pharmacy, University of Naples “Federico II”, Via Domenico Montesano 49, 80131 Naples, Italy;
- UNESCO Chair on Health Education and Sustainable Development, “Federico II” University, 80131 Naples, Italy
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Bianco C, Jamialahmadi O, Pelusi S, Baselli G, Dongiovanni P, Zanoni I, Santoro L, Maier S, Liguori A, Meroni M, Borroni V, D'Ambrosio R, Spagnuolo R, Alisi A, Federico A, Bugianesi E, Petta S, Miele L, Vespasiani-Gentilucci U, Anstee QM, Stickel F, Hampe J, Fischer J, Berg T, Fracanzani AL, Soardo G, Reeves H, Prati D, Romeo S, Valenti L. Non-invasive stratification of hepatocellular carcinoma risk in non-alcoholic fatty liver using polygenic risk scores. J Hepatol 2021; 74:775-782. [PMID: 33248170 PMCID: PMC7987554 DOI: 10.1016/j.jhep.2020.11.024] [Citation(s) in RCA: 173] [Impact Index Per Article: 57.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) risk stratification in individuals with dysmetabolism is a major unmet need. Genetic predisposition contributes to non-alcoholic fatty liver disease (NAFLD). We aimed to exploit robust polygenic risk scores (PRS) that can be evaluated in the clinic to gain insight into the causal relationship between NAFLD and HCC, and to improve HCC risk stratification. METHODS We examined at-risk individuals (NAFLD cohort, n = 2,566; 226 with HCC; and a replication cohort of 427 German patients with NAFLD) and the general population (UK Biobank [UKBB] cohort, n = 364,048; 202 with HCC). Variants in PNPLA3-TM6SF2-GCKR-MBOAT7 were combined in a hepatic fat PRS (PRS-HFC), and then adjusted for HSD17B13 (PRS-5). RESULTS In the NAFLD cohort, the adjusted impact of genetic risk variants on HCC was proportional to the predisposition to fatty liver (p = 0.002) with some heterogeneity in the effect. PRS predicted HCC more robustly than single variants (p <10-13). The association between PRS and HCC was mainly mediated through severe fibrosis, but was independent of fibrosis in clinically relevant subgroups, and was also observed in those without severe fibrosis (p <0.05). In the UKBB cohort, PRS predicted HCC independently of classical risk factors and cirrhosis (p <10-7). In the NAFLD cohort, we identified high PRS cut-offs (≥0.532/0.495 for PRS-HFC/PRS-5) that in the UKBB cohort detected HCC with ~90% specificity but limited sensitivity; PRS predicted HCC both in individuals with (p <10-5) and without cirrhosis (p <0.05). CONCLUSIONS Our results are consistent with a causal relationship between hepatic fat and HCC. PRS improved the accuracy of HCC detection and may help stratify HCC risk in individuals with dysmetabolism, including those without severe liver fibrosis. Further studies are needed to validate our findings. LAY SUMMARY By analyzing variations in genes that contribute to fatty liver disease, we developed two risk scores to help predict liver cancer in individuals with obesity-related metabolic complications. These risk scores can be easily tested in the clinic. We showed that the risk scores helped to identify the risk of liver cancer both in high-risk individuals and in the general population.
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Affiliation(s)
- Cristiana Bianco
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Oveis Jamialahmadi
- Department of Clinical and Molecular Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Serena Pelusi
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Guido Baselli
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Dongiovanni
- General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Zanoni
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luigi Santoro
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Maier
- Clinic of Internal Medicine - Liver Unit, Department of Medical Area (DAME), Università degli Studi di Udine, Udine, Italy
| | - Antonio Liguori
- Department of Internal Medicine, Fondazione Policlinico A. Gemelli, Università Cattolica di Roma, Rome, Italy
| | - Marica Meroni
- General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vittorio Borroni
- Unit of Medicine, ASST Valle Olona, Ospedale di Gallarate, Varese, Italy
| | - Roberta D'Ambrosio
- Division of Gastroenterology and Hepatology, CRC "A.M. and A. Migliavacca" Center for Liver Disease, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rocco Spagnuolo
- Department of Clinical and Molecular Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Alisi
- Research Unit of Molecular Genetics of Complex Phenotypes, IRCCS Ospedale Bambino Gesù, Rome, Italy
| | - Alessandro Federico
- Division of Hepatogastroenterology, Deparment of Precision Medicine, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastro-Hepatology, A.O. Città della Salute e della Scienza di Torino, Università di Torino, Turin, Italy
| | - Salvatore Petta
- Gastroenterology and Hepatology, PROMISE, Università di Palermo, Palermo, Italy
| | - Luca Miele
- Department of Internal Medicine, Fondazione Policlinico A. Gemelli, Università Cattolica di Roma, Rome, Italy
| | | | - Quentin M Anstee
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Felix Stickel
- Department of Gastroenterology and Hepatology, University Hospital of Zürich, Switzerland
| | - Jochen Hampe
- Medical Department 1, University Hospital Dresden, TU Dresden, Germany
| | - Janett Fischer
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Laboratory for Clinical and Experimental Hepatology, Leipzig, Germany
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Laboratory for Clinical and Experimental Hepatology, Leipzig, Germany
| | - Anna Ludovica Fracanzani
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; General Medicine and Metabolic Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Soardo
- Clinic of Internal Medicine - Liver Unit, Department of Medical Area (DAME), Università degli Studi di Udine, Udine, Italy; Italian Liver Foundation, Area Science Park, Basovizza Campus, Trieste, Italy
| | - Helen Reeves
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Daniele Prati
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Romeo
- Department of Clinical and Molecular Medicine, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden; Clinical Nutrition Unit, Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy.
| | - Luca Valenti
- Translational Medicine - Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
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Vietri MT, D'Elia G, Caliendo G, Casamassimi A, Federico A, Passariello L, Cioffi M, Molinari AM. Prevalence of mutations in BRCA and MMR genes in patients affected with hereditary endometrial cancer. Med Oncol 2021; 38:13. [PMID: 33484353 PMCID: PMC7826304 DOI: 10.1007/s12032-021-01454-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/01/2021] [Indexed: 10/29/2022]
Abstract
Endometrial cancer (EC) is the fifth most common cancer in women from developed countries, accounting for 4.8% of new cases and 2.1% of deaths. The genetic basis for the familial risk of endometrial cancer has not been completely defined. Mostly, hereditary EC is part of two syndromes as Lynch syndrome (LS) and Hereditary Breast and Ovarian Cancer syndrome (HBOC). LS is the prototypical hereditary cancer syndrome in EC and accounts for 2-6% of all endometrial cancers. This disease is caused by autosomal dominant mutations in DNA mismatch repair (MMR) genes. Patients carrying a germline mutation in one of the MMR genes have a cumulative lifetime risk to develop EC of 20-70%. HBOC is an autosomal dominantly inherited disease, which mostly predisposes to breast and ovarian cancers, but it can be also associated with other malignancies. HBOC results from germline mutations in BRCA1/2 genes. The aim of this study was to determine the mutational status of a cohort of 40 EC patients, 19 belonging to families with LS and 21 to HBOC. Mutation analysis of MLH1, MSH2, BRCA1 and BRCA2 genes showed pathogenic variants in 17/40 (42.5%) patients. Out of 19 patients belonging to LS families, 8 (42.1%) showed a pathogenic variant. Out of 21 patients belonging to HBOC families, 9 (42.8%) showed a pathogenic variant. 1/21 (4.8%) patient report 1 variant of unknown significance (UV), c.599 C > T (p.T200I), in BRCA2. Moreover, in 1/21 (4.8%) patient we identified a novel missense variant in BRCA2, c.9541A > T (p.Met3181Leu). Mutational analysis was extended to family members, both healthy and cancer affected, of mutated patients; all the tested relatives affected with cancer displayed the pathogenic variant. Our data suggest that patients with hereditary EC have a high percentage of mutations in the LS and HBOC main susceptibility genes; therefore, the surveillance for EC, already indicated in LS patients, should also be recommended for patients with HBOC.
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Affiliation(s)
- Maria Teresa Vietri
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy. .,U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
| | - Giovanna D'Elia
- U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Gemma Caliendo
- U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Amelia Casamassimi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.,U.O.C. Hepato-Gastroenterology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Luana Passariello
- U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Michele Cioffi
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.,U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Anna Maria Molinari
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.,U.O.C. Clinical and Molecular Pathology, A.O.U. University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
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Gravina AG, Tessitore A, Ormando VM, Nagar F, Romeo M, Amato MR, Dallio M, Loguercio C, Federico A, Romano M, Ferraro F. May chronic cough in chronic obstructive pulmonary disease be a contraindication of Percutaneous Endoscopic Gastrostomy placement: a case report. BMC Gastroenterol 2021; 21:31. [PMID: 33478385 PMCID: PMC7819233 DOI: 10.1186/s12876-021-01603-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 01/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Percutaneous Endoscopic Gastrostomy (PEG) can involve some complications, despite the good safety of its track record. The Buried Bumper Syndrome (BBS) is a rare, late and dangerous complication that consists in the erosion of the internal bumper through the gastric wall. Case presentation We report the development of BBS in a man with chronic obstructive pulmonary disease (COPD) who had a persistent chronic cough which was prevalently but not solely in the morning and required placement of a PEG tube for continuous infusion of Levodopa/carbidopa intestinal gel for advanced Parkinson's disease. Conclusion We believe that COPD with chronic cough while not representing an absolute contraindication to PEG placement, may potentially cause BBS and therefore an appropriate regimen of tube care by expert personnel is mandatory in this setting.
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Affiliation(s)
- A G Gravina
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy.
| | - A Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - V M Ormando
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - F Nagar
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M Romeo
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - M R Amato
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - M Dallio
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - C Loguercio
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - A Federico
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - M Romano
- Hepatogastropenterology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via Pansini, 5, 80131, Naples, Italy
| | - F Ferraro
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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Masarone M, Troisi J, Aglitti A, Torre P, Colucci A, Dallio M, Federico A, Balsano C, Persico M. Untargeted metabolomics as a diagnostic tool in NAFLD: discrimination of steatosis, steatohepatitis and cirrhosis. Metabolomics 2021; 17:12. [PMID: 33458794 DOI: 10.1007/s11306-020-01756-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease encompasses a spectrum of diseases ranging from simple steatosis to steatohepatitis (or NASH), up to cirrhosis and hepatocellular carcinoma (HCC). The challenge is to recognize the more severe and/or progressive pathology. A reliable non-invasive method does not exist. Untargeted metabolomics is a novel method to discover biomarkers and give insights on diseases pathophysiology. OBJECTIVES We applied metabolomics to understand if simple steatosis, steatohepatitis and cirrhosis in NAFLD patients have peculiar metabolites profiles that can differentiate them among each-others and from controls. METHODS Metabolomics signatures were obtained from 307 subjects from two separated enrollments. The first collected samples from 69 controls and 144 patients (78 steatosis, 23 NASH, 15 NASH-cirrhosis, 8 HCV-cirrhosis, 20 cryptogenic cirrhosis). The second, used as validation-set, enrolled 44 controls and 50 patients (34 steatosis, 10 NASH and 6 NASH-cirrhosis).The "Partial-Least-Square Discriminant-Analysis"(PLS-DA) was used to reveal class separation in metabolomics profiles between patients and controls and among each class of patients, and to reveal the metabolites contributing to class differentiation. RESULTS Several metabolites were selected as relevant, in particular:Glycocholic acid, Taurocholic acid, Phenylalanine, branched-chain amino-acids increased at the increase of the severity of the disease from steatosis to NASH, NASH-cirrhosis, while glutathione decreased (p < 0.001 for each). Moreover, an ensemble machine learning (EML) model was built (comprehending 10 different mathematical models) to verify diagnostic performance, showing an accuracy > 80% in NAFLD clinical stages prediction. CONCLUSIONS Metabolomics profiles of NAFLD patients could be a useful tool to non-invasively diagnose NAFLD and discriminate among the various stages of the disease, giving insights into its pathophysiology.
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Affiliation(s)
- Mario Masarone
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Jacopo Troisi
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
- Theoreo srl, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy
- European Biomedical Research Institute of Salerno (EBRIS), Via S. de Renzi, 3, 84125, Salerno, SA, Italy
- Hosmotic srl, Via R. Bosco 178, 80069, Vico Equense, NA, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Pietro Torre
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Angelo Colucci
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
- Theoreo srl, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy
| | - Marcello Dallio
- Hepatogastroenterology Division, University of Campania "Luigi Vanvitelli", Via S Pansini 5, 80131, Naples, Italy
| | - Alessandro Federico
- Hepatogastroenterology Division, University of Campania "Luigi Vanvitelli", Via S Pansini 5, 80131, Naples, Italy
| | - Clara Balsano
- MESVA Department, University of L'Aquila, Piazza S. Salvatore Tommasi 1, 67100, Coppito, L'Aquila, Italy
- F. Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy.
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59
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Gravina AG, Priadko K, Ciamarra P, Granata L, Facchiano A, Miranda A, Dallio M, Federico A, Romano M. Extra-Gastric Manifestations of Helicobacter pylori Infection. J Clin Med 2020; 9:jcm9123887. [PMID: 33265933 PMCID: PMC7761397 DOI: 10.3390/jcm9123887] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Helicobacter Pylori (H. pylori) is a Gram-negative flagellated microorganism that has been extensively studied since its first isolation due to its widespread diffusion and association with numerous diseases. While the bacterium is proved to be a causative factor for a number of gastric diseases such as gastritis, gastric adenocarcinoma, and MALT-lymphoma, its role at other gastrointestinal levels and in other systems is being thoroughly studied. In this article, we reviewed the latest published clinical and laboratory studies that investigated associations of H. pylori with hematologic diseases such as Vitamin B12- and iron-deficiency anemia, primary immune thrombocytopenia, and with a number of dermatologic and ophthalmic diseases. In addition, the putative role of the bacterium in inflammatory bowel diseases, esophageal disorders, metabolic, diseases, neurologic diseases and allergy were outlined.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marco Romano
- Correspondence: (A.G.G.); (M.R.); Tel.: +39-3382465767 (A.G.G.)
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60
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Ferrandina G, Gallotta V, Federico A, Fanfani F, Ercoli A, Chiantera V, Cosentino F, Turco LC, Legge F, Anchora LP, Bizzarri N, Moroni R, Macchia G, Valentini V, Scambia G. Minimally Invasive Approaches in Locally Advanced Cervical Cancer Patients Undergoing Radical Surgery After Chemoradiotherapy: A Propensity Score Analysis. Ann Surg Oncol 2020; 28:3616-3626. [PMID: 33165720 PMCID: PMC8184543 DOI: 10.1245/s10434-020-09302-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/13/2020] [Indexed: 12/24/2022]
Abstract
Purpose Chemoradiation (CT/RT) followed by radical surgery (RS) may play a role in locally advanced cervical cancer (LACC) patients with suboptimal response to CT/RT or in low-income countries with limited access to radiotherapy. Our aim is to evaluate oncological and surgical outcomes of minimally invasive radical surgery (MI-RS) compared with open radical surgery (O-RS). Patients and Methods Data for stage IB2–IVA cervical cancer patients managed by CT/RT and RS were retrospectively analyzed. Results Beginning with 686 patients, propensity score matching resulted in 462 cases (231 per group), balanced for FIGO stage, lymph node status, histotype, tumor grade, and clinical response to CT/RT. The 5-year disease-free survival (DFS) was 73.7% in the O-RS patients and 73.0% in the MI-RS patients (HR 1.034, 95% CI 0.708–1.512, p = 0.861). The 5-year locoregional recurrence rate was 12.5% (O-RS) versus 15.2% (MI-RS) (HR 1.174, 95% CI 0.656–2.104, p = 0.588). The 5-year disease-specific survival (DSS) was 80.4% in O-RS patients and 85.3% in the MI-RS group (HR 0.731, 95% CI 0.438–1.220, p = 0.228). Estimated blood loss was lower in the MI-RS group (p < 0.001), as was length of hospital stay (p < 0.001). Early postoperative complications occurred in 77 patients (33.3%) in the O-RS group versus 88 patients (38.1%) in the MI-RS group (p = 0.331). Fifty-six (24.2%) patients experienced late postoperative complications in the O-RS group, versus 61 patients (26.4%) in the MI-RS group (p = 0.668). Conclusion MI-RS and O-RS are associated with similar rates of recurrence and death in LACC patients managed by surgery after CT/RT. No difference in early or late complications was reported. Electronic supplementary material The online version of this article (10.1245/s10434-020-09302-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G Ferrandina
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Gallotta
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Federico
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - F Fanfani
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Ercoli
- Department of Obstetrics and Gynecology, University of Messina, Messina, Italy
| | - V Chiantera
- Department of Gynecologic Oncology, University of Palermo, Palermo, Italy
| | - F Cosentino
- Gynecologic Oncology, Gemelli Molise, Campobasso, Italy
| | - L C Turco
- Gynecology and Breast Care Unit, Mater Olbia Hospital, Olbia, Italy
| | - F Legge
- Gynecologic Oncology Unit, Department Obstetrics/Gynecology "F. Miulli" General Regional Hospital, Acquaviva delle Fonti, Bari, Italy
| | - L Pedone Anchora
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - N Bizzarri
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - R Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario A.Gemelli, IRCCS, Rome, Italy
| | - G Macchia
- Radiotherapy Unit, Gemelli Molise Hospital, Campobasso, Italy
| | - V Valentini
- Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC di Radioterapia, Rome, Italy.,Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Scambia
- Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Istituto di Ginecologia e Ostetricia, Università Cattolica del Sacro Cuore, Rome, Italy
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61
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Pisaturo M, Starace M, Minichini C, De Pascalis S, Macera M, Occhiello L, Messina V, Sangiovanni V, Claar E, Precone D, Stornaiuolo G, Stanzione M, Gentile I, Brancaccio G, Martini S, Masiello A, Megna AS, Coppola C, Federico A, Sagnelli E, Persico M, Lanza AG, Marrone A, Gaeta GB, Coppola N. Patients with HCV genotype-1 who have failed a direct-acting antiviral regimen: virological characteristics and efficacy of retreatment. Antivir Ther 2020; 24:485-493. [PMID: 30758299 DOI: 10.3851/imp3296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND This real-world clinical setting study characterized the virological patterns in genotype-1 patients failing interferon (IFN)-free regimens and evaluated the efficacy of re-treatment. METHODS A total of 73 consecutive patients failing IFN-free regimens were enrolled (17 genotype-1a and 56 -1b). At failure Sanger sequencing of NS3, NS5A and NS5B regions was performed by home-made protocols. RESULTS In patients having failed an NS3 inhibitor, the prevalence of NS3-RASs was higher in the 10 with genotype-1a than in the 24 with genotype-1b (80% versus 41.6%). In patients treated with an NS5A inhibitor, the prevalence of NS5A-RASs was very high in the 14 with genotype-1a and the 27 with genotype-1b (78.6% and 92.5%, respectively). In patients having failed sofosbuvir, the prevalence of NS5B-RASs was more frequently identified in the 45 with genotype-1b than in the 10 with genotype-1a (37.7% versus 10%). The prevalence of NS5B-RASs in patients having failed dasabuvir was high in both genotypes, 66.6% in the 6 with genotype-1a and 45.5% in the 11 with genotype-1b. The 6 patients re-treated with genotype-1a less frequently (50%) showed sustained virological response (SVR) than the 18 with genotype-1b (88.8%; P=0.07). SVR was more frequent in the 21 patients with an effective second-line direct-acting antiviral (DAA) regimen than the 3 without (90.4% versus 0%; P<0.005). CONCLUSIONS The prevalence of RASs was high in our real-world population. NS3, NS5A and NS5B sequencing seems mandatory in the choice of DAA re-treatment.
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Affiliation(s)
- Mariantonietta Pisaturo
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy
| | - Mario Starace
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy
| | - Carmine Minichini
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy
| | - Stefania De Pascalis
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Margherita Macera
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Laura Occhiello
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy
| | - Vincenzo Messina
- Infectious Diseases Unit, A.O. S Anna and S Sebastiano Caserta, Caserta, Italy
| | | | - Ernesto Claar
- Internal Medicine Unit, Evangelical Hospital Villa Betania, Naples, Italy
| | - Davide Precone
- Internal Medicine Unit A.O. Sarno, Sarno (SA)Campania L. Vanvitelli, & Infectious and Transplant Medicine, AORN Ospedali dei Colli- Monaldi Hospital, Naples, Italy
| | - Gianfranca Stornaiuolo
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Maria Stanzione
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Ivan Gentile
- Infectious Diseases Unit, University Federico II, Naples, Italy
| | - Giuseppina Brancaccio
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | | | | | | | | | - Alessandro Federico
- Internal Medicine and Hepatology Department of Clinical and Experimental Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Evangelista Sagnelli
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, PO G. Da Procida-AOU- San Giovanni and Ruggi D'Aragona, University of Salerno, Salerno Italy
| | | | - Aldo Marrone
- Department of Medical, Surgical, Neurological, Metabolic, and Geriatric Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | - Giovanni Battista Gaeta
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania L. Vanvitelli, Naples, Italy
| | - Nicola Coppola
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania L. Vanvitelli, Naples, Italy.,Infectious Diseases Unit, A.O. S Anna and S Sebastiano Caserta, Caserta, Italy
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Romano M, Gravina AG, Nardone G, Federico A, Dallio M, Martorano M, Mucherino C, Romiti A, Avallone L, Granata L, Priadko K, Compare D, Tuccillo C, Romito MR, Sgambato D, Miranda A, Romano L, Loguercio C, Bazzoli F, Zagari RM. Non-bismuth and bismuth quadruple therapies based on previous clarithromycin exposure are as effective and safe in an area of high clarithromycin resistance: A real-life study. Helicobacter 2020; 25:e12694. [PMID: PMID: 32314519 DOI: 10.1111/hel.12694] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/14/2020] [Accepted: 03/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Bismuth quadruple (BQT) and non-bismuth quadruple (N-BQT) therapies are the recommended first-line treatments for Helicobacter (H.) pylori infection. OBJECTIVE To compare the efficacy of BQT and N-BQT in clinical practice in an area with high clarithromycin resistance, choosing the regimen on the basis of previous exposure to clarithromycin. METHODS A total of 404 consecutive H pylori-positive, naïve patients were enrolled. A total of 203 patients without previous exposure to clarithromycin received N-BQT, 100 patients for 10 days and 103 for 14 days, whereas 201 with previous exposure to clarithromycin received 10-day BQT. Efficacy and treatment-related adverse events were assessed. RESULTS AND CONCLUSIONS Eradication rates by intention-to-treat analysis were 88.2% for N-BQT and 91.5% for BQT (P = .26); per-protocol analysis eradication rates were 91.2% and 95.8% for N-BQT and BQT, respectively (P = .07). Eradication rates were significantly higher with 14-day than 10-day CT (P < .003). Almost all patients had a good compliance with both N-BQT (95.6%) and BQT (95%). Adverse events occurred in 24.1% and 26.9% (P = .53) of patients in the N-BQT and BQT group, respectively. In conclusion, clarithromycin-containing non-bismuth or bismuth quadruple therapy, based on the knowledge of previous clarithromycin exposure, is effective and safe even in an area of high prevalence of clarithromycin-resistant H pylori strains.
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Affiliation(s)
- Marco Romano
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonietta Gerarda Gravina
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gerardo Nardone
- Division of Gastroenterology, "Federico II" University, Naples, Italy
| | - Alessandro Federico
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcello Dallio
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Martorano
- Gastroenterology and Endoscopy Unit, Immacolata Hospital, Sapri, Italy
| | - Caterina Mucherino
- Gastroenterology and Endoscopy Unit, S. Anna-S. Sebastiano Hospital, Caserta, Italy
| | - Alessandra Romiti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Luciana Avallone
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lucia Granata
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Katerina Priadko
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Debora Compare
- Division of Gastroenterology, "Federico II" University, Naples, Italy
| | - Concetta Tuccillo
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Dolores Sgambato
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Agnese Miranda
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lorenzo Romano
- Surgical Digestive Endoscopy, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Carmelina Loguercio
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Franco Bazzoli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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63
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Bersano A, Kraemer M, Burlina A, Mancuso M, Finsterer J, Sacco S, Salvarani C, Caputi L, Chabriat H, Oberstein SL, Federico A, Tournier-Lasserve E, Hunt D, Dichgans M, Arnold M, Debette S, Markus HS. Correction to: Heritable and non-heritable uncommon causes of stroke. J Neurol 2020; 268:2808-2809. [PMID: 32556534 DOI: 10.1007/s00415-020-09948-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Bersano
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - M Kraemer
- Department of Neurology Alfried, Krupp-Hospital, Essen, Germany.,Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - A Burlina
- Neurological Unit, St. Bassano Hospital, Bassano del Grappa, Italy
| | - M Mancuso
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - J Finsterer
- Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria
| | - S Sacco
- Department of Neurology, Avezzano Hospital, University of L'Aquila, L'Aquila, Italy
| | - C Salvarani
- University of Modena and Reggio Emilia, and Azienda USL-IRCCS, Reggio Emilia, Italy
| | - L Caputi
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - H Chabriat
- Department of Neurology and CERVCO, DHU Neurovasc, INSERM U1141, University of Paris, Paris, France
| | - S Lesnik Oberstein
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - E Tournier-Lasserve
- Department of Genetics, Lariboisière Hospital and INSERM U1141, Paris-Diderot University, Paris, France
| | - D Hunt
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - M Dichgans
- Institute for Stroke and Dementia Research, Klinikum Der Universität München, Munich, Germany
| | - M Arnold
- Inserm Centre Bordeaux Population Health (U1219), University of Bordeaux, Bordeaux, France
| | - S Debette
- Department of Neurology, INSELSPITAL, University Hospital Bern, Bern, Switzerland
| | - H S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Abstract
INTRODUCTION Recently CDK4/6 inhibitors have been introduced for the treatment of hormone positive breast cancer resistant to endocrine therapy. Among their side effects, alopecia is often reported being associated to patients' distress and depressive symptoms. CASE REPORT We report the case of a 70-year-old woman affected by breast cancer in treatment with Palbociclib, who developed alopecia.Management and Outcome: We prescribed a topical solution with cetirizine. Global photography, trichoscopy and trichogram were assessed. All evaluations demonstrated alopecia improvement. DISCUSSION Currently, no treatment options for CDK 4/6 inhibitors induced alopecia have been proposed. Herein, we report the use of topical cetirizine.
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Affiliation(s)
- Gemma Caro
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Maria C Fortuna
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Francesca Magri
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Alessandro Federico
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Marta Carlesimo
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
| | - Alfredo Rossi
- Department of Ematology, Oncology and Dermatology, "Sapienza" University of Rome, Rome, Italy
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65
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Mancuso M, Arnold M, Bersano A, Burlina A, Chabriat H, Debette S, Enzinger C, Federico A, Filla A, Finsterer J, Hunt D, Lesnik Oberstein S, Tournier-Lasserve E, Markus HS. Monogenic cerebral small-vessel diseases: diagnosis and therapy. Consensus recommendations of the European Academy of Neurology. Eur J Neurol 2020; 27:909-927. [PMID: 32196841 DOI: 10.1111/ene.14183] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Guidelines on monogenic cerebral small-vessel disease (cSVD) diagnosis and management are lacking. Endorsed by the Stroke and Neurogenetics Panels of the European Academy of Neurology, a group of experts has provided recommendations on selected monogenic cSVDs, i.e. cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL), autosomal dominant High Temperature Requirement A Serine Peptidase 1 (HTRA1), cathepsin-A-related arteriopathy with strokes and leukoencephalopathy (CARASAL), pontine autosomal dominant microangiopathy and leukoencephalopathy (PADMAL), Fabry disease, mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) and type IV collagen (COL4)A1/2. METHODS We followed the Delphi methodology to provide recommendations on several unanswered questions related to monogenic cSVD, including genetic testing, clinical and neuroradiological diagnosis, and management. RESULTS We have proposed 'red-flag' features suggestive of a monogenic disease. General principles applying to the management of all cSVDs and specific recommendations for the individual forms of monogenic cSVD were agreed by consensus. CONCLUSIONS The results provide a framework for clinicians involved in the diagnosis and management of monogenic cSVD. Further multicentre observational and treatment studies are still needed to increase the level of evidence supporting our recommendations.
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Affiliation(s)
- M Mancuso
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - M Arnold
- Department of Neurology, INSELSPITAL, University Hospital Bern, Bern, Switzerland
| | - A Bersano
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Burlina
- Neurological Unit, St. Bassiano Hospital, Bassano del Grappa, Italy
| | - H Chabriat
- Department of Neurology and CERVCO, DHU Neurovasc, INSERM U1141, University of Paris, Paris, France
| | - S Debette
- Department of Neurology, INSERM Centre Bordeaux Population Health (U1219), Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - C Enzinger
- Department of Neurology and Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - A Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - A Filla
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Napoli, Italy
| | - J Finsterer
- Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria
| | - D Hunt
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - S Lesnik Oberstein
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - E Tournier-Lasserve
- Department of Genetics, Lariboisière Hospital and INSERM U1141, Paris-Diderot University, Paris, France
| | - H S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Rossi A, Magri F, D'Arino A, Pigliacelli F, Muscianese M, Leoncini P, Caro G, Federico A, Fortuna MC, Carlesimo M. Efficacy of Topical Finasteride 0.5% vs 17α-Estradiol 0.05% in the Treatment of Postmenopausal Female Pattern Hair Loss: A Retrospective, Single-Blind Study of 119 Patients. Dermatol Pract Concept 2020; 10:e2020039. [PMID: 32363101 DOI: 10.5826/dpc.1002a39] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2019] [Indexed: 10/31/2022] Open
Abstract
Background and Objectives Female pattern hair loss (FPHL) is a common form of scalp hair loss that occurs in 38% of females. Currently, minoxidil solution is the only therapy approved by the US Food and Drug Administration, but many other treatments are used, including cyproterone acetate, spironolactone, topical 17α-estradiol, and prostaglandin analogs. Systemic finasteride has been considered a treatment option in women even though its teratogenic effects tend to limit its prescription. Recently, topical finasteride has been evaluated to limit the side effect profile of the drug. The objective of the present study is to compare retrospectively the efficacy of topical 0.05% 17α-estradiol solution and a 0.5% finasteride lotion in the treatment of FPHL. Patients and Methods We enrolled 119 postmenopausal female patients. The first group comprised 69 women treated with finasteride 0.5% and minoxidil 2%. The second group included 50 women treated with 17α-estradiol 0.05% and minoxidil 2%. At baseline and at 6- and 12- to 18-month follow-up, global photographs were systematically taken. Three operators blind to the prescribed treatment evaluated photographs using a 7-point scale. One-way analysis of variance and unpaired Student t tests were performed to analyze 7-point scale scores. Results The improvement was statistically significant from 6 months to 12-18 months, both for finasteride (P < 0.005) and 17α-estradiol (P < 0.05). The efficacy of topical finasteride was significantly greater than that of 17α-estradiol solution, both at the 6-month (P < 0.05) and at the 12- to 18-month follow-up (P < 0.005). In general, the highest improvement was observed after 12-18 months of treatment with topical finasteride therapy. Conclusions Topical finasteride 0.5% in combination with minoxidil 2% could represent a valid therapeutic option for the treatment of postmenopausal FPHL, showing higher efficacy than topical 17α-estradiol with minoxidil 2% both at 6-month and 12- to 18-month follow-up.
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Affiliation(s)
- Alfredo Rossi
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Francesca Magri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea D'Arino
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Flavia Pigliacelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Marta Muscianese
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Pierpaolo Leoncini
- Department of Pediatric Hematology and Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Bambino Gesù Children's Hospital, Rome, Italy
| | - Gemma Caro
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Alessandro Federico
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Maria Caterina Fortuna
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Marta Carlesimo
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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Di Sarno R, Brigida A, Caprio GG, Ciardiello D, Dallio M, Sangineto M, Fagoonee S, Abenavoli L, Luzza F, Gravina AG, De Magistris L, Federico A, Loguercio C. Critical review on the use and abuse of alcohol. When the dose makes the difference. Minerva Med 2020; 111:344-353. [PMID: 32338485 DOI: 10.23736/s0026-4806.20.06584-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nowadays harmful alcohol consumption represents one of the most important risk factors for the development of several type of chronic and acute diseases in the western countries, contributing to a great number of deaths. Focusing the attention on cancer development and progression, the scientific community has a large consensus in declaring the existence of a harmful association between alcohol consumption and liver, breast, upper aerodigestive tract (mouth, oropharynx, hypopharynx, and esophagus), pancreas and colon cancer appearance. However the precise biological links by which the alcohol could be responsible for cancer initiation and progression are not fully understood yet, even if the International Agency for Research on Cancer (IARC) indicated both ethanol and acetaldehyde as carcinogen for humans. The possible explanation of the effect exerted by ethanol and acetaldehyde could be related to direct genotoxicity, hormonal disturbance, triggering of oxidative stress and inflammation. In this review, we examine the relationship between alcohol dosage and associated diseases, with focus on alcohol-related cancers. Furthermore, to understand the potential molecular mechanisms of these diseases, the results of in vivo experiments on animal models were discussed.
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Affiliation(s)
- Rosa Di Sarno
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Annalisa Brigida
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giuseppe G Caprio
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Davide Ciardiello
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marcello Dallio
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Moris Sangineto
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Sharmila Fagoonee
- Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, Turin, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Antonietta G Gravina
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Laura De Magistris
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Carmelina Loguercio
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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Bersano A, Kraemer M, Burlina A, Mancuso M, Finsterer J, Sacco S, Salvarani C, Caputi L, Chabriat H, Oberstein SL, Federico A, Lasserve ET, Hunt D, Dichgans M, Arnold M, Debette S, Markus HS. Heritable and non-heritable uncommon causes of stroke. J Neurol 2020; 268:2780-2807. [PMID: 32318851 DOI: 10.1007/s00415-020-09836-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/15/2022]
Abstract
Despite intensive investigations, about 30% of stroke cases remains of undetermined origin. After exclusion of common causes of stroke, there is a number of rare heritable and non-heritable conditions, which often remain misdiagnosed, that should be additionally considered in the diagnosis of cryptogenic stroke. The identification of these diseases requires a complex work up including detailed clinical evaluation for the detection of systemic symptoms and signs, an adequate neuroimaging assessment and a careful family history collection. The task becomes more complicated by phenotype heterogeneity since stroke could be the primary or unique manifestation of a syndrome or represent just a manifestation (sometimes minor) of a multisystem disorder. The aim of this review paper is to provide clinicians with an update on clinical and neuroradiological features and a set of practical suggestions for the diagnostic work up and management of these uncommon causes of stroke. The identification of these stroke causes is important to avoid inappropriate and expensive diagnostic tests, to establish appropriate management measures, including presymptomatic testing, genetic counseling, and, if available, therapy. Therefore, physicians should become familiar with these diseases to provide future risk assessment and family counseling.
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Affiliation(s)
- A Bersano
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
| | - M Kraemer
- Department of Neurology Alfried, Krupp-Hospital, Essen, Germany.,Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - A Burlina
- Neurological Unit, St. Bassano Hospital, Bassano del Grappa, Italy
| | - M Mancuso
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - J Finsterer
- Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria
| | - S Sacco
- Department of Neurology, Avezzano Hospital, University of L'Aquila, L'Aquila, Italy
| | - C Salvarani
- University of Modena and Reggio Emilia, and Azienda USL-IRCCS, Reggio Emilia, Italy
| | - L Caputi
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - H Chabriat
- Department of Neurology and CERVCO, DHU Neurovasc, INSERM U1141, University of Paris, Paris, France
| | - S Lesnik Oberstein
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - A Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - E Tournier Lasserve
- Department of Genetics, Lariboisière Hospital and INSERM U1141, Paris-Diderot University, Paris, France
| | - D Hunt
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - M Dichgans
- Institute for Stroke and Dementia Research, Klinikum Der Universität München, Munich, Germany
| | - M Arnold
- Inserm Centre Bordeaux Population Health (U1219), University of Bordeaux, Bordeaux, France
| | - S Debette
- Department of Neurology, INSELSPITAL, University Hospital Bern, Bern, Switzerland
| | - H S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Rossi A, Magri F, Caro G, Federico A, Fortuna MC, Soda G, De Vincentiis L, Carlesimo M. Eosinophilic folliculitis of the scalp associated with PD‐1/PDL1 inhibitors. J Cosmet Dermatol 2020; 19:3367-3370. [DOI: 10.1111/jocd.13388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Alfredo Rossi
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
| | - Francesca Magri
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
| | - Gemma Caro
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
| | - Alessandro Federico
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
| | - Maria Caterina Fortuna
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
| | - Giuseppe Soda
- Department of Molecular Medicine Sapienza University of Rome Rome Italy
| | | | - Marta Carlesimo
- Department of Ematology, Oncology and Dermatology “Sapienza” University of Rome Rome Italy
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70
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Quaranta MG, Ferrigno L, Monti M, Filomia R, Biliotti E, Iannone A, Migliorino G, Coco B, Morisco F, Vinci M, D'Ambrosio R, Chemello L, Massari M, Ieluzzi D, Russo FP, Blanc P, Verucchi G, Puoti M, Rumi MG, Barbaro F, Santantonio TA, Federico A, Chessa L, Gentile I, Zuin M, Parruti G, Morsica G, Kondili LA. Advanced liver disease outcomes after hepatitis C eradication by human immunodeficiency virus infection in PITER cohort. Hepatol Int 2020; 14:362-372. [PMID: 32279177 PMCID: PMC7220859 DOI: 10.1007/s12072-020-10034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/18/2020] [Indexed: 02/06/2023]
Abstract
Background Liver disease progression after Hepatitis C Virus (HCV) eradication following direct-acting antiviral (DAA) treatment in the real-life setting according to Human Immunodeficiency Virus (HIV) coinfection was evaluated. Methods Patients consecutively enrolled in PITER between April 2014 and June 2019 and with at least 12-weeks follow-up following treatment were analysed. Cox regression analysis were used to evaluate HIV coinfection and factors independently associated with liver disease outcomes following viral eradication in DAA treated patients with pre-treatment liver cirrhosis. Results 93 HIV/HCV coinfected and 1109 HCV monoinfected patients were evaluated during a median follow-up of 26.7 (range 6–44.6) and 24.6 (range 6.8–47.3) months, respectively. No difference in the cumulative HCC incidence and hepatic decompensation was observed between coinfected and monoinfected patients. Age (Hazard Ratio [HR] = 1.08; 95% CI 1.04–1.13), male sex (HR = 2.76; 95% CI 1.28–5.96), lower albumin levels (HR = 3.94; 95% CI 1.81–8.58), genotype 3 (HR = 5.05; 95% CI 1.75–14.57) and serum anti-HBc positivity (HR = 1.99, 95% CI 1.01–3.95) were independently associated with HCC incidence. Older age (HR = 1.03; 95% CI 1.00–1.07), male sex (HR = 2.13; 95% CI 1.06–4.26) and lower albumin levels (HR = 3.75; 95% CI 1.89–7.46) were independently associated with the appearance of a decompensating event after viral eradication. Conclusion Different demographic, clinical and genotype distribution between HIV coinfected vs those monoinfected, was observed in a representative cohort of HCV infected patients in Italy. Once liver cirrhosis is established the disease progression is decreased, but still persists regardless of viral eradication in both coinfected and monoinfected patients. In patients with cirrhosis, HIV coinfection was not associated with a higher probability of liver complications, after viral eradication.
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Affiliation(s)
| | - Luigina Ferrigno
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Monica Monti
- Center for Systemic Manifestations of Hepatitis Viruses (MaSVE), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Roberto Filomia
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Elisa Biliotti
- Department of Clinical Medicine, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Andrea Iannone
- Department of Emergency and Organ Transplantation, Gastroenterology Unit, University of Bari, Bari, Italy
| | | | - Barbara Coco
- Hepatology and Liver Physiopathology Laboratory and Internal Medicine, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy
| | - Filomena Morisco
- Gastroenterology and Hepatology Unit, Federico II University Hospital, Naples, Italy
| | - Maria Vinci
- Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | - Roberta D'Ambrosio
- Gastroenterology and Hepatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Liliana Chemello
- Department of Medicine, University Hospital of Padua, Padua, Italy
| | - Marco Massari
- Infectious Diseases, Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Francesco Paolo Russo
- Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Pierluigi Blanc
- Infectious Disease Unit, Santa Maria Annunziata Hospital, Florence, Italy
| | - Gabriella Verucchi
- Department of Medical and Surgical Sciences, Infectious Disease Unit, University Hospital S.Orsola-Malpighi, Bologna, Italy
| | - Massimo Puoti
- Department of Infectious Disease, Niguarda Hospital, Milan, Italy
| | - Maria Grazia Rumi
- Hepatology Unit, San Giuseppe Hospital, University of Milan, Milan, Italy
| | - Francesco Barbaro
- Infectious and Tropical Diseases Unit, Azienda Ospedaliera di Padova, Padua, Italy
| | | | - Alessandro Federico
- Department of Hepato-Gastroenterology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luchino Chessa
- Liver Unit, University Hospital, Monserrato, Cagliari, Italy
| | - Ivan Gentile
- Infectious Disease Unit, Federico II University Hospital, Naples, Italy
| | - Massimo Zuin
- Gastroenterology and Hepatology Unit, San Paolo Hospital, University of Milan, Milan, Italy
| | - Giustino Parruti
- Infectious Disease Unit, Spirito Santo General Hospital, Pescara, Italy
| | - Giulia Morsica
- Department of Infectious Diseases, San Raffaele Hospital, Milan, Italy
| | - Loreta A Kondili
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy.
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Addolorato G, Abenavoli L, Dallio M, Federico A, Germani G, Gitto S, Leandro G, Loguercio C, Marra F, Stasi E. Alcohol associated liver disease 2020: A clinical practice guideline by the Italian Association for the Study of the Liver (AISF). Dig Liver Dis 2020; 52:374-391. [PMID: 32001151 DOI: 10.1016/j.dld.2019.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/06/2019] [Accepted: 12/17/2019] [Indexed: 12/11/2022]
Abstract
Alcohol use disorder which includes alcohol abuse and dependence represents one of the leading risk factors for premature mortality in Europe and it is responsible of over 200 conditions, including neuropsychiatric disorders, chronic diseases, cancers and accidents leading to permanent disability. Alcohol use disorder represents the most common cause of liver damage in the Western world, with a wide spectrum of diseases ranging from steatosis, steatohepatitis, fibrosis, cirrhosis and cancer. The present clinical practice guidelines by the Italian Association for the Study of the Liver (AISF) are focused on the current knowledge about epidemiology, pathophysiology, clinical features, diagnosis and treatment of alcohol associated liver disease, aiming to provide practical recommendations on the management of this complex pathological condition.
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Affiliation(s)
- Giovanni Addolorato
- Alcohol Use Disorder Unit, Division of Internal Medicine, Gastroenterology and Hepatology Unit, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy; "Agostino Gemelli" Hospital Foundation - IRCCS, Rome, Italy.
| | - Ludovico Abenavoli
- Department of Health Sciences, University Magna Graecia, Catanzaro, Italy
| | - Marcello Dallio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giacomo Germani
- Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Padova, Italy
| | - Stefano Gitto
- Department of Experimental and Clinical Medicine, University of Florence, Italy
| | - Gioacchino Leandro
- National Institute of Gastroenterology "S. De Bellis" Research Hospital, Castellana Grotte, Italy
| | - Carmelina Loguercio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Research Center Denothe, University of Florence, Italy
| | - Elisa Stasi
- National Institute of Gastroenterology "S. De Bellis" Research Hospital, Castellana Grotte, Italy
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Abstract
The frailty represents a key determinant of elderly clinical assessment, especially because it allows the identification of risk factors potentially modifiable by clinical and therapeutic interventions. The frailty assessment in elderly patients usually is made by using of Fried criteria. However, to assess the frailty in cirrhotic patients, multiple but different tools are used by researchers. Thus, we aimed to compare frailty prevalence in elderly patients with well-compensated liver cirrhosis and without cirrhosis, according to Fried criteria.Among 205 elderly patients screened, a total of 148 patients were enrolled. The patients were divided into 2 groups according to the presence/absence of well-compensated liver cirrhosis.After clinical examination with conventional scores of cirrhosis, all patients underwent anthropometric measurements, nutritional, biochemical, comorbidity, and cognitive performances. Frailty assessment was evaluated according to Fried frailty criteria.Unexpectedly, according to the Fried criteria, non-cirrhotic patients were frailer (14.2%) than well-compensated liver cirrhotic patients (7.5%). The most represented Fried criterion was the unintentional weight loss in non-cirrhotic patients (10.1%) compared to well-compensated liver cirrhotic patients (1.4%). Moreover, cumulative illness rating scale -G severity score was significantly and positively associated with frailty status (r = 0.234, P < .004). In a multivariate linear regression model, only female gender, body mass index and mini nutritional assessment resulted associated with frailty status, independently of other confounding variables.Despite the fact that elderly cirrhotic patients are considered to be frailer than the non-cirrhotic elderly patient, relying solely on "mere visual appearance," our data show that paradoxically non-cirrhotic elderly patients are frailer than elderly well-compensated liver cirrhotic patients. Thus, clinical implication of this finding is that frailty assessment performed in the well-compensated liver cirrhotic patient can identify those cirrhotic patients who may benefit from tailored interventions similarly to non-cirrhotic elderly patients.
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Affiliation(s)
| | | | - Anna Maria Dalise
- Department of Advanced Medical and Surgical Sciences - University of Campania Luigi Vanvitelli Naples, Italy
| | - Michelangela Barbieri
- Department of Advanced Medical and Surgical Sciences - University of Campania Luigi Vanvitelli Naples, Italy
| | | | | | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences - University of Campania Luigi Vanvitelli Naples, Italy
| | - Maria Rosaria Rizzo
- Department of Advanced Medical and Surgical Sciences - University of Campania Luigi Vanvitelli Naples, Italy
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Rossi A, Muscianese M, Federico A, Magri F, Caro G, Fortuna MC, D'Arino A, Pigliacelli F, Carlesimo M. Associations between alopecia areata and multiple sclerosis: a report of two cases and review of the literature. Int J Dermatol 2019; 59:490-493. [PMID: 31797349 DOI: 10.1111/ijd.14737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/19/2019] [Accepted: 11/05/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Marta Muscianese
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Alessandro Federico
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Francesca Magri
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Maria Caterina Fortuna
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Andrea D'Arino
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Flavia Pigliacelli
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
| | - Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, Dermatology, Sapienza, University of Rome, Rome, Italy
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Persico M, Aglitti A, Milella M, Coppola C, Messina V, Claar E, Gentile I, Sogari F, Pierri P, Surace LA, Morisco F, Tundo P, Brancaccio G, Serviddio G, Gatti P, Termite AP, Di Costanzo GG, Caroleo B, Cozzolongo R, Coppola N, Longo A, Fontanella L, Federico A, Rosato V, Terrenato I, Masarone M. Real-life glecaprevir/pibrentasvir in a large cohort of patients with hepatitis C virus infection: The MISTRAL study. Liver Int 2019; 39:1852-1859. [PMID: 31175707 DOI: 10.1111/liv.14170] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS It is paramount to identify predictors of treatment failure with direct antiviral agents in 'field-practice' patients, including people who inject drugs (PWID). Data on the efficacy of glecaprevir/pibrentasvir (GLE/PIB) in a field-practice scenario are scant. The multicentre MISTRAL study enrolled 1177 patients, including PWID, to assess real-life efficacy and safety of GLE/PIB and to identify the predictive factors for this treatment. METHODS This was a prospective, longitudinal study. The outcome variable was the rate of sustained virological response (SVR) at week 12. RESULTS A total of 123 patients (10%) were infected from hepatitis C virus (HCV) 3. METAVIR fibrosis score was F4 in 104 subjects (9%); 118 patients (10%) were PWID. Overall, 1163/1177 (99%) patients achieved SVR. The baseline clinical factors discriminating between treatment success and treatment failure were age at treatment (P = 0.031) and creatinine level (P = 0.034). SVR rates were not influenced by gender, substance abuse, previous treatment, treatment duration, fibrosis or chronic kidney disease stage. Compared with non-substance users, the 118 PWID exhibited a significantly different genotype pattern distribution (χ2 < 0.001). A total of 40/118 (33.9%) of substance users were HCV3 compared to 83/1056 (7.9%) non-substance users. Only 6 patients (0.5%) reported a serious adverse event. CONCLUSIONS The MISTRAL study provides evidence of GLE/PIB efficacy in a field-practice scenario in a highly epidemic HCV area in southern Italy; it unveiled significant differences in genotype distribution among the most underserved and difficult-to-treat patient subgroups including PWID.
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Affiliation(s)
- Marcello Persico
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
| | - Michele Milella
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
| | - Carmine Coppola
- Internal Medicine and Hepatology Unit, Hospital of Gragnano, Gragnano, Italy
| | | | - Ernesto Claar
- Hepatology Unit, "Villa Betania" Evangelical Hospital, Naples, Italy
| | - Ivan Gentile
- Department of Clinical Medicine and Surgery, Section of Infectious Diseases, University of Naples Federico II, Naples, Italy
| | - Fernando Sogari
- Internal Medicine Unit, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Paola Pierri
- Infectious Diseases and Hepatology Unit, Cotugno Hospital, Naples, Italy
| | - Lorenzo A Surace
- Traveler and Migration Medicine Center, ASP Catanzaro, Catanzaro, Italy
| | - Filomena Morisco
- Department of Clinical Medicine and Surgery, Gastroenterology and Hepatology Unit, Federico II University, Naples, Italy
| | - Paolo Tundo
- S. Caterina Novella Hospital, Galatina, Lecce, Italy
| | | | | | | | | | | | | | | | - Nicola Coppola
- Infectious Diseases Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Luca Fontanella
- Liver Diseases Unit, Fatebenefratelli Hospital, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valerio Rosato
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.,Hepatology Unit, "Villa Betania" Evangelical Hospital, Naples, Italy
| | - Irene Terrenato
- Biostatistics-Scientific Direction, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Mario Masarone
- Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy
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Rossi A, Muscianese M, Piraccini BM, Starace M, Carlesimo M, Mandel VD, Alessandrini A, Calvieri S, Caro G, D'arino A, Federico A, Magri F, Pigliacelli F, Amendolagine G, Annunziata MC, Arisi MC, Astorino S, Babino G, Bardazzi F, Barruscotti S, Belloni Fortina A, Borghi A, Bruni F, Caccavale S, Calzavara-Pinton P, Cameli N, Cardone M, Carugno A, Coppola R, Dattola A, De Felici Del Giudice MB, Di Cesare A, Dika E, Di Nunno D, D'ovidio R, Fabbrocini G, Feliciani C, Fulgione E, Galluzzo M, Garcovich S, Garelli V, Guerriero C, Hansel K, La Placa M, Lacarrubba F, Lora V, Marinello E, Megna M, Micali G, Misciali C, Monari P, Monfrecola G, Neri I, Offidani A, Orlando G, Papini M, Patrizi A, Piaserico S, Rivetti N, Simonetti O, Stan TR, Stingeni L, Talamonti M, Tassone F, Villa L, Vincenzi C, Fortuna MC. Italian Guidelines in diagnosis and treatment of alopecia areata. GIORN ITAL DERMAT V 2019; 154:609-623. [PMID: 31578836 DOI: 10.23736/s0392-0488.19.06458-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The Italian Study Group for Cutaneous Annexial Disease of the Italian Society of dermatology proposes these Italian guidelines for diagnosis and treatment of Alopecia Areata deeming useful for the daily management of the disease. This article summarizes evidence-based treatment associated with expert-based recommendations.
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Affiliation(s)
- Alfredo Rossi
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy -
| | - Marta Muscianese
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Bianca M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Marta Carlesimo
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Victor D Mandel
- Unit of Dermatology, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Calvieri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Gemma Caro
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea D'arino
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Alessandro Federico
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Francesca Magri
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Flavia Pigliacelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Graziana Amendolagine
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria C Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Maria C Arisi
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Stefano Astorino
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | - Graziella Babino
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Federico Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefania Barruscotti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesca Bruni
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Caccavale
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | - Norma Cameli
- San Gallicano Dermatological Institute (IRCCS), Rome, Italy
| | - Michele Cardone
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Andrea Carugno
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Rosa Coppola
- Campus Bio-Medico University (Hospital), Rome, Italy
| | - Annunziata Dattola
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | | | - Antonella Di Cesare
- Section of Dermatology, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Emi Dika
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Donato Di Nunno
- Unit of Dermatology and Venereology, Celio Military Hospital, Rome, Italy
| | | | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Elisabetta Fulgione
- Unit of Dermatology, Nuovo Policlinico, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Galluzzo
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Simone Garcovich
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Valentina Garelli
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Cristina Guerriero
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Michelangelo La Placa
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Viviana Lora
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | - Elena Marinello
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giuseppe Micali
- Department of Dermatology, University of Catania, Catania, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Paola Monari
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Gloria Orlando
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Manuela Papini
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Niccolò Rivetti
- Unit of Dermatology, S. Matteo University Polyclinic, IRCCS and Foundation, Pavia, Italy
| | - Oriana Simonetti
- Unit of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Teodora R Stan
- Unit of Dermatology, Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Marina Talamonti
- Department of Dermatology, Tor Vergata Polyclinic and University, Rome, Italy
| | - Francesco Tassone
- Institute of Dermatology, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Carholic University, Rome, Italy
| | | | - Colombina Vincenzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Maria C Fortuna
- Division of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
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Dallio M, Diano N, Masarone M, Gravina AG, Patanè V, Romeo M, Di Sarno R, Errico S, Nicolucci C, Abenavoli L, Scarpellini E, Boccuto L, Persico M, Loguercio C, Federico A. Chemical Effect of Bisphenol A on Non-Alcoholic Fatty Liver Disease. Int J Environ Res Public Health 2019; 16:ijerph16173134. [PMID: 31466361 PMCID: PMC6747307 DOI: 10.3390/ijerph16173134] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/18/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is considered a predominant chronic liver disease worldwide and a component of metabolic syndrome. Due to its relationship with multiple organs, it is extremely complex to precisely define its pathogenesis as well as to set appropriate therapeutic and preventive strategies. Endocrine disruptors (EDCs) in general, and bisphenol A (BPA) in particular, are a heterogeneous group of substances, largely distributed in daily use items, able to interfere with the normal signaling of several hormones that seem to be related to type 2 diabetes mellitus (T2DM), obesity, and other metabolic disorders. It is reasonable to hypothesize a BPA involvement in the pathogenesis and evolution of NAFLD. However, its mechanisms of action as well as its burden in the vicious circle that connects obesity, T2DM, metabolic syndrome, and NAFLD still remain to be completely defined. In this review we analyzed the scientific evidence on this promising research area, in order to provide an overview of the harmful effects linked to the exposure to EDCs as well as to frame the role that BPA would have in all phases of NAFLD evolution.
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Affiliation(s)
- Marcello Dallio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy.
| | - Nadia Diano
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Mario Masarone
- Department of Medicine and Surgery, University of Salerno, via Salvador Allende, 84081 Salerno, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Vittorio Patanè
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Mario Romeo
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Rosa Di Sarno
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Sonia Errico
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Carla Nicolucci
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, University "Magna Graecia", Viale Europa-Germaneto, 88110 Catanzaro, Italy
| | - Emidio Scarpellini
- Division of Gastroenterology, Department of Internal Medicine, TARGID, University Hospital Gasthuisberg, 3000 Leuven, Belgium
| | - Luigi Boccuto
- Greenwood Genetic Center, 113 Gregor Mendel Circle, Greenwood, SC 29646, USA
| | - Marcello Persico
- Department of Medicine and Surgery, University of Salerno, via Salvador Allende, 84081 Salerno, Italy
| | - Carmelina Loguercio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", via Pansini 5, 80131 Naples, Italy
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Taliento AE, Dallio M, Federico A, Prati D, Valenti L. Novel Insights into the Genetic Landscape of Nonalcoholic Fatty Liver Disease. Int J Environ Res Public Health 2019; 16:E2755. [PMID: 31375010 PMCID: PMC6695718 DOI: 10.3390/ijerph16152755] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/27/2019] [Accepted: 07/30/2019] [Indexed: 12/19/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD), the most common liver disorder worldwide, is epidemiologically associated with overweight, insulin resistance features and type 2 diabetes, and can progress to advanced liver fibrosis and hepatocellular carcinoma. Genetic factors play an important role in the development of NAFLD, which is a multifactorial disease. Several common naturally occurring variants modulating lipid and retinol metabolism in hepatocytes predispose to NAFLD development and progression, in particular those in PNPLA3, TM6SF2, MBOAT7, and HSD17B13. In addition, genetic variants that protect hepatic cells from oxidative stress modulate the susceptibility to progressive NAFLD. Although the molecular mechanisms linking these genetic variants with liver disease are not yet fully understood, hepatic fat has emerged as a major driver of the disease, while altered retinol metabolism and mitochondrial oxidative stress play a role in determining the development of advanced NAFLD.
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Affiliation(s)
- Alice Emma Taliento
- Translational Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, 20122 Milan, Italy
| | - Marcello Dallio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Daniele Prati
- Translational Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, 20122 Milan, Italy
| | - Luca Valenti
- Translational Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico IRCCS, 20122 Milan, Italy.
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milano, Italy.
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Gravina AG, Dallio M, Tuccillo C, Martorano M, Abenavoli L, Luzza F, Stiuso P, Lama S, Grieco P, Merlino F, Caraglia M, Loguercio C, Federico A. Urotensin II receptor expression in patients with ulcerative colitis: a pilot study. MINERVA GASTROENTERO 2019; 66:23-28. [PMID: 31293119 DOI: 10.23736/s1121-421x.19.02602-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Urotensin II (U-II) is a vasoactive peptide that interacts with a specific receptor named UTR. Recently, our group has demonstrated increased UTR expression in both human colon adenocarcinoma cell lines and adenomatous polyps, as well as in colon carcinoma samples if compared to healthy colon samples of the same patients. We also showed that an UTR agonist induced an increase in colon adenocarcinoma cell growth in vitro, whereas the UTR block with a specific antagonist caused an inhibition of their growth and an inhibition of about 50% of both motility and cell invasion. Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) associated with an increased baseline risk for colon cancer compared with the general population, and this risk is mostly attributed to chronic inflammation and immune dysregulation. This risk increases along with the duration of the disease, as demonstrated by many studies. There are no UTR expression data related to UC, and we therefore evaluated UTR expression in ill colon biopsies and in healthy colon ones of patients with UC and colon biopsies of healthy patients. METHODS We enrolled, prior to informed consent, 11 patients (5 males and 6 females, age range 29-75 years, median age 52 years) with first UC diagnosis compared to 11 healthy controls (6 males and 5 females, age range 30-78 years, median age 55 years). We have therefore sampled inflammatory and healthy tissue in UC patients. We have also taken colic tissue samples in healthy subjects. Evaluation of receptor expression was performed by reverse transcription-polymerase chain reaction (RT-PCR), Western Blot analysis. The ANOVA Test (P<0.05) was used for statistical analysis. RESULTS We found: 1) increased expression of UTR in 11/11 UC patients with ill mucosa biopsies compared to healthy controls in RT-PCR and in Western Blot analysis; 2) increased UTR expression in 11/11 UC patients with ill colon biopsies compared to the results obtained from healthy colon biopsies of the same patients both in RT-PCR and in Western Blot analysis; 3) increased UTR expression in 9/11 UC patients healthy colon biopsy specimens compared to healthy controls. CONCLUSIONS UTR could be considered as an inflammatory UC disease marker because its expression is greater in the mucosa of ill colon than in the healthy colon of the same patients and compared to healthy controls.
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Affiliation(s)
- Antonietta G Gravina
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Marcello Dallio
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Concetta Tuccillo
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Marco Martorano
- Unit of Gastroenterology and Endoscopy, Immacolata Hospital, Sapri, Salerno, Italy
| | - Ludovico Abenavoli
- Department of Health Sciences, Magna Grecia University, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Sciences, Magna Grecia University, Catanzaro, Italy
| | - Paola Stiuso
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Stefania Lama
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Paolo Grieco
- Department of Pharmacy, Federico II University, Naples, Italy
| | | | - Michele Caraglia
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Carmelina Loguercio
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alessandro Federico
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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D'Alessandro V, Rentería F, Herrera J, Federico A, Barán E, Varas C, Diez G, Cano L, Andreozzi P, Antonioli C, Finocchiaro J, Ditondo J, Nabais I, Palmisciano V, Sirimarco L, Segal E. WS10-5 First report of cystic fibrosis patientś survival from a region of Argentina: data collected by its own Registry. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30176-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Zappavigna S, Vanacore D, Lama S, Potenza N, Russo A, Ferranti P, Dallio M, Federico A, Loguercio C, Sperlongano P, Caraglia M, Stiuso P. Silybin-Induced Apoptosis Occurs in Parallel to the Increase of Ceramides Synthesis and miRNAs Secretion in Human Hepatocarcinoma Cells. Int J Mol Sci 2019; 20:ijms20092190. [PMID: 31058823 PMCID: PMC6539179 DOI: 10.3390/ijms20092190] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 02/08/2023] Open
Abstract
Silybin is a flavonolignan extracted from Silybum marianum (milk thistle) with hepatoprotective, antioxidant, and anti-inflammatory activity. Several studies have shown that silybin is highly effective to prevent and treat different types of cancer and that its antitumor mechanisms involve the arrest of the cell cycle and/or apoptosis. An MTT assay was performed to study cell viability, lipid peroxidation, extracellular NO production, and scavenger enzyme activity were studied by Thiobarbituric Acid-Reactive Species (TBARS) assay, NO assay, and MnSOD assay, respectively. Cell cycle and apoptosis analysis were performed by FACS. miRNA profiling were evaluated by real time PCR. In this study, we demonstrated that Silybin induced growth inhibition blocking the Hepg2 cells in G1 phase of cell cycle and activating the process of programmed cell death. Moreover, the antiproliferative effects of silybin were paralleled by a strong increase of the number of ceramides involved in the modulation of miRNA secretion. In particular, after treatment with silybin, miR223-3p and miR16-5p were upregulated, while miR-92-3p was downregulated (p < 0.05). In conclusion, our results suggest that silybin-Induced apoptosis occurs in parallel to the increase of ceramides synthesis and miRNAs secretion in HepG2 cells.
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Affiliation(s)
- Silvia Zappavigna
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Daniela Vanacore
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Stefania Lama
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Nicoletta Potenza
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "L. Vanvitelli", viale Lincoln, 81100 Caserta, Italy.
| | - Aniello Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "L. Vanvitelli", viale Lincoln, 81100 Caserta, Italy.
| | - Pasquale Ferranti
- Department of Agricultural Sciences, University of Naples Federico II, Via Università, 100, 80055 Portici, NA, Italy.
| | - Marcello Dallio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Alessandro Federico
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Carmelina Loguercio
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Pasquale Sperlongano
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Michele Caraglia
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
| | - Paola Stiuso
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Via De Crecchio 7, 80138 Naples, Italy.
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Magri F, Pranteda G, Federico A, Muscianese M, Pigliacelli F, D'arino A, Paolino G, Bottoni U, Pranteda G. Kerion mimicking an erosive pustular dermatosis of the scalp. GIORN ITAL DERMAT V 2019; 154:96-98. [PMID: 30616337 DOI: 10.23736/s0392-0488.17.05673-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Francesca Magri
- Department of Dermatology (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Guglielmo Pranteda
- Department of Dermatology (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy -
| | - Alessandro Federico
- Department of Dermatology (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Marta Muscianese
- Department of Dermatology (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Flavia Pigliacelli
- Department of Dermatology (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Andrea D'arino
- Unit of Dermatology, Faculty of Medicine and Psychology, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Giovanni Paolino
- Unit of Dermatology, Faculty of Medicine and Psychology, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Ugo Bottoni
- Department of Health Sciences, University of Catanzaro Magna Græcia, Catanzaro, Italy
| | - Giulia Pranteda
- Unit of Dermatology, Faculty of Medicine and Psychology, Umberto I Hospital, Sapienza University, Rome, Italy
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83
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Patano A, Federico A, Benizio G, Del Prete R, Ninivaggi R, Petruzzi M. HPV 28 anyplex II seegene Real Time PCR on samples collected using cytobrush and microbiopsy for the detection of HPV infection in patients affected by oral lichen planus and leukoplakia. Front Physiol 2019. [DOI: 10.3389/conf.fphys.2019.27.00079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kondili LA, Robbins S, Blach S, Gamkrelidze I, Zignego AL, Brunetto MR, Raimondo G, Taliani G, Iannone A, Russo FP, Santantonio TA, Zuin M, Chessa L, Blanc P, Puoti M, Vinci M, Erne EM, Strazzabosco M, Massari M, Lampertico P, Rumi MG, Federico A, Orlandini A, Ciancio A, Borgia G, Andreone P, Caporaso N, Persico M, Ieluzzi D, Madonia S, Gori A, Gasbarrini A, Coppola C, Brancaccio G, Andriulli A, Quaranta MG, Montilla S, Razavi H, Melazzini M, Vella S, Craxì A. Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals? Liver Int 2018; 38:2190-2198. [PMID: 29900654 PMCID: PMC6282782 DOI: 10.1111/liv.13901] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/03/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Advances in direct-acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked-to-care individuals on overall HCV burden estimates and identified a possible strategy to achieve the WHO targets by 2030. METHODS Using a modelling approach grounded in Italian real-life data of diagnosed and treated patients, different linkage-to-care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals. RESULTS Under the 40% linked-to-care scenario, viraemic burden would decline (60%); however, eligible patients to treat will be depleted by 2025. Increased case finding through a targeted screening strategy in 1948-1978 birth cohorts could supplement the pool of diagnosed patients by finding 75% of F0-F3 cases. Under the 60% linked-to-care scenario, viraemic infections would decline by 70% by 2030 but the patients eligible for treatment will run out by 2028. If treatment is to be maintained, a screening strategy focusing on 1958-1978 birth cohorts could capture 55% of F0-F3 individuals. Under the 80% linked-to-care scenario, screening limited in 1968-1978 birth cohorts could sustain treatment at levels required to achieve the HCV elimination goals. CONCLUSION In Italy, which is an HCV endemic country, the eligible pool of patients to treat will run out between 2025 and 2028. To maintain the treatment rate and achieve the HCV elimination goals, increased case finding in targeted, high prevalence groups is required.
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Affiliation(s)
| | - Sarah Robbins
- Center for Disease AnalysisCDA Foundation | Polaris ObservatoryLafayetteCOUSA
| | - Sarah Blach
- Center for Disease AnalysisCDA Foundation | Polaris ObservatoryLafayetteCOUSA
| | - Ivane Gamkrelidze
- Center for Disease AnalysisCDA Foundation | Polaris ObservatoryLafayetteCOUSA
| | - Anna L. Zignego
- Department of Experimental and Clinical MedicineInterdepartmental Centre MASVEUniversity of FlorenceFlorenceItaly
| | - Maurizia R. Brunetto
- Internal MedicineDepartment of Clinical and Experimental Medicine University of Pisa and Liver UnitPisa University HospitalPisaItaly
| | - Giovanni Raimondo
- Department of Internal MedicineUniversity Hospital of MessinaMessinaItaly
| | - Gloria Taliani
- Infectious and Tropical Diseases UnitUmberto I HospitalSapienza UniversityRomeItaly
| | - Andrea Iannone
- Department of GastroenterologyUniversity Hospital of BariBariItaly
| | | | | | - Massimo Zuin
- Liver and Gastroenterology UnitASST Santi Paolo e CarloMilanItaly
| | | | - Pierluigi Blanc
- Department of Infectious DiseaseS.M. Annunziata HospitalFlorenceItaly
| | - Massimo Puoti
- Department of Infectious DiseaseNiguarda HospitalMilanItaly
| | | | - Elke M. Erne
- Department of Infectious DiseaseUniversity Hospital of PaduaPaduaItaly
| | | | - Marco Massari
- Department of Infectious DiseaseArcispedale Santa Maria NuovaReggio EmiliaItaly
| | - Pietro Lampertico
- Department of Gastroenterology and HepatologyFondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoUniversity of MilanMilanItaly
| | - Maria G. Rumi
- Department of Gastroenterology and HepatologySan Giuseppe HospitalMilanItaly
| | - Alessandro Federico
- Department of Hepatology and GastroenterologyUniversità della Campania Luigi VanvitelliNaplesItaly
| | | | - Alessia Ciancio
- Gastoenterology UnitCittà della Salute e della Scienza‐Ospedale MolinetteTurinItaly
| | - Guglielmo Borgia
- Department of Infectious DiseaseFederico II UniversityNaplesItaly
| | | | | | - Marcello Persico
- Department of Internal Medicine and HepatologyUniversity of SalernoSalernoItaly
| | | | | | - Andrea Gori
- Department of Infectious DiseaseSan Gerardo HospitalMonzaItaly
| | - Antonio Gasbarrini
- Department of Internal Medicine and GastroenterologyCatholic University of RomeRomeItaly
| | | | - Giuseppina Brancaccio
- Infectious DiseasesDepartment of Mental and Physical Health and Preventive MedicineUniversità della Campania Luigi VanvitelliNaplesItaly
| | - Angelo Andriulli
- Division of GastroenterologyIstituto di Ricovero e Cura a Carattere ScientificoCasa Sollievo Sofferenza HospitalSan Giovanni Rotondo, FoggiaItaly
| | | | | | - Homie Razavi
- Center for Disease AnalysisCDA Foundation | Polaris ObservatoryLafayetteCOUSA
| | | | - Stefano Vella
- Center for Global HealthIstituto Superiore di SanitàRomeItaly
| | - Antonio Craxì
- Gastroenterolgy and Liver UnitDiBiMISUniversity of PalermoPalermoItaly
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Vinciguerra C, Giorgio A, Zhang J, Di Donato I, Stromillo ML, Tappa Brocci R, Federico A, Dotti MT, De Stefano N. Peak width of skeletonized mean diffusivity (PSMD) as marker of widespread white matter tissue damage in multiple sclerosis. Mult Scler Relat Disord 2018; 27:294-297. [PMID: 30448470 DOI: 10.1016/j.msard.2018.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/07/2018] [Accepted: 11/12/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Peak width of skeletonized mean diffusivity (PSMD) is a novel and fully automated, MRI biomarker, which has shown clinical relevance in cerebral small vessel diseases (SVD). We aimed here to assess PSMD levels across the brain of patients with multiple sclerosis (MS), in comparison to normal controls (NC) and patients with CADASIL, a genetically defined form of severe SVD. METHODS We assessed PSMD in relapsing-remitting (RR) MS patients (n = 47) in comparison to age-matched CADASIL patients (n = 25) and NC (n = 28). Diffusion Tensor Imaging data were acquired on 1.5T MR clinical scanner to automatically compute PSMD through "skeletonization" of WM tracts and diffusion histograms. RESULTS RRMS had lower WM lesion volume (LV) than CADASIL (8.6 ± 8.2 vs 24.4 ± 17.4 cm3, p < 0.001). After correction for LV, PSMD values in MS were higher than in CADASIL patients (adjusted mean values: 4.5 vs 3.9 × 10-4 mm2/s, p = 0.03) and in both patient groups were higher than in NC (2.8 ± 0.3 × 10-4 mm2/s, p < 0.001). PSMD values correlated with LV in both patient groups (r = 0.8, p < 0.001 in MS; r = 0.6, p = 0.002 in CADASIL). CONCLUSIONS In both patient groups, PSMD was higher than in NC and closely correlated with LV, suggesting sensitivity in assessing brain tissue damage in these disorders. In MS patients, PSMD levels were higher than in CADASIL patients, despite the lower LV. This might be related to more severe normal-appearing WM abnormalities occurring in the MS brains. This novel, fully automated, MRI metric may represent a useful marker for a robust quantification of the diffuse WM tissue damage in MS.
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Affiliation(s)
- C Vinciguerra
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - A Giorgio
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - J Zhang
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - I Di Donato
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - M L Stromillo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - R Tappa Brocci
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - A Federico
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - M T Dotti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - N De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
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Gravina AG, Prevete N, Tuccillo C, De Musis C, Romano L, Federico A, de Paulis A, D’Argenio G, Romano M. Peptide Hp(2-20) accelerates healing of TNBS-induced colitis in the rat. United European Gastroenterol J 2018; 6:1428-1436. [PMID: 30386616 PMCID: PMC6206543 DOI: 10.1177/2050640618793564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Hp(2-20), a Helicobacter pylori-derived peptide interacting with N-formyl peptide receptors (FPRs), accelerates the healing of gastric injury in rats. Whether Hp(2-20) affects the recovery of inflamed colonic mucosa is unknown. We evaluated whether Hp(2-20) accelerated the healing of 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced colitis and explored the mechanism(s) underlying any such effect. METHODS Fifteen rats underwent rectal administration of Hp(2-20) 250-500 µg/kg/day, or of its control peptide Hp1 for 10 days, following induction of colitis with TNBS. Macroscopic and histological damage was quantified using predetermined injury scores. FPR1, COX-2, TNF-α, TGF-β, HB-EGF and tissue transglutaminase (t-TG) messenger RNA (mRNA) expression in colonic tissue was determined by quantitative polymerase chain reaction; FPR1, TNF-α and COX-2 protein levels by Western blotting. RESULTS (1) Hp(2-20) accelerated healing of TNBS-induced colitis compared to controls consistently with the expression of FPRs in colonic mucosa; (2) TNBS upregulated mRNA mucosal expression of COX-2, TNF-α, TGF-β, HB-EGF and t-TG and (3) this, with the exception of HB-EGF, was significantly counteracted by Hp(2-20). CONCLUSIONS Hp(2-20), an FPR agonist, accelerates the healing of TNBS-induced colitis in the rat. This effect is associated with a significant reduction in colonic tissue levels of COX-2, TGF-β, TNF-α and t-TG. We postulate that FPR-dependent pathways may be involved in the repair of inflamed colonic mucosa.
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Affiliation(s)
- AG Gravina
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
| | - N Prevete
- Department of Translational Medical
Sciences (DiSMeT)-University of Naples Federico II and Institute of Endocrinology
and Experimental Oncology (IEOS) “G. Salvatore,” CNR, Naples, Italy
| | - C Tuccillo
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
| | - C De Musis
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
| | - L Romano
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
| | - A Federico
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
| | - A de Paulis
- Department of Translational Medical
Sciences (DiSMeT) and Center for Basic and Clinical Immunologic Research (CISI),
University of Naples Federico II, Naples, Italy
| | - G D’Argenio
- Gastroenterology Unit, Department of
Clinical and Experimental Medicine, University of Naples Federico II, Naples,
Italy
| | - M Romano
- Hepatogastroenterology Unit, Department
of Precision Medicine, University of Campania “Luigi Vanvitelli,” Naples,
Italy
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Federico A, Dallio M, Caprio GG, de Sio I, Cotticelli G, Esposito P, Loguercio C. A Real-Life Study of New Antiviral Therapies in a High Prevalence Geographical Area for Hepatitis C Virus Infection. Hepat Mon 2018; In Press. [DOI: 10.5812/hepatmon.74224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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88
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Taglia I, Di Donato I, Bianchi S, Cerase A, Monti L, Marconi R, Orrico A, Rufa A, Federico A, Dotti MT. AARS2-related ovarioleukodystrophy: Clinical and neuroimaging features of three new cases. Acta Neurol Scand 2018; 138:278-283. [PMID: 29749055 DOI: 10.1111/ane.12954] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), previously known as hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) or pigmentary orthochromatic leukodystrophy (POLD), is the most frequent non-vascular adult-onset leukoencephalopathy. It is caused by autosomal dominant mutations in CSF1R gene. Recently, also autosomal recessive mutations in AARS2 gene were found to be the cause of an adult-onset leukodystrophy with axonal spheroids. Our aim was to achieve a genetic diagnosis in a cohort of CSF1R-negative patients, performing a sequence analysis of AARS2 gene. MATERIAL AND METHODS AARS2 sequencing was performed in 38 CSF1R-negative patients with clinical and magnetic resonance imaging (MRI) findings of adult-onset leukoencephalopathy. RESULTS Three patients carrying AARS2 compound heterozygous mutations have been found. All patients were female with ovarian failure and leukoencephalopathy. In 2 patients, MRI findings were consistent with previous reports while the third patient showed focal white matter (WM) lesions in the centrum semiovale and the corpus callosum in the absence of extensive involvement and rarefaction of the WM. MRI spectroscopy showed the presence of increased lactate in 2 patients, thus linking AARS2-related leukoencephalopathy with other mitochondrial leukoencephalopathies with high levels of cerebral lactate. CONCLUSION We recommend screening for mutations in AARS2 gene in CSF1R-negative patients, also in the absence of a clear family history and peculiar MRI findings. Our results also suggest that findings of conventional MRI and MR spectroscopy may be useful in prompting the genetic screening.
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Affiliation(s)
- I. Taglia
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - I. Di Donato
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - S. Bianchi
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - A. Cerase
- Unit of Neuroradiology; Department of Neurosciences; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - L. Monti
- Unit of Neuroradiology; Department of Neurosciences; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - R. Marconi
- Unit of Neurology; Misericordia Hospital; Grosseto Italy
| | - A. Orrico
- Molecular Medicine; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - A. Rufa
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - A. Federico
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - M. T. Dotti
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
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Pranteda G, Magri F, Muscianese M, Pigliacelli F, D'Arino A, Federico A, Pranteda G, Bartolazzi A. The management of pseudomyogenic hemangioendothelioma of the foot: A case report and review of the literature. Dermatol Ther 2018; 31:e12725. [PMID: 30239066 DOI: 10.1111/dth.12725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/21/2018] [Accepted: 08/22/2018] [Indexed: 11/30/2022]
Abstract
Pseudomyogenic hemangioendothelioma (PMH) is a rare, mostly indolent, endothelial neoplasm of low-grade malignancy, often mimicking myoid and epithelioid tumors histologically. It is more frequent in young adult males and it usually presents with multiple cutaneous nodules, mostly localized at the extremities. It traverses several tissue planes simultaneously and can involve dermis, subcutis, skeletal muscle, and bone. Histologically, it is characterized by plump spindle cells with eosinophilic cytoplasm, often arranged in fascicles and epithelioid cells with "pseudomyogenic" morphology. Immunohistochemically, PMH is positive for Factor VIII, FLI-1, INI-1, vimentin, MDM2, CDK4, CD31, AE1/AE3, EMA, and P63. The efficacy of treatments is only partially known. Because of the frequent multifocal aspect of PMH, which contraindicates surgery, systemic treatments, such as gemcitabine, sirolimus, and everolimus are used. Based on our observation of multifocal PMH of the foot in a 17-year-old male patient, treated with gemcitabine with complete cutaneous response in a 2-year follow-up, we decided to discuss this rare tumor and underline its progression and therapeutic approaches. Thanks to a correct diagnosis, it is possible to avoid aggressive therapeutic approaches, which would be necessary for nonindolent diseases, such as sarcoma, which often needs amputation.
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Affiliation(s)
- Guglielmo Pranteda
- Dermatology Department, Sapienza University of Rome, Sant'Andrea General Hospital, Rome, Italy
| | - Francesca Magri
- Dermatology Department, Sapienza University of Rome, Sant'Andrea General Hospital, Rome, Italy
| | - Marta Muscianese
- Dermatology Department, Sapienza University of Rome, Umberto I Polyclinic, Rome, Italy
| | - Flavia Pigliacelli
- Dermatology Department, Sapienza University of Rome, Umberto I Polyclinic, Rome, Italy
| | - Andrea D'Arino
- Dermatology Department, Sapienza University of Rome, Umberto I Polyclinic, Rome, Italy
| | - Alessandro Federico
- Dermatology Department, Sapienza University of Rome, Umberto I Polyclinic, Rome, Italy
| | - Giulia Pranteda
- Dermatology Department, Sapienza University of Rome, Umberto I Polyclinic, Rome, Italy
| | - Armando Bartolazzi
- Department of Pathology, St. Andrea General Hospital, Rome, Italy.,Pathology Research Laboratory, Cancer Center Karolinska, Karolinska Hospital, Stockholm, Sweden
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Zaino D, Chiarotti I, Battisti C, Salvatore S, Federico A, Cerase A. Six-year clinical and MRI quantitative susceptibility mapping (QSM) follow-up in neurological Wilson's disease under zinc therapy: a case report. Neurol Sci 2018; 40:199-201. [PMID: 30209700 DOI: 10.1007/s10072-018-3557-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/04/2018] [Indexed: 01/28/2023]
Affiliation(s)
- D Zaino
- Department of Medical, Surgical and Neurological Sciences, University of Siena, viale Mario Bracci n. 2, 53100, Siena, Italy.
| | - I Chiarotti
- Department of Medical, Surgical and Neurological Sciences, University of Siena, viale Mario Bracci n. 2, 53100, Siena, Italy
| | - C Battisti
- Department of Medical, Surgical and Neurological Sciences, University of Siena, viale Mario Bracci n. 2, 53100, Siena, Italy
| | - S Salvatore
- Department of Medical, Surgical and Neurological Sciences, University of Siena, viale Mario Bracci n. 2, 53100, Siena, Italy
| | - A Federico
- Department of Medical, Surgical and Neurological Sciences, University of Siena, viale Mario Bracci n. 2, 53100, Siena, Italy
| | - A Cerase
- Neuroimaging and Neurointervention Unit, Department of Neurological and Sensorineural Neurosciences, Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy
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91
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Pati AR, Battisti C, Taglia I, Galluzzi P, Bianchi M, Federico A. A new case of autosomal dominant small vessel disease carrying a novel heterozygous mutation in HTRA1 gene: 2-year follow-up. Neurol Sci 2018; 39:1479-1481. [PMID: 29546604 DOI: 10.1007/s10072-018-3294-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
Affiliation(s)
- A R Pati
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - C Battisti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - I Taglia
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - P Galluzzi
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - M Bianchi
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - A Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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Taglia I, Di Donato I, De Stefano N, Bianchi S, Galluzzi P, Federico A, Dotti MT. Blood–brain barrier permeability in a patient with Labrune syndrome due to
SNORD118
mutations. Eur J Neurol 2018; 25:e86-e87. [DOI: 10.1111/ene.13656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/22/2018] [Indexed: 02/02/2023]
Affiliation(s)
- I. Taglia
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
| | - I. Di Donato
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
| | - N. De Stefano
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
| | - S. Bianchi
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
| | - P. Galluzzi
- Unit of Diagnostic and Therapeutic Neuroradiology Azienda Ospedaliera Siena Siena Italy
| | - A. Federico
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
| | - M. T. Dotti
- Department of Medicine, Surgery and Neurosciences University of Siena Siena Italy
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Sgambato D, Miranda A, Ranaldo R, Federico A, Romano M. The Role of Stress in Inflammatory Bowel Diseases. Curr Pharm Des 2018; 23:3997-4002. [PMID: 28245757 DOI: 10.2174/1381612823666170228123357] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 02/13/2017] [Accepted: 02/23/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a multi-factorial systemic disorder which involves immune, genetic and environmental factors. Stress, in its various forms, plays an important role in gastrointestinal diseases and, in particular, in IBD. METHODS Here, we focus on the environmental stressors in different aspects of IBD (pathogenesis, course and severity of disease) and, in particular, will evaluate the mechanisms by which they may influence IBD. RESULTS The effect of stress on IBD might be mediated by autonomic nervous system and hypothalamic pituitary adrenal axis. These nervous pathways are part of the so called "brain-gut axis" which links gastrointestinal integrity and functions to central nervous system acting through the increase of intestinal permeability, bacterial translocation and cytokines network. CONCLUSION The incidence of emotional disorders is higher in Crohn's Disease and Ulcerative Colitis compared to general population. Moreover, depression and anxiety influence the course and the severity of the underlying intestinal disease. Hence, it is important to consider appropriate psychological therapy in IBD patients.
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Affiliation(s)
- Dolores Sgambato
- Department of Clinical and Experimental Medicine-Gastroenterology, Second University of Naples, Naples. Italy
| | - Agnese Miranda
- Department of Clinical and Experimental Medicine-Gastroenterology, Second University of Naples, Naples. Italy
| | - Rocco Ranaldo
- Department of Clinical and Experimental Medicine-Gastroenterology, Second University of Naples, Naples. Italy
| | - Alessandro Federico
- Department of Clinical and Experimental Medicine-Gastroenterology, Second University of Naples, Naples. Italy
| | - Marco Romano
- Division of Hepato- Gastroenterology, Department of Clinical and Experimental Medicine, Second University of Naples, Via Pansini 5, 80131 Naples. Italy
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Morgillo F, Dallio M, Della Corte CM, Gravina AG, Viscardi G, Loguercio C, Ciardiello F, Federico A. Carcinogenesis as a Result of Multiple Inflammatory and Oxidative Hits: a Comprehensive Review from Tumor Microenvironment to Gut Microbiota. Neoplasia 2018; 20:721-733. [PMID: 29859426 PMCID: PMC6014569 DOI: 10.1016/j.neo.2018.05.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Floriana Morgillo
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy.
| | - Marcello Dallio
- Gastroenterologia, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Carminia Maria Della Corte
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonietta Gerarda Gravina
- Gastroenterologia, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Viscardi
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Carmelina Loguercio
- Gastroenterologia, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Fortunato Ciardiello
- Oncologia Medica, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Federico
- Gastroenterologia, Dipartimento di Internistica Clinica e Sperimentale "F.Magrassi", Università della Campania "Luigi Vanvitelli", Naples, Italy
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95
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Caraceni P, Riggio O, Angeli P, Alessandria C, Neri S, Foschi FG, Levantesi F, Airoldi A, Boccia S, Svegliati-Baroni G, Fagiuoli S, Romanelli RG, Cozzolongo R, Di Marco V, Sangiovanni V, Morisco F, Toniutto P, Tortora A, De Marco R, Angelico M, Cacciola I, Elia G, Federico A, Massironi S, Guarisco R, Galioto A, Ballardini G, Rendina M, Nardelli S, Piano S, Elia C, Prestianni L, Cappa FM, Cesarini L, Simone L, Pasquale C, Cavallin M, Andrealli A, Fidone F, Ruggeri M, Roncadori A, Baldassarre M, Tufoni M, Zaccherini G, Bernardi M. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial. Lancet 2018; 391:2417-2429. [PMID: 29861076 DOI: 10.1016/s0140-6736(18)30840-7] [Citation(s) in RCA: 265] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/14/2018] [Accepted: 03/22/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Evidence is scarce on the efficacy of long-term human albumin (HA) administration in patients with decompensated cirrhosis. The human Albumin for the treatmeNt of aScites in patients With hEpatic ciRrhosis (ANSWER) study was designed to clarify this issue. METHODS We did an investigator-initiated multicentre randomised, parallel, open-label, pragmatic trial in 33 academic and non-academic Italian hospitals. We randomly assigned patients with cirrhosis and uncomplicated ascites who were treated with anti-aldosteronic drugs (≥200 mg/day) and furosemide (≥25 mg/day) to receive either standard medical treatment (SMT) or SMT plus HA (40 g twice weekly for 2 weeks, and then 40 g weekly) for up to 18 months. The primary endpoint was 18-month mortality, evaluated as difference of events and analysis of survival time in patients included in the modified intention-to-treat and per-protocol populations. This study is registered with EudraCT, number 2008-000625-19, and ClinicalTrials.gov, number NCT01288794. FINDINGS From April 2, 2011, to May 27, 2015, 440 patients were randomly assigned and 431 were included in the modified intention-to-treat analysis. 38 of 218 patients died in the SMT plus HA group and 46 of 213 in the SMT group. Overall 18-month survival was significantly higher in the SMT plus HA than in the SMT group (Kaplan-Meier estimates 77% vs 66%; p=0·028), resulting in a 38% reduction in the mortality hazard ratio (0·62 [95% CI 0·40-0·95]). 46 (22%) patients in the SMT group and 49 (22%) in the SMT plus HA group had grade 3-4 non-liver related adverse events. INTERPRETATION In this trial, long-term HA administration prolongs overall survival and might act as a disease modifying treatment in patients with decompensated cirrhosis. FUNDING Italian Medicine Agency.
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Affiliation(s)
- Paolo Caraceni
- Department of Medical and Surgical Sciences, and Center for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - Oliviero Riggio
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Paolo Angeli
- Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padua, Padua, Italy
| | - Carlo Alessandria
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Sergio Neri
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesco G Foschi
- Internal Medicine, Hospital of Faenza, Azienda Unità Sanitaria Locale of Romagna, Faenza, Italy
| | - Fabio Levantesi
- Internal Medicine, Hospital of Bentivoglio, AUSL of Bologna, Bologna, Italy
| | - Aldo Airoldi
- Liver Unit, Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | - Sergio Boccia
- Gastroenterology Unit, University Hospital, Ferrara, Italy
| | | | - Stefano Fagiuoli
- Gastroenterology and Transplant Hepatology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Roberto G Romanelli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Raffaele Cozzolongo
- Division of Gastroenterology, National Institute of Gastroenterology S De Bellis, Castellana Grotte (Bari), Italy
| | - Vito Di Marco
- Unit of Gastroenterology and Hepatology, Biomedical Department of Internal and Specialistic Medicine, University of Palermo, Palermo, Italy
| | - Vincenzo Sangiovanni
- Azienda Ospedaliera di Rilievo Nazionale dei Colli, Cotugno Hospital of Naples, Naples, Italy
| | - Filomena Morisco
- Gastroenterology Unit, Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Pierluigi Toniutto
- Internal Medicine, Department of Medical Area, University of Udine, Udine, Italy
| | - Annalisa Tortora
- Gastroenterology, Gemelli Foundation, Catholic University, Rome, Italy
| | | | | | - Irene Cacciola
- Division of Clinical and Molecular Hepatology, University Hospital of Messina, Messina, Italy
| | - Gianfranco Elia
- Infectious Diseases and Hepatology, University Hospital of Parma, Parma, Italy
| | - Alessandro Federico
- Department of Clinical and Experimental Internal Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Sara Massironi
- Gastroenterology and Endoscopy Unit, Foundation Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Riccardo Guarisco
- Internal Medicine, S Sebastiano General Hospital, Frascati (Rome), Italy
| | - Alessandra Galioto
- Internal Medicine, Hospital of Dolo, Azienda Unità Locale Socio-sanitaria Serenissima, Mestre, Italy
| | | | - Maria Rendina
- Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvia Nardelli
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padua, Padua, Italy
| | - Chiara Elia
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Loredana Prestianni
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Mirici Cappa
- Internal Medicine, Hospital of Faenza, Azienda Unità Sanitaria Locale of Romagna, Faenza, Italy
| | - Lucia Cesarini
- Liver Unit, Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | | | - Chiara Pasquale
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Marta Cavallin
- Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padua, Padua, Italy
| | - Alida Andrealli
- Division of Gastroenterology and Hepatology, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Federica Fidone
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Matteo Ruggeri
- Graduate School of Health Economics and Management, Catholic University, Rome, Italy
| | | | - Maurizio Baldassarre
- Department of Medical and Surgical Sciences, and Center for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - Manuel Tufoni
- Department of Medical and Surgical Sciences, and Center for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - Giacomo Zaccherini
- Department of Medical and Surgical Sciences, and Center for Applied Biomedical Research, University of Bologna, Bologna, Italy
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, and Center for Applied Biomedical Research, University of Bologna, Bologna, Italy.
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Abstract
Obesity, diabetes and metabolic disorders represent hugely significant problems concerning the health in Western countries and the study of gut microbiota in metabolic pathologies is part of this framework. Diet effects on intestinal microbial composition and its role in pathogenetic mechanisms responsible for both obesity and systemic, hepatic and adipose tissue inflammation, represent at the moment one of this mostpromising topic in gastroenterology research. Gut health safety is essential, but it needs to be further explored in order to understand and interrupt the pathogenetic mechanisms, which support a large number of diseases. The aim of this review is to describe what are the modifications of gut microbial composition that occur in metabolic disorders and the role of gut microbiota in the pathogenesis of several diseases such as obesity, metabolic syndrome and type II diabetes mellitus, showing how gut microbiota and adipose tissue, liver and brain, together with intestinal permeability increase, carry out an interconnection systemthat plays a pivotal role in the field.
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Affiliation(s)
- Alessandro Federico
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy -
| | - Marcello Dallio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Rosa DI Sarno
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valentina Giorgio
- Department of Pediatrics, Fondazione Policlinico Gemelli, Sacro Cuore Catholic University, Rome, Italy
| | - Luca Miele
- Internal Medicine, Gastroenterology and Liver Unit, A. Gemelli Polyclinic, Sacro Cuore Catholic University, Rome, Italy
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97
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Abstract
Nowadays liver diseases represent one of major healthy problems in the world in terms of morbidity and mortality. The high prevalence of liver pathologies represents the key point to understand the necessity to identify the pathogenetic mechanisms that support these disorders in order to nurse them. Alterations of intestinal microbiota seem to play an important role in induction and promotion of liver damage progression, in addition to direct injury resulting from different causal agents. Gut microbiota is considered both as a promoting factor and as a potential therapeutic target of a large number of liver pathologies due to the connection between intestine and liver: the gut-liver axis. This connection influences absorption and deposition of nutrients into the liver, but also induces the activation of toll-like receptors due to the passage of pathogen-associated molecular patterns in the portal blood and therefore may start both the development of liver damage and its consequent progression to more advanced stages, including cirrhosis and hepatocarcinoma. The gut liver axis also includes the intestinal permeability (IP) degree. It is very variable and interconnected to several factors, most of them dependent from gut microbiota, that is the "lead" in the control of IP. This revue is aimed to report the more recent knowledges about gut microbiota and chronic liver disease, from liver steatosis to cirrhosis and its complications, including hepatocellular carcinoma. For these reasons, it could be useful to intervene, through suitable therapeutic approaches, on the interruption of mechanisms that underlie dysbiosis, IP increase, activation of liver inflammasome, hepatic stellate cells and hepatocarcinogenic processes in order to reduce the liver damage.
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Affiliation(s)
- Alessandro Federico
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy -
| | - Marcello Dallio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giuseppe G Caprio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Vittorio M Ormando
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carmela Loguercio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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98
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Cruccu G, Deuschl G, Federico A. Scientific publications of European neurologists: a survey commissioned by the European Academy of Neurology. Eur J Neurol 2018; 25:1128-1133. [PMID: 29687522 DOI: 10.1111/ene.13666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Bibliometric searches may provide an indirect assessment of research in a field or country. The European Academy of Neurology decided to investigate how article production was developing in European countries, as an indicator of neurological vitality. METHODS We searched two databases, Scopus and PubMed, for articles published by authors belonging to neurological institutions in all European countries, the USA, Brazil, China and Japan. The search assessed production in the period between 2000 and 2015. We calculated four indicators, i.e. gross neurological product (GNP) (which includes all articles published in any indexed journal), production in top neurological journals, GNP per inhabitant and GNP per gross domestic product. RESULTS All indicators greatly increased over time. The European GNP paralleled that of the USA and was higher than those of the other countries. Restricting the search to top neurological journals showed that, since 2012, European production grew faster than that of the USA. Germany had the highest production within Europe, Switzerland had the best ratio between GNP and inhabitants, and The Netherlands had the best ratio between GNP and gross domestic product. CONCLUSIONS Although this search had several limitations, the results were so straightforward that we can conclude that European neurology is highly active in the world. Future analyses should compare neurology with other main medical disciplines.
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Affiliation(s)
- G Cruccu
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
| | - G Deuschl
- Department of Neurology, Universitätsklinikum Schleswig-Holstein, Christian-Albrechts University, Kiel, Germany
| | - A Federico
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena and Chair of Scientific Committee, European Academy of Neurology, Siena, Italy
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99
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Federico A, Conti V, Russomanno G, Dallio M, Masarone M, Stiuso P, Tuccillo C, Caraglia M, Manzo V, Persico M, Filippelli A, Loguercio C. A Long-term Treatment with Silybin in Patients with Non-alcoholic Steatohepatitis Stimulates Catalase Activity in Human Endothelial Cells. ACTA ACUST UNITED AC 2018; 31:609-618. [PMID: 28652427 DOI: 10.21873/invivo.11101] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 05/13/2017] [Accepted: 05/15/2017] [Indexed: 02/06/2023]
Abstract
AIM To compare levels of oxidative stress markers in patients' sera with non-alcoholic steatohepatitis (NASH) treated for 12 months (T12) with silybin conjugated with phosphatidylcholine (Realsil®) (R) or placebo (P) and investigate oxidative stress responses in human endothelial cells conditioned with patients' sera. PATIENTS AND METHODS We recruited twenty-seven patients with histological NASH. We measured thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD) and catalase (CAT) activities in human endothelial cells conditioned with patients' sera exposed or not to H2O2 Results: We found in decreased-TBARS patients' sera, at T12, a decrease of alanine aminotransferase (p=0.038), transforming growth factor-beta (p=0.009) and procollagen I (p=0.001). By dividing patients into two groups, increased (P-I/R-I) and decreased TBARS (P-II/R-II) at T12 compared to T0, we found an increased CAT activity in conditioned endothelial cells at T12 in both groups (p=0.05 and p=0.001, respectively). CONCLUSION Realsil® may be effective against endothelial dysfunction by stimulating the cellular antioxidant defense.
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Affiliation(s)
- Alessandro Federico
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valeria Conti
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Giusy Russomanno
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Marcello Dallio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Masarone
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Paola Stiuso
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Concetta Tuccillo
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valentina Manzo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Marcello Persico
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Amelia Filippelli
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Carmelina Loguercio
- Department of Clinical and Experimental Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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100
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Morisco F, Masarone M, Rosato V, Camera S, Granata R, Tartaglione MT, Coppola C, Coppola N, Salomone-Megna A, Gentile I, De Luna A, Federico A, Precone D, Claar E, Abenavoli L, Persico M. Impact of Telaprevir in HCV Patients with Cirrhosis and RVR: Real-Life Data from Boceprevir or Telaprevir based "Triple Therapy" Experience in Southern Italy. Rev Recent Clin Trials 2018; 11:306-316. [PMID: 26672601 DOI: 10.2174/1574887111666151217123222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/10/2015] [Accepted: 12/15/2015] [Indexed: 11/22/2022]
Abstract
Background and Rationale of Study: The real-life data of triple therapy-based treatment in patients with chronic hepatitis C were investigated in this survey of 12 clinical centers of southern Italy. This retrospective study analyzed data from 176 consecutive patients. METHODS 125 (70%) patients were treated with telaprevir, and 51(30%) with boceprevir. There were no differences in demographic characteristics between the groups. The degree of Liver Fibrosis (LF) was evaluated according to Liver Biopsy (LB) and/or Transient Elastography (TE). 53/176 patients (30%) had liver cirrhosis. Sixteen patients (9%) were treatment naïve, and the remaining were not: 92 were non-responders (52, 84%), 63 relapsed (35,79%), and 5 discontinued treatment (2, 8%). RESULTS Overall, the rapid Virological Response (RVR) rate was 67.6%. Of the 103 patients who had follow-up for at least 12 weeks after the end of treatment, 61 (59, 2%) achieved a Sustained Virological Response (SVR). According to multivariate analysis for SVR, RVR was the only independent predictive factor of SVR, irrespective of the degree of LF and the type of response to previous treatments. In telaprevir-treated patients, the rate of RVR was similar in patients with F0-F2, F3 and F4 fibrosis (85%, 84%, 78%, respectively), and the SVR rates among RVR patients was similar irrespective of LF. CONCLUSIONS Data from this real-life study confirm the efficacy reported in clinical trials, although cirrhosis appears to play a smaller role in influencing treatment efficacy. Moreover, RVR is the only independent predictive factor of response regardless of cirrhosis. Based on RVR and for patients with cirrhosis, a shorter therapy might be considered, at least with telaprevir-based therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcello Persico
- Salerno University of Medicine, Internal Medicine and Hepatology Unit, Salerno, Italy
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